Nursing Shortage Factors
Nurses increasingly are facing deteriorating working conditions at the facilities in which they work. This problem is reflected in the decline in nurse staffing nationwide.
According to a 2001 ANA Staffing Survey, 75 percent of nurses surveyed feel the quality of nursing care at the facility in which they work has declined over the past two years, while 56 percent of nurses surveyed believe the time available for patient care has decreased. In addition, more than 40 percent of nurses surveyed said they would not feel comfortable having a family member cared for in the facility in which they work. And over 54 percent of respondents would not recommend their profession to their children or friends. (Source: ANA Staffing Survey, Feb. 6, 2001. See the Nurse Staffing section of this Web site for details.)
An ANA Health and Safety Survey reveals that 88 percent of nurses reported that health and safety concerns influence their decision to remain in nursing and the kind of nursing work they choose to perform. More than 70 percent said the acute and chronic effects of stress and overwork were among their top three health concerns, with more than two-thirds reporting they work some type of mandatory overtime every month. In addition, nurses cited a disabling back injury (60 percent), followed by contracting HIV or hepatitis from a needlestick injury (45 percent) as also being among their top three health and safety concerns. The survey further revealed that fewer than 20 percent of respondents felt safe in their current work environment. Seventeen percent had been physically assaulted in the past year, and more than half were threatened or experienced verbal abuse. And, nearly 20 percent said their facilities still do not provide safe needle devices. (Source: ANA Health & Safety Survey, Sept. 7, 2001.)
The solution to the bedside nurse staffing shortage lies in paying nurses more and decreasing the number of patients each nurse must care for, said a majority of staff RNs polled in a national sample survey released by ANA’s union arm, the United American Nurses, AFL-CIO (UAN). Fully 82 percent of those surveyed responded that increased pay was a top solution to the nurse staffing shortage; 85 percent responded that a reduced nurse/patient ratio would improve the shortage. Other highly rated solutions include greater autonomy and control for staff nurses (66 percent) and safer working conditions (65 percent). (Source: Telephone survey of 600 staff nurses conducted Nov. 4-11, 2002 by Lake Snell Perry & Associates, Washington, DC; see www.uannurse.org.)
Nurses also are reporting increasing burnout and widespread job dissatisfaction.
More than 40 percent of hospital nurses reported being dissatisfied with their jobs, according to a study of nurses in five countries by Linda Aiken, PhD, FAAN, FRCN, RN, and colleagues at the University of Pennsylvania School of Nursing. The study, published in the May/June 2001 Health Affairs, found that one out of every three nurses under age 30 is planning to leave her or his hospital nursing job within the next year. (Source: Nurses’ reports of hospital quality of care and working conditions in five countries. Health Affairs, 2001, 20, 43-53.)
A study by Julie Sochalski, PhD, FAAN, RN, at the University Of Pennsylvania School Of Nursing, found higher numbers of new graduates of the nation’s nursing schools are not going into nursing at all. Among the most recent crop of nursing graduates, more than four out of every 100 female nurses were not working in nursing after graduating. And that number is nearly twice as high for new male nurses. (See Health Affairs, September/October 2002 edition, for details.)
One of every five working nurses is considering leaving patient care for reasons other than retirement within the next five years, according to The Nurse Shortage: Perspectives from Current Direct Care Nurses and Former Direct Care Nurses, an April 2001 study commissioned by the Federation of Nurses and Health Professionals.
Salary levels are typically not cited as among the chief reasons for job dissatisfaction among nurses. According to 2004 National Sample Survey figures, the actual average annual earnings of RNs employed full-time in 2004 were competitive at $56,784. And this figure represents an apparent increase over the $46,782 average annual salary reported in 2000. However, when adjusted using the Consumer Price Index (CPI), the “real” earnings of RNs employed full-time in 2004 were estimated at $26,366 compared to $17,398 in 1980 and $23,369 in 2000. A 12.8 increase since 2000, this change is the first up-tick in real earnings since 1988.
Nursing school enrollments are increasing but applicants are also being turned away:
A Dec. 9, 2005, National League of Nursing (NLN) study confirmed that an estimated 147,000 nursing school applicants were turned away from nursing education programs at all levels last year – an increase of 18 percent over 2004. The cause is a continuing critical shortage of nursing school faculty. (For details, see www.nln.org/newsreleases/nedsdec05.pdf)
Enrollments in entry-level baccalaureate programs in nursing increased by 13 percent in fall 2005 over the previous year, according to an annual survey by the American Association of Colleges of Nursing (AACN). Despite this significant gain, 32,617 qualified students were turned away from baccalaureate nursing programs due primarily to a shortage of nursing educators. Increased federal support is needed to counteract this trend and to meet the projected demand for more than a million new nurses over the next decade. According to AACN, this is the fifth consecutive year of enrollment increases with 14.1, 16.6, 8.1, and 3.7 percent increases in 2004, 2003, 2002, and 2001, respectively. Prior to the five-year upswing, baccalaureate nursing programs experienced six years of declining enrollments from 1995 through 2000. For more information, visit the AACN Web site at http://www.aacn.nche.edu.