Cath Lab Digest

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  Several months ago, at a social gathering of community leaders, an older gentleman was decrying the fact that so many nurses have become real estate agents. These agents, he said, were very efficient, hard working, and knowledgeable. Why would a nurse ever leave all that experience and education to sell houses?

  Since then, the Journal of the American Medical Association (JAMA) has released a widely publicized study revealing the quantifiable and adverse outcomes associated with certain patient-to-RN ratios. How does this affect a nurse's perception of patient care delivery or the obligation to provide safe, reasonable care? Equally important, to what extent has the spirit of nursing been undermined based on this seemingly dismal situation? Healthcare professionals by nature tend to have the patient's best interest at heart, but proponents of the theory compassion burnout might argue that these circumstances are damaging the essence of the caring professions.

Current State of the Shortage

  The current nursing shortage is a local, regional, national, and global concern. Experienced RNs are needed in all areas. Unlike previous crises, traditional recruiting efforts are not proving successful. This may be due to the rapidly changing demographics of the American population. For example, people older than 85 are the fastest growing segment. Baby boomers are close to retiring. Not only are nurses necessary to care for this aging sector, but also they are aging along with the rest of the population. The average RN is 44 years old and one-third of the RN population is over 50.¹

  The Bureau of Labor Statistics projects a 12.5% increase in hospital-based nursing positions by 2005, and yet colleges have not expanded nursing programs because they are more expensive to provide than other educational programs. Even universities and colleges offering nursing programs have discovered that many young men and women are not choosing nursing as a profession. At the same time, nurses are discovering more work options within and beyond healthcare. Hospitals and colleges face intense competition. Numerous barriers exist in addressing this shortage.

What are the Barriers?

  Barriers to resolving the current shortage are attributed to the aging nursing workforce, low unemployment, and the global nature of the shortage. Additionally, some authors believe that the increased level of patient acuity leads to challenges in recruiting experienced or especially skilled RNs.²

  National trends in the general work environment are different now than during the last nursing shortage. Employees today seek more personal time as opposed to financial compensation. Employees want to be active both at work and at home and don't want to choose between the two. Employees in their 20s and 30s view the workplace differently, preferring greater autonomy and less bureaucracy. They are loyal to work rather than the employer. Thus, many are choosing independent work, consulting opportunities, or temporary work through agencies. Each of these factors, coupled with the traditional and hierarchical nature of hospital structure, discourages long-time hospital nursing employment. These circumstances work together to create a nursing shortage that serves as a threat to patient safety.