title: Thoughts on the "new nursing shortage".
abstract: The nursing shortage is a frequently recurring phenomena in the United States and in many developed countries worldwide. It is time that serious consideration be given to the necessary changes that are essential for supplying an adequate nursing force worldwide. This article compares the late 1980s nursing shortage in the United States with the current one and finds that many of the same causes are prevalent. These causes stem from the gender-based history of modern nursing and the cultural- and professional-based problems that nursing has had great difficulty changing and are discussed in this article. The decentralization of health care has also created greater demand for nurses. The nursing component of a hospital's budget representing its largest component has also been targeted by hospital administrations and ownership as a source for supporting other departments or functions at the expense of nursing personnel. Finally, the vast opportunities that have opened up to women since the Civil Rights Act in the 1960s and today's booming economy and high-technology environments make nursing much less attractive and competitive in today's market. Also, the managed care movement has significantly contributed to problems of nursing. Nursing educators have also found that the 3 levels of nursing education has confused today's high school graduates, leading to their rejection of nursing as a career. Thus, efforts are underway in nursing education to correct this problem--one that is beginning to be corrected through role differentiation that is now seen in many hospitals, but most prevalent in so-called "magnet" hospitals. Investigators have done much research--first in distinguishing the difference between magnet and nonmagnet hospitals, and now, regarding patient outcomes from those hospitals. These can lead to the efforts of nursing to come to grips with multiple entry points for a single licensure. However, the problems associated with the barriers to practice, prompted by long outdated mores and cultural influences discussed in this article that must change if nursing is to remain a viable and attractive profession in the 21st century. Investigators have found higher mortality rates between magnet and nonmagnet hospitals, favoring the magnet hospitals that have a better nurse-to-patient ratio, higher baccalaureate registered nurse staffs, and greater nursing autonomy. It is time that decision makers take heed and make changes. Nothing less than the lives of patients are at stake.
authors.affiliation: Nurse Anesthesia Affairs, El Paso, TX, USA.
authors.forename: I P
authors.initials: IP
authors.lastname: Gunn
mesh_terms: D002321:Career Choice; D004506:Education, Nursing; D018166:Health Care Reform; D006801:Humans; D009729:Nursing; D009741:Nursing Staff, Hospital / Q000600:supply & distribution*; D010557:Personnel Administration, Hospital; D014481:United States; D000078329:Workforce