Similarly, when we consider where to work, we have lots of choices. We choose the areas we work in based on the levels of energy, excitement, teamwork, and action we want. Whether we’re in the trauma room, taking care of patients suffering from chronic illnesses, or helping alleviate someone’s pain from a broken bone, we desire to pour out comfort and compassion to those around us. We’re the calming voice in the time of chaos and uncertainty.
For a nurse, each patient brings unique demands and knowledge requirements in order to assess and deliver what’s needed. All this takes time and experience to acquire. It’s the expert nurse who notices that the patient usually puts out a lot more fluid during dialysis and that his blood pressure normally runs high. We’re the ones that go to the attending physician overseeing the patient’s care to say, “Something is just not right with this patient.”
As nurses we might share our concerns and ask for a repeat echocardiogram, just to make sure before transferring a patient. And, astute physicians know to listen to the skilled, instinctive nurse to find that in fact a patient’s condition has deteriorated. So, it’s the nurse whose intuition can result in a patient being rushed to surgery just in time to save a life.
Some days are harder than others for nurses, and the greatest challenge is to come in every day ready to give our time, talents, and treasures gained over years of experience caring for and loving those who face major struggles.
Yet a lack of true support for nurses has contributed to a shortage that is one of our most urgent public health crises. The nursing shortage has claimed countless lives and threatens to overwhelm the world’s health systems. It’s no overstatement to say that our future depends on superior attention to nursing.
We need to change the everyday lives of nurses by focusing on what is important to them. Nurses want to be sought out for counsel. They spend all day with patients and want to be asked for their opinions and insights. If this doesn’t happen, the nurse’s heart is in pain. If, in addition to professional neglect, we are not respected, asked for counsel, and romanced in our home lives, we are often suffering in silence.
Since 1960 the U.S. has had numerous minor nursing shortages that were resolved fairly quickly. The current crisis, however, not only persists, but is expected to get a lot worse.
The shortage began after managed care ushered in an era of cost cutting in the early 1990s. Less skilled workers replaced nurses. In Massachusetts 27% of hospital nurses were laid off, the largest number in the country. At the same time, nursing was becoming less appealing to women, who began to have many other career choices. And, as nurses left the workforce, studies showed that patient care deteriorated.
Some large-scale nursing research studies found specifically that if an optimal workload of four patients per nurse is increased to six, the patients are 14% more likely to die within 30 days of admission. If the patient workload is increased to eight, the patient mortality rate rises 31%.
As hospitals started experiencing acute shortages of nurses, they responded by raising salaries and offering bonuses as inducements to entering the profession. Campaigns were launched to attract people to nursing. 185,000 new registered nurses had entered the workforce by 2003. But in 2008, even with this huge influx of new nurses, the shortage is still here and is predicted to continue growing as the demand for nursing increases.
According to the Department of Labor, nursing is the second fastest growing occupation in the U.S. And though nursing program applications are up, we can’t even train all those who are interested in becoming RNs. Due to a shortage of faculty, 147,000 eligible applicants were turned away from U.S. nursing schools in 2005.
At present, hospitals are recruiting both foreign-trained as well as U.S.-trained nurses. However, the nursing shortage will continue and probably get worse unless working conditions for nurses are addressed, including nurse-patient ratios, work schedule issues, and a general lack of respect.
Some hospitals have improved conditions for new nursing graduates by providing longer orientation programs and other support like rapid response teams that deploy to help any nurse in a pinch.
However, despite changes in some hospitals, many nurses say conditions have gotten worse — they are caring for sicker patients, and their job demands have become unrealistic. In more than a dozen states, nurses are pushing to mandate nurse-to-patient ratios in hospitals. But despite all the efforts to address the growing shortage, the demand for nurses is expected to increase by 40% over the next decade, while the supply will steadily drop.
Many young nurses entering the profession today are overwhelmed because there is so much to learn and do. Nursing schools don’t provide the clinical training and technical expertise needed by nurses today, and hospitals must finish up the needed education and support.
For more information, or to donate to the LEAD Fund, contact Doris Young, PhD, RN.
About the Author
Doris Young, the Nurse Doctor, works with health care facilities to meet the challenges described in this article. She works with nurses and nursing leaders to develop extraordinary atmospheres where nurses thrive and provide the exceptional care that people deserve. Doris supports health care leaders to create the environments that will eliminate nursing burnout and the nursing shortage, and improve the health of all. To reach Doris Young, author of Save the First Dance for You: The Complete Nurses Guide to Serving Your Profession, Your Patients, and Yourself, call (800) 673-8005 or email Doris at Doris@DorisYoungAssociates.com.
