Addressing Health Care Staffing Needs (Download as a PDF)

The Issue

The American health care system is undergoing a staffing crisis unlike previous staffing problems. A combination of an aging nursing workforce and declining enrollments in nursing schools demands a comprehensive national strategy, involving public and private energies and resources.

Although shortages are reported in many health care professions, including pharmacy, physical therapy, occupational therapy, radiological and other technologies, the most pervasive (and probably most long-lasting) is the exploding shortage of registered nurses needed to deliver quality care in our communities.

According to the latest projections from the U.S. Bureau of Labor Statistics, more than 1.2 million new and replacement nurses will be needed by 2014. Government analysts project that more than 703,000 new RN positions will be created through 2014, which will account for two-fifths of all new jobs in the health care sector.

Vacancies in acute, long-term and home care are becoming habitual, with some health care organizations reporting up to 30 percent vacancy rates. Shortages seem to be especially severe in areas such as critical care, trauma care, and labor and delivery. Geriatrics, traditionally one of the least popular nursing specialties, is also experiencing staffing shortages. As a result, nursing units are being closed, patients are diverted to other locations, surgeries and other medical procedures are being canceled, and nurses are being asked to work extra hours and, often, in understaffed conditions, creating and escalating spiral of shortages as conditions force nurses to seek less chaotic employment.

The nurse/staffing crisis has many dimensions. The numbers of nurses leaving the workforce outnumber those who are entering the job market, and younger nurses are not replacing those who are retiring.The nursing workforce is aging at the same time our communities' populations are aging and older persons will require even more comprehensive nursing care. As the nursing workforce becomes older and retires, the same process is occurring at an even faster pace in nursing schools where there are shortages of qualified faculty, which results in diminished capacity to enroll students.

An especially alarming dimension of the nursing shortage is that nursing is increasingly seen as an unsatisfactory and unattractive profession. The work is always demanding, usually difficult, sometimes dangerous, and nurses are often underpaid and perceive themselves to be under-appreciated.

The CHRISTUS Health Position: Support full funding for nurse training, education and recruitment.

The public has a significant role in dealing with current and impending nurse shortages. CHRISTUS Health advocates for a strong federal commitment to increase funding for undergraduate and graduate nursing and allied health professional education, training, and faculty development, fortified by adequate reimbursement to help attract and retain qualified caregivers.

President George W. Bush signed the Nurse Investment Act in August 2002. Provisions of this new law include scholarship money to attract new students into nursing, a Faculty Loan Cancellation Program to remove financial barriers to faculty careers, funding to promote best practices in nursing care and public service announcements to champion nursing careers.

CHRISTUS Health urges Congress to appropriate full funding to implement programs designed to attract more students into nursing programs; improve the workplace for nursing; support schools of nursing to provide faculty and updated curricula; recruit a more diverse student population; provide assistance to students to enable them to complete nursing studies, and; ensure the collection and analysis of current nursing workforce data to guide the appropriate implementation of these programs.