By Abigail Rome
October 28, 2009
Unemployment in the U.S. is near 10%, one the highest rates in years. Nevertheless, we've got a severe shortage of workers in one of most well-known and necessary careers in the world. It's a career where you can start working without slogging through years and years of school. All that's required to begin is a two-year associates degree and a license. And, according to the Bureau of Labor, growth in this field between 2006 and 2016 will be 23%, much faster than the average for all occupations. Median income is about $57,000. Not bad, really.
The field is nursing. And, the need for nurses - whether Registered Nurses (RNs) with an associates degree or those with bachelors and master's degrees is huge. According to a study by the Health and Human Services Administration (HHSA), there will be a shortfall of over 400,000 nurses in 2010 and over 1 million in 2020. While other studies have offered more conservative estimates, and there has been an increase in nurses over the past five years, there is no doubt that the shortage of trained nurses is dire and here to stay.
Explaining the shortage of nurses
Reasons for the deficiency were revealed by numerous studies conducted in the early 2000s when the crisis became imminent. They are summarized by the Kaiser Family Foundation, and include: steep population growth in some areas of the country; general aging of the American population, especially baby boomers expecting significant health care assistance; fewer people entering nursing careers; declines in RN earnings relative to other careers; low job satisfaction and poor working conditions; aging and retirement of the current nursing workforce, and insufficient faculty in nursing education programs.
"The nursing shortage at our long-term care facility is difficult and getting worse. We can't get enough RNs for geriatric care. The focus of nursing education programs today is on acute care, which is more glitzy and pays more," says Chris Urbano, Director of Nursing Services at Seton Health/Schuyler Ridge in Clifton Park, NY. She then cites another major reason for the dilemma. "We have four nursing colleges in the area, and they all have waiting lists because there aren't enough teachers."
Not enough nursing educators
Unfortunately, Urbano's experience is just one example of a nationwide phenomenon. One of the main challenges to increasing the nursing pool is the lack of faculty to train new and existing nurses. The Center to Champion Nursing in America reports that, according to the National League for Nursing, 99,000 qualified applicants were turned away from nursing programs in 2008 due to lack of faculty and other resource constraints. An American Association of Colleges of Nursing (AACN) study says that faculty shortages were cited by 71.4 percent of the nursing colleges surveyed.
A 2008 report commissioned by the Center to Champion Nursing in America describes what it calls the bottleneck in nursing education capacity. The aging of nursing educators, the increased time needed for graduate education, heavy faculty work loads and lower wages, limited clinical education sites, and the challenges of revising curricula to better match the realities of clinical practice in the 21st century are cited as obstacles.
New funding available for nursing education
However, there is now reason for hope, as foundations and the U.S. government are responding. For instance, the Boston Herald reports that the Robert Wood Johnson Foundation, Tufts Help Plan Foundation, and others have provided a $250,000 grant to the states of Rhode Island, Massachusetts and New Hampshire to increase the number of nursing teachers, add training opportunities, and provide incentives for nurses to pursue advanced degrees.
And, the Health Resources and Services Administration of HHS supports nurse education, practice and retention by offering scholarships, loans and loan repayments, and grants to registered nurses to increase their skills in the field. In fact, according to "http://www.hhs.gov/news/press/2009pres/08/20090812a.html">HHS, the recently enacted American Recovery and Reinvestment Act (ARRA) will enable the agency to provide $13.4 million for loan repayments to nurses who agree to practice in facilities with critical shortages, and to schools of nursing to train masters and doctoral nursing students who will become faculty.
Impacts of the recession on nursing career
Getting back to the issue of the recession, the The Times Free Press in Chattanooga, TN reports that the shortage of nurses has eased due to the economic downturn. Nationwide, nurses are delaying retirement, moving from part-time to full time jobs, and putting off career changes. And some who left work are now returning in order to cover expenses when their spouses have lost their jobs. In addition, some hospitals have laid off workers or even closed.
However, hospital nursing executives say that the shortage is still very real, especially in rural areas, and they worry about the future. "One of my major fears is that people will feel that the nursing shortage is ending," said Lynn Whisman, chief nursing officer at Erlanger hospital in Chattanooga. "There is a lull right now, but it is going to be a short-term lull, and the nursing shortage is going to get even worse. ... It really is scary to me as a chief nursing officer what lies ahead."
Deborah Deal, a colleague at a nearby hospital, Parkridge Medical Center, offers a more sanguine assessment, "Nursing is a cycle. We see periods of time when there is a huge shortage, and following that, you usually do have an influx. There still is a need for people that really truly want to be nurses ... because it will cycle back around."
Looking to the future
A recent article in Health Affairs looks at the effects of the recession, as well as the gradual 7-year increase in the numbers of nurses, a result of the well-publicized crisis and subsequent promotion of the field. Peter Buerhaus of Vanderbilt University Medical Center and author of the study, reports that much of the increase came from older workers, but he found that there has also been a significant number of young workers entering the field. This is especially important because registered nurses over the age of 50 are the fastest growing group and they will be retiring in the next decade or so.
"We need to take advantage of the current increase in nurse employment and easing of the shortage by strengthening the current workforce before the recession lifts and imbalances in the supply and demand for RNs reappear," said Buerhaus in a Vanderbilt University Medical Center article. "A steady stream of new and well-prepared registered nurses is vital to fill the void that will be left by retiring nurses."