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Where Are the Nurses?
Where Are the Nurses? Face it: w e have an image problem and w e have stress within the workplace.
Barbara Peterson Sinclair, MN, RNC, OGNP, FAAN is editor of AWHONN Lifelines and acting dean of the School of Health at California State University, Dominguez Hills, CA, and director of the Institute of Nursing.
s nurses, most of us are aware of the nursing shortage throughout the U.S. Some geographic areas are experiencing minimal impact; in others, the shortage is severe. Concurrently, the demand for nurses is expected to rise through 2008. Not only is nursing experiencing a deficit in overall numbers of nurses, but a real need is arising for nurses in specialty areas, particularly critical care (ICU, ER, L&D, OR, and NICU) and in primary care (advanced practice, health promotion, case management). Through the years, there have been periodic fluctuations in the supply and demand of nurses; however, the current nursing shortage seems to be different in both causes and effects. This time, the shortage isn’t due to the usual vagaries of the marketplace-rather, an actual decline exists in the numbers of women and men avaiIable and prepared to enter nursing. One of the underlying causes of this decrease is a decline in the pool of potential students because of the many career fields now open to women. Historically, most women who wanted advanced education went into teaching or nursing. This is no longer the case. All professions have opened their doors to women and some fields, such as medicine, have made terrific strides to encourage women. In medicine, currently almost 50 percent of first-year students are female. This, and a poor marketing effort to attract nursing students, has contributed mightily to the growing shortage. According to the American Association of Colleges of Nursing, there has been a continuing five-year decline in overall nursing program enroflments, including a 4.6 percent reduction in new baccalaureate students in 1999. Another consideration is the tremendous upheaval in the current health care delivery system and the impact this has had on both prospective and actual nurses. Face it: we have an image problem and we have stress within the workplace. These have occurred because of: changes in the type and place of nursing care delivery inadequate staffing ratios lack of adequate salary increases inflexible hours insufficient control over nursing activities relatively poor communication within organizational infrastructures L
Although all of these problems don’t exist in all delivery sites, there are enough to create concern. The system certainly recognizes the need, yet I continue to be amazed at the ever-increasing advertisements offering large sums of money as sign-on or referral bonuses. We’re seeing the need for strategies involving nursing recruitment and retention. Is the nursing shortage affecting your environment? Are there stories that should be shared regarding the quality of care provided for women and newborns? What about current expectations placed upon nurses-are they realistic? Do you have ideas regarding how to combat the actuaUpotentia1 shortage in our field? Is there a role for professional nursing organizations in this effort? Are you willing to help “market” nursing to prospective students, even to those in middle school? AWHONN Lifelines would be interested in hearing from you on any of these issues; just drop me a note.
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AugusUSepternber 2000
AWHONN Lifelines
7
Barbara Peterson Sinclair, MN, RNC, OGNP, FAAN is editor of AWHONN Lifelines and acting dean of the School of Health at California State University, Dominguez Hills, CA, and director of the Institute of Nursing.
s nurses, most of us are aware of the nursing shortage throughout the U.S. Some geographic areas are experiencing minimal impact; in others, the shortage is severe. Concurrently, the demand for nurses is expected to rise through 2008. Not only is nursing experiencing a deficit in overall numbers of nurses, but a real need is arising for nurses in specialty areas, particularly critical care (ICU, ER, L&D, OR, and NICU) and in primary care (advanced practice, health promotion, case management). Through the years, there have been periodic fluctuations in the supply and demand of nurses; however, the current nursing shortage seems to be different in both causes and effects. This time, the shortage isn’t due to the usual vagaries of the marketplace-rather, an actual decline exists in the numbers of women and men avaiIable and prepared to enter nursing. One of the underlying causes of this decrease is a decline in the pool of potential students because of the many career fields now open to women. Historically, most women who wanted advanced education went into teaching or nursing. This is no longer the case. All professions have opened their doors to women and some fields, such as medicine, have made terrific strides to encourage women. In medicine, currently almost 50 percent of first-year students are female. This, and a poor marketing effort to attract nursing students, has contributed mightily to the growing shortage. According to the American Association of Colleges of Nursing, there has been a continuing five-year decline in overall nursing program enroflments, including a 4.6 percent reduction in new baccalaureate students in 1999. Another consideration is the tremendous upheaval in the current health care delivery system and the impact this has had on both prospective and actual nurses. Face it: we have an image problem and we have stress within the workplace. These have occurred because of: changes in the type and place of nursing care delivery inadequate staffing ratios lack of adequate salary increases inflexible hours insufficient control over nursing activities relatively poor communication within organizational infrastructures L
Although all of these problems don’t exist in all delivery sites, there are enough to create concern. The system certainly recognizes the need, yet I continue to be amazed at the ever-increasing advertisements offering large sums of money as sign-on or referral bonuses. We’re seeing the need for strategies involving nursing recruitment and retention. Is the nursing shortage affecting your environment? Are there stories that should be shared regarding the quality of care provided for women and newborns? What about current expectations placed upon nurses-are they realistic? Do you have ideas regarding how to combat the actuaUpotentia1 shortage in our field? Is there a role for professional nursing organizations in this effort? Are you willing to help “market” nursing to prospective students, even to those in middle school? AWHONN Lifelines would be interested in hearing from you on any of these issues; just drop me a note.
+
AugusUSepternber 2000
AWHONN Lifelines
7