U.S. faces severe nursing shortage

As the time comes for Penn seniors to start their job searches, those in the Nursing School might have it fairly easy.

At least 30 states in the United States -- including Pennsylvania -- are being affected by a recent nursing shortage, according to a report released by the Federal Division of Nursing.

Experts say this current shortage is by far the most severe and widespread the field has ever seen.

The significant decrease in nurses is not only being felt by hospitals, institutions and schools, but many say it has also affected the quality of national health care.

"We have never been in this situation with a shortage of this magnitude," American Association of Colleges of Nursing spokesman Robert Rosseter said. "The demand for care is going up when a lot of nurses are leaving the profession, and not enough students are entering the profession."

In 2000 alone, the report found there was a shortfall of almost 111,000 nurses nationwide.

And an overwhelming 94 percent of nurses are still women.

However, experts say the nursing profession has a number of bigger concerns than its lack of gender diversity.

Issues such as increased financial pressure to keep costs down, deteriorating working environments, limited mobility within the profession, insufficient staff support, decline in interest and increasing job opportunities in related fields were major factors that spurred many nurses to leave the profession.

"Workloads for nurses are too great and they don't have enough support from other people in the hospital," said Penn Director of the Center for Health Outcomes and Policy Research Linda Aiken. "Nurses are frustrated because they really don't have adequate resources to take care of their patients, so they can't meet their own personal performance level."

There has also been a decrease in nursing faculty. Certain schools have had to reduce the number of students accepted due to the limited faculty members.

In research done at the Penn Center for Health Outcomes and Policy Research, one of the most significant findings has been that magnet hospitals -- a status accredited to hospitals that comply with nursing excellence standards -- have better nursing satisfaction reports and retain more nurses.

"The center has created the scientific evidence base to linking these standards in the magnet program to better patient outcomes and [nurse] retention," Aiken said.

However, Rosseter is more worried about the way younger generations perceive the nursing profession.

"We have a number of campaigns to change their perception and expose them to all the opportunities within the profession," he said.

The biggest nursing advertising campaign launched so far -- costing $20 million -- is sponsored by Johnson and Johnson.

Director of Nursing Practice and Research at the Children's Hospital of Philadelphia Jane Barnsteiner thinks that such advertising is exactly what the nursing profession needs.

"We are a well-kept secret," Barnsteiner said. "What Johnson and Johnson is doing -- their media campaign -- has been wonderful. I think that that's going to do a lot for the profession of nursing."

But while the members of the nursing profession discuss ways of drawing more people to the business, the shortage has become so large that Congress has taken action to help boost enrollment in nursing programs.

The Nursing Reinvestment Act of 2001 was signed into law on Aug. 1. The bill, which is currently awaiting appropriations of up to $250 million, is meant to provide money for awareness campaigns, scholarships and loans to increase enrollment in nursing schools and grants to help hospitals reach "magnet" status.

Receiving the proper monetary support is difficult, according to some experts, because often those controlling the money don't have a firm handle on the issues at hand.

"It's hard because some of those people are health care providers and they don't understand the issues that we are really dealing with in the work place," said former President of the National Student Nurses' Association Michael Dejardins.

The shortage has not only affected the profession, but has had an impact on nursing schools as well.

There has been a decrease in nursing baccalaureate program enrollments over the past few years. Although there was a 3.7 percent increase in national enrollments in 2000-2001, that figure is still nearly 21,000 students below the 1995 enrollment level.

For Penn's Nursing School, the impact of the shortage has had a small, but notable impact. Application numbers took a 16 percent dip in 2001, dropping from 215 applicants in 2000 to 181. They did, however, bounce back to 199 applicants in 2002.

The Penn Health System has not been isolated from the effects of the shortage.

"It has taken longer to fill vacant positions [and] stress has increased for our nurses," Hospital of the University of Pennsylvania Chief Nursing Executive Maureen McCausland said.

Some claim the nursing shortage stemmed from the failure of the Clinton administration's health reform in 1995, but no one wants to venture a guess as to when it will end.

"I hope it's over by the time I need nursing care," Barnsteiner said.

However, some are hopeful that the trend will be reversed.

"We are hopeful that after September 11, many more young people will want to enter professions where they can help people, and give back to society," Interim Associate Dean and Director of Undergraduate Studies Kathy McCauley said.

And Nursing Professor Julie Sochalski said she believes that hospitals are starting to take the problem seriously.

"I have faith that we actually are at a point that hospitals are taking a real serious look at how to retain nurses," Sochalski said.

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