In spite of the public's extremely positive perception of nurses, the healthcare industry is in short supply of these highly trusted professionals. Ninety-two percent of those surveyed in a Harris Poll said they trusted information about healthcare provided by a registered nurse. However, about half of the registered nurse workforce will reach retirement age in the next 15 years and enrollments in schools of nursing are down 6.6%, dropping for the third year in a row, according to industry surveys.
While the nursing shortage has not gone unnoticed by hospitals, which are the primary employers of nurses, the crisis demands more strategic outreach that focuses on nursing concerns. Though better compensation is key, nursing experts say that what is perhaps more important is improving their work environment to:
- increase the nurse-patient ratio;
- provide career enhancement and scheduling flexibility; and
- encourage more recognition of achievements and less management bureaucracy.
Nurses Don't Want to Strike
As frustrated as nurses are with managed care's focus on streamlining costs, nurses consider strikes as a last resort, says Joan Carter, associate dean of nursing at the St. Louis School of Nursing. Nurses are looking for better support systems and strengthened opportunities to provide high-quality patient care - goals that have been threatened by managed care trends of hiring less prepared nursing assistants.
The reality is that striking and unionization grabs the attention of administrators and the community and nurses are playing this card more aggressively.
In addition, nurses and physicians are starting to collaborate on union strategies and campaigns to improve patient care.
The best way to prevent this worst-case scenario is convincing your executive management to take inventory of your nursing staff concerns and following up with appropriate solutions.
If unionization seems inevitable, encourage your executive management to develop:
- strategies that encourage nurse autonomy and clinical decision-making;
- additional evaluation systems that measure the relationship of timely nursing interventions to patient outcome; and
- additional mechanisms for recognition of clinical achievements.
Overhauling Nurses' Image
On the recruitment side, nursing is losing out to other career opportunities that have opened up for women, like engineering, medicine (physicians) and law. Though some of this lost interest is inevitable, the nursing profession is in serious need of an image overhaul, says Nancy Dickenson-Hazard, executive officer of Sigma Theta Tau International, a national honor society for nurses. In September, 16 healthcare organizations launched a fundraising drive to underwrite a national advertising campaign aimed at recruitment and retention.
The key messages of the campaign focus on expanded opportunities for nurses in research, management and entrepreneurial ventures.
In California, where the nursing shortage is the most severe, state hospitals and managed care organizations also are raising money to promote nursing as an exciting career choice. Kaiser Permanente is among the hospitals that donated seed money to research the state's crisis.
Unlike previous nursing shortages, this one is significantly different because of the aging workforce and declining interest among young people in pursuing nursing careers, says Katie Bray, R.N and Kaiser's project manager for nurse work planning. Seniors and aging baby boomers will be hardest hit by this shortage.
In addition to donating to the image campaign, Kaiser is focusing on retaining its 16,000 staff nurses with career development programs like teleconference classes for baccalaureate and masters degrees.
Other hospital-based retention strategies include on-site child care and tuition assistance for nurses, according to Karen Bortz, employment manager for Pitt County Memorial Hospital in Greenville, N.C.
(Sigma Theta Tau International, Nancy Dickenson-Hazard, 888/634-7575, www.nursingsociety.org, St. Louis School of Nursing, Joan Carter, 314/577-8908; Kaiser Permanente, Katie Bray, R.N., 510/987-1531; Pitt County Memorial Hospital, 252/816-4129)
Nursing Shortage Snapshot
- The demand for registered nurses will grow 23% by 2006 - faster than any other occupation, according to the Bureau of Labor Statistics.
- About half the RN workforce will reach retirement age in the next 15 years.
- The average age of RN graduates is 31, which means entrants are older and will have fewer years to work than nurses have had traditionally.
- Source: Sigma Theta Tau International