Nursing shortage

[The unexplainable Moo Cow]

I was doing some reviewing from a textbook regarding staffing issues in nursing. One plan to resolve the nursing shortage was to increase the pay rate for RNs and thus bring the supply and demand into balance. The book cited a pay increase in 2003 of 8.3% above the 2002 average reflecting “the acceleration in the demand for RNs” that occurred the previous 2 years (Contemporary Nursing issues, trends & Management, p. 272).

“Historically, nursing shortages have lasted 3 to 8 years and have been followed by periods of equilibrium or surpluses of similar strength…According to projections, cumulative real wage growth between 2002 and 2016 would need to exceed 55.4% to substantially affect the abatement of the shortage.” (Contemporary Nursing issues, trends & management, p.272)

1. Let us assume the by the year 2016 the shortage has been met. New grad RNs would have a starting pay in the mid $80,000 range equivalent for today -- if my calculations are correct – let alone the year 2016. Where does that money come from and how will it be sustained to avoid another critical shortage?

2. What happens to the standards of practice and care if the shortage is not met and many of our instructors retire? A different theory and practice of RNs? More ancillary staff with more responsibilities? If there are not enough “mothers” to lay “eggs”…well, you get the point. We’ll just have to reinvent the wheel.

3. What does this mean for nursing unions? If the demand is met, will we see more unions? If the shortage is as bad as predicted, will there be enough RNs to make the unions? What about “mandatory overtime”?

While I welcome the pay increase, I loathe the idea of lower standards of practice and more stress.

Just some thoughts.

[Ricu]

I was doing some reviewing from a textbook regarding staffing issues in nursing. One plan to resolve the nursing shortage was to increase the pay rate for RNs and thus bring the supply and demand into balance. The book cited a pay increase in 2003 of 8.3% above the 2002 average reflecting “the acceleration in the demand for RNs” that occurred the previous 2 years (Contemporary Nursing issues, trends & Management, p. 272).

“Historically, nursing shortages have lasted 3 to 8 years and have been followed by periods of equilibrium or surpluses of similar strength…According to projections, cumulative real wage growth between 2002 and 2016 would need to exceed 55.4% to substantially affect the abatement of the shortage.” (Contemporary Nursing issues, trends & management, p.272)

1. Let us assume the by the year 2016 the shortage has been met. New grad RNs would have a starting pay in the mid $80,000 range equivalent for today -- if my calculations are correct – let alone the year 2016. Where does that money come from and how will it be sustained to avoid another critical shortage?

2. What happens to the standards of practice and care if the shortage is not met and many of our instructors retire? A different theory and practice of RNs? More ancillary staff with more responsibilities? If there are not enough “mothers” to lay “eggs”…well, you get the point. We’ll just have to reinvent the wheel.

3. What does this mean for nursing unions? If the demand is met, will we see more unions? If the shortage is as bad as predicted, will there be enough RNs to make the unions? What about “mandatory overtime”?

While I welcome the pay increase, I loathe the idea of lower standards of practice and more stress.

Just some thoughts.

Hey Moo,

You raise some very crucial concerns. I've wondered about those things too but not recently- your 2016 projection really opened my eyes. On the subject, have you ever seen a time when pay raises alone sustained a workforce? In fact, don't you wonder what's wrong with a place when you see large pay offerings? I do. I wonder too, if we will soon see an increase in assistive personnel, licensed or otherwise in response to a shrinking nursing workforce. On an optimistic note, I trust that our well supported national nursing agencies will work to ensure that there won't be too much of a derangement in the healthcare model while the legislators get more creative with reimbursement. I saw the beginnings of healthcare reform with the Medicare DRG system back in the early eighties. It was scary then but actually improved things a bit by tighting up medical practice. Let's keep our fingers crossed. Thanks for the thought provoking post.

R

[singingtothewheat]

One problem with raising pay to help the nursing crunch is that it makes it a more desirable job to folks who want money and really don't make good nurses. It's a crummy truth but still the truth. I feel very strongly that increasing an R.N.'s ability to get his/her B.S.N. and M.S.N. is the key to many problems nursing is having right now. We need good educators with extremely high standards. In my area getting instructors is very difficult. The potential for alot of people who wish to be nurses is certainly lessened when they can't get into a school or have to wait to get into a nursing program because there just are not enough teachers.
More good nurses in the workforce = better patient outcome because you have some continuity of care. Better patient outcomes = better finacial picture for BIG HEALTHCARE BUSINESS. I'd like to think that some of that trickles down either knowingly or unknowingly. A better crop of high quality nurses also presents the picture that nurses are worth MORE. Like so many other floors, my floor frequently has to use agency, float, and travelers. We've had pretty good luck with the travelers. Some of them have been just wonderful to work with and they take ownership. I must say however, the picture is much less pleasant when it comes to float and agency R.N.'s. Where I work we all sort of groan inside when these folks come because all to frequently they don't take ownership. We have had some real good nurses, don't get me wrong but more often than not they don't cut it. It's like we should be glad they decide to show up and a few times they haven't even done that!

[hsrealinvest]

I am completing my MBA concentration in healthcare management (I will be 96% complete by summer of 08). I am Asian Indian and previously owned a real estate business for 10 years. My hobbies are improving historic houses, Koi ponds (built 3 so far), landscaping, nature, traveling, and natural food, cooking, traveling and making new friends. I am scared to death to apply for the MSN program since I have not seen any Indian male nurses. I am not sure how minority male nurses get treated during the process in the nursing school. Also with MBA/MSN, can anyone decide to go into administration without practicing clinical aspect of it? What are the benefits of having MBA and MSN instead of just having a MBA with healthcare administration? Are there any Indian male nurses in this field? I would also like to get some information to the universities that are two year program for non-nurses and enjoy a diverse body of students. Preferably a nursing program, where 50% are males instead of only 10 to 11% standard male enrollment in most universities.

[XOEmmyLouOX]

I am currently an LPN who is looking to further my education, but the cost of college is outrageous. Not to mention my employer isnt willing to work around my schedule if I went back. How are we supposed to advance ourselves when we aren't given the chance to?

[SoldierNurse]

I am currently an LPN who is looking to further my education, but the cost of college is outrageous. Not to mention my employer isnt willing to work around my schedule if I went back. How are we supposed to advance ourselves when we aren't given the chance to?

Stafford loans, and find an employer that will allow you a work schedule to correlate somewhat with a school schedule.

I was a single parent dad w/two sons, working full-time [32 hrs/wk] as a surg tech [CST] while going to nursing school. If, I can do it ... anybody can do it.

[XOEmmyLouOX]

Stafford loans, and find an employer that will allow you a work schedule to correlate somewhat with a school schedule.

I was a single parent dad w/two sons, working full-time [32 hrs/wk] as a surg tech [CST] while going to nursing school. If, I can do it ... anybody can do it.

Finding someone who will is a lot easier said than done. The only places in this area who are willing to even consider this is long term care, which I don't think I can do again. I am trying to get into a hospital, however I am finding it next to imposible in this area.. You are a very determined person. While in LPN school I worked full time as well..

[cgrunrun]

Em, it can be done. When I started nursing school, I had a two year old and a four month old and a drug-and-alcohol-using husband. I worked about 20 hrs per week and did it all in 2 years. It can be done- depends on your motivation and how much you are willing to sacrifice to reach your goals. Do it!! cg

[SoldierNurse]

Finding someone who will is a lot easier said than done...

I can say it because I did it.

[SoldierNurse]

Em, it can be done. When I started nursing school, I had a two year old and a four month old and a drug-and-alcohol-using husband. I worked about 20 hrs per week and did it all in 2 years. It can be done- depends on your motivation and how much you are willing to sacrifice to reach your goals. Do it!! cg

Yep, it can be done. Just like the commercial; Just Do It.