Strategies for addressing the evolving nursing crisis.
BACKGROUND
The shortage of registered nurses, which is already having ill effects on the U.S. health care delivery system, is burgeoning at a time when patient acuity is high, care is complex, and demand for services often exceeds capacity. This is a prescription for danger.
Some hospitals fare better in recruiting and retaining nurses than others. Top-level managers who provide nurses with delegated authority, adequate staffing, competitive compensation, and a collaborative culture have a built-in resistance to cyclical nursing shortages--theirs is too good a place to work to leave.
The shortage of nurses is mirrored by a corresponding shortage of nursing faculty. As nursing educator attrition continues, it is unclear where the future nursing school faculty will come from. Federal funding of nursing education is modest. Structured postgraduate training programs for nurses could provide an opportunity for skill building in real clinical settings.
Although there is clearly a business case for creating a culture of nursing staff retention-based on lower turnover, lower costs, higher profitability, and better outcomes--there is just as clear a need for the investment of new dollars in hospitals to establish a new base of response capacity. For hospitals to be truly able to invest in nursing and to resolve the problems that have led to the impending nurse staffing crisis, new federal monies specifically targeted for nursing need to be made available.
D002321:Career Choice; D004649:Employee Incentive Plans; D005181:Faculty, Nursing; D006301:Health Services Needs and Demand / Q000639:trends; D006280:Health Workforce / Q000639:trends*; D006801:Humans; D007588:Job Satisfaction; D009741:Nursing Staff, Hospital / Q000191:economics / Q000193:education / Q000523:psychology / Q000600:supply & distribution*; D016272:Occupational Health; D015279:Organizational Culture; D010557:Personnel Administration, Hospital / Q000379:methods*; D010558:Personnel Loyalty; D010560:Personnel Selection; D011787:Quality of Health Care / Q000639:trends; D014146:Training Support; D014481:United States