Shortage of nurses in the hospital setting

Shortage of nurses in the hospital setting

Hospitals are struggling to meet the growing need for nurses. The Bureau of Labor Statistics shows that while nursing is one of the fasting growing careers fields, the growth is still unable to keep pace with demand.  They forecast 1.2 million vacancies for registered nurses by 2022.

Why nurses are in more demand than ever before:

1)    People are aging. More Americans are over the age of 65 now than at any other time in U.S. history. Throughout the next 20 years, 1 in 5 people will be considered a senior citizen according to the social security administration. As the baby boomers age, medicine has advanced to where we can prolong life, but with this comes the need for more care, often outside of a traditional hospital setting. Because of this, assisted living facilities, skilled nursing centers, nursing homes and rehabilitation centers are opening at a rapid rate. They are hiring nurses away from the traditional hospital setting, contributing to   the shortage of nurses   in hospitals.

2)    There is also a physician shortage. Keeping pace with the nursing shortage, general practitioner physicians are becoming hard to find. (Check out this physician workforce report.) This is causing a trickle down effect in nursing. There is more need for registered nurses to become nurse practitioners to fill these physician vacancies.

3)    Patients in the hospital are sicker than they used to be. Much of what would have been treated in the hospital is now done at home, physician offices or skilled nursing facilities. There are fewer patients requiring hospital care but they are sicker and require complex care.  Nursing care in hospitals today involves more technical care involving computers and equipment.  Everything is computerized.  Nurses often feel they are attached to their computers.   This type of patient care is often less satisfying to nurses, who are drawn to nursing because they enjoy that patient/caregiver interaction.

4)     Today’s nurses are required to have more education. Over recent years there has been a push for bachelor’s degrees as the entry level for nursing instead of associate degrees. This equates to more time in class, which means fewer nurses hitting the floor each year. And those that do, because of the less clinical degree program, have not spent enough time actually providing hands on care for patients during their training. This lack of preparation equates to dissatisfaction in their chosen profession, often resulting in leaving the traditional hospital setting early on in their career.

5)    Patients and families can be more difficult to care for than they used to be. Nurses are seeing an increase in difficult patients due to increased illegal drug abuse and psychiatric illness. On any given day, a nurse is putting him or herself in harm's way, not knowing if a patient will become out of control. Many healthcare workers have been injured, some seriously, just trying to care for patients.  This adds stress to an already stressful profession.

6)    Change in work expectations   Many nurses, especially Millennials, adhere to an evolved work code. Todays nurse is looking for quality of life over “sense of duty.” This results in nurses working part-time or prn at multiple sites so they can control work schedules to create a better work life balance.

Hospitals are continually faced with a shortage of experienced nurses.   In recent years much has changed to alter the perspective of the nursing profession.  The advent of social media has brought with it instant access for minute-to-minute updates from nurses: how tired they are feeling standing on their feet for 12 hours at a time, how heartbreaking it is to lose a patient, how sick of paperwork they are.... the list goes on. It’s human nature to state the negative, often leaving out those life-changing, heart-warming and truly rewarding moments we experience as nurses. One nurse posting such things is negligible, but multiply that by thousands, the effect is profound on the perspective of nursing, and ultimately, the longevity of the profession.

No one will deny that nursing is one of the most grueling, tiring and sometimes thankless professions, but it’s one that we do for a noble reason -- to help patients get through a difficult time in their lives and make a difference in the lives of others. As a nurse, you know this, but other people only know what you tell them. So while we can’t single-handedly solve the nursing shortage, each of us can do our part to tell the real story of nursing on a daily basis.

How can we get nurses back on the floor?

1)    Give our nursing students more time actually caring for patients while in school. Encourage our schools to get their students into hospitals for hands-on experience. One of the most difficult challenges with nursing is how to handle situations when working with patients and their families.  This is difficult to teach in class.  Student nurses need to learn how to manage multiple patients with a variety of needs.  We need to show them early on that they can make a difference. 

2)    Partner hospitals and high schools to create excitement about being a healthcare provider. Hospitals should have teen volunteer programs to get high school students interested in healthcare.  My hospital partners with area schools to provide a summer experience program. Students have a chance to interact with nurses and other healthcare professionals, exposing the students to healthcare professions at a young age.

3)    Generate positive buzz about nursing. This starts with you. Tell your heart-touching stories (staying within confidentiality boundaries) to your friends and family. Instead of using social media to decompress from a bad day, talk with a friend or mentor that is also in healthcare.  Don’t just go to Facebook or Twitter and let loose!   Be very proud of what you do.  Your care is truly making a difference in this world.  

4)    Pay attention to the nurses currently working in our hospitals   Take a close look at what is drawing our nurses away into other areas and make adjustments where you can. Show them how important they are to the hospital and to patient care.

As a former nurse of 30+ years, now a hospital executive, nursing is near and dear to my heart. I strongly believe that the way to keep nurses starts at the executive level. If appreciation is shown from the top down, it will take hold in the entire culture of the hospital.  Leaders cannot manage hospitals without nursing care. We must make every effort to provide a safe environment in which our nurses can practice.  We must show genuine appreciation and respect for the difficult job nursing is today.  Happy, engaged nurses lead to quality care and improved outcomes for our patients. 

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