Nursing nears a critical stage

March 13, 2001|By Barbara R. Heller

THE U.S. Department of Health and Human Services and health experts recently warned Congress that the nation's pool of registered nurses would shrink steadily over the next 20 years.

This crisis of epic proportions will touch every man, woman and child in America. Who will care for the elderly, the newborn, and the chronically ill? We have never seen a nursing shortage of this magnitude.

Health facilities in Baltimore and throughout the state are already struggling to fill nursing positions.

In Maryland, the number of registered nurses available to work dropped 4.8 percent to 45,525 in a year. The average age of registered nurses has risen from 44.3 to 45.2 from 1996 to 2000.

Fewer students are choosing nursing as a profession. Dr. Georges Benjamin, secretary of the state's Department of Health and Mental Hygiene, reports that for every eight nurses retiring, only three new graduates are entering the field.

At the same time, the acuity level of hospitalized patients is intensifying, requiring more highly skilled, better-educated nurses. As baby boomers retire, the elderly population will grow exponentially, resulting in an increased demand for long-term care.

There are other deeper, more disturbing reasons for the nursing shortage.

An outdated perception of nursing persists, with continued negative media stereotypes and a lack of true understanding about the profession. In reality, to handle the complexity of patient care today, nurses require critical thinking skills, technological proficiency, scientific and medical expertise and advanced education.

Nurses practice independently; they do not simply carry out physicians' orders. There is increasing demand for more highly educated nurses, and the need for advanced- practice nurses rises with the surge in life expectancy rates and the evolution of managed care.

Many nurses experience burnout as stress in the workplace escalates, complaining of being overworked and under-appreciated. As reasons they cite insufficient nurse-patient staffing ratios, excessive paperwork, little control over the practice environment, inadequate compensation and inflexible work schedules.

Solutions to the nursing shortage require a varied and far-reaching approach from all levels government, the health care industry, education institutions, the media and the public. The federal government can make finding, training and retaining nurses a national priority, much as it has with police officers and teachers.

Maryland has taken the first steps in addressing the issue by forming the Statewide Commission on the Crisis In Nursing, which has made some preliminary recommendations.

The health care industry and education institutions must partner to make nursing more attractive to college-bound men and women. Guidance counselors must be informed about the positive aspects of a nursing career. Pre-nursing education programs can be developed in high schools. Scholarships can help fund nursing education and education access can be expanded to geographically underserved areas through satellite courses, distance learning technology and online learning options.

Barbara R. Heller is dean and professor of the University of Maryland School of Nursing and vice chair of the Statewide Commission on the Crisis In Nursing.

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