Addressing the nursing shortage

This is National Nurses Week. The observance certainly is appropriate. Honoring the women and men who fill the ranks of what is likely the largest single health-care profession in the United States recognizes their key role in health care and in society. Nurses arguably are the unsung heroes of a system that is being stretched and strained by divisive debate about the cost, delivery and availability of services. What's needed, of course, are serious discussions about the most efficient ways to provide adequate care and treatment to the most people.

While physicians, prescription drugs and hospitals receive the most attention in any talk of health care, truth is that nurses are front-line troops in the health care professions. They assist physicians in private and public practice, work in surgical suites and other specialized areas of hospitals, and deliver direct care to patients in short and long-term care facilities and on an outpatient basis. Nurses aren't boasting when they claim that they are the glue that helps hold the system together.

All is not well in the profession, though. There is a shortage of nurses in the United States (and in other nations) and it is starting to have an adverse impact on patient care, especially in hospitals. The severity of the shortage has been blunted a bit by the nation's recent economic uncertainties. Many experienced and retired nurses have returned to work or switched from part-time to full time status to help their families through the crisis. Still, the underlying problems of the profession - an aging workforce, recruitment and retention, wages and working conditions - remain. They will be exacerbated as the economy improves and the composition of the workforce changes.

There's little doubt that many more skilled nurses will be needed in coming years. An aging population will require more of the services and care they provide. The time of increased demand, experts say, will intersect with a sharp decline in the number of experienced nurses available to work. A recent survey indicated that more than half of the nation's currently working registered nurses - whose average age is nearly 50 - plan to retire within the next five years. There's no ready antidote for the shortage.

There are not enough new nurses entering the workforce. It's not for lack of interest. There are far more qualified applicants for degree programs than there are slots available. The problems: There are not enough qualified teachers or approved training programs. And new graduates have trouble finding jobs. Many hospitals are raising nurse-patient ratios rather than hiring new nurses. That's short-sighted policy.

A nursing shortage is not the only personnel issue besetting contemporary health care. Similar declines in primary care and family physicians, especially in small towns and rural areas, and a lack of skilled technicians to operate high-tech diagnostic equipment are problems, too. Meeting 21st century health-care staffing demands will require nimble thinking and complex policies. Nurses Week is another reminder of how far the nation still must travel if it is to address those requirements in a meaningful way.

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