9/22//2006
- Pat Mahan, Nurse-Recruiter.com
The short answer is no! There is not
a nursing shortage in the U.S. though many power players
in the nursing industry are working over time to make you
and the public think otherwise. Unlike the nursing
shortages of the past, this nursing shortage is composed
of a multi-factoral, playing with the numbers. The
real problems in declaring this nursing shortage is that
it is an inaccurate assessment. If the assessment
is wrong, so too will be the plan.
First, let's take a look at how they're coming
up with the definition of a nursing shortage:
- They're only counting nurses that are providing bedside
nursing care. There are just over 2.9 million registered
nurses currently licensed in the U.S., but too many have
left the "traditional" nursing role.
- They are not counting the nearly 1,000,000 LP/VNs in
the United States that have been providing skilled bedside
nursing care since the early 1940's.
- The latest trend to mandate nurse patient ratios, that
too often look at just the numbers and don't consider
acuity in the ratio. This too is wrong.
Now before you send me an email, let me make sure you're
undestanding my position. There is not a nursing shortage,
but there is a shortage of nurses willing to provide bedside
care. I see this as an even bigger problem than a
simple nursing shortage and the fix will be much harder
to indentify.
It is important to clarify the situation so we get to the
right solution. Let me use an anology to make my point.
Let's say you're car won't start. It appears as though
the battery doesn't have enough power so you get a new battery.
You install the new battery (now you know you have enough
power) but the car still doesn't start. What's the
problem? That battery cable is fraid and isn't providing
the connection needed to get enough power to meet the cars
needs to start.
In the analogy, enough power represents the total number
of nurses currently available and licensed in the U.S.
The new battery represents adding more nurses to the mix.
The fraid cable represents the fact that nurses are disconnecting
from the historic bedside care role that has marked and
made our profession. So, simply adding more nurses
will not fix the problem, the disconnect will still be there.
Yes, adding more nurses can minimize the problem, but it
would be like fixing the cable with electrical tape rather
than getting a new cable and fixing the problem the right
way.
How does one fix the problem. Well for all the years
that I've been in business, I still use the nursing process
to solve the problems. We need to Assess, Plan, Implament
and Evaluate. The point of this article is that we
have a flawed assessment. And that is simply a fact.
There are 2.9 million RNs and nearly 1,000,000 LPNs in the
U.S. We need to assess why it is they are not providing
traditional bedside nursing care. What it will take
to get them back at the bedside in quantity sufficient to
meet the nursing care needs of our communities. How
to keep those that are providing care in their positions.
Why aren't we talking about that? Well, primarily
it's because the solutions will be harder and likely it
will be much more expensive. Traditionally we let
politicians and big business rule the provision of healthcare.
Did you know that even Newt Gingrich has come out saying
the providing healthcare to everyone is
a "moral issue". Now I certainly don't
agree with most of his plan, but he is absolutely right
on that point. And providing bedside care is a moral
and fiscal issue for nurses and nursing to consider.
To do that, we must call on the nursing leaders to get the
assessment right. Quit trying to scare the public
and legilsatures, they're not going to make the right decision,
history is repleat with the evidence to support that.
Let's apply the science of evidence based practice to this
practice issue. In order for the problem to be fixed,
we must first clearly and accurately identify the issues
and then declare a diagnosis and plan.
Follow-Up
As a follow-up to the article in the July edition of Nurses~4~Nurses,
the bill that required a 1:5 nurse to patient ratio in MA
was defeated. As you know, we came out, along with
many nurisng organizations against the proposed bill in
MA. The primary problem with the bill is that is was
a simple cookie cutter solution that did not take in to
consideration the complex nature of nursing care and the
varying degrees a care required by patients. So congratulations
to the MA legislature for getting in right. Look to
the experts to help you draft legislation that will make
sure the patients in your state get adequate nursing care.
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