A New and Very Real Nursing Shortage

ere we go again, reports everywhere of a severe nursing shortage in this country. Many of us say that we have heard it all before. But this time it is not just nursing’s issue, this particular shortage is much more complex. Hospital beds are being closed, patient acuity levels in hospitals are continuing to increase, ambulances are being diverted, and patients are having an increasingly difficult time accessing timely services. Because of managed health care, the length of stay in hospitals continues to decrease and more care is being rendered in homes, ambulatory, and community settings. In addition, the recent Institute of Medicine report on errors in hospitals adds to the bad news, focusing more attention on hospital personnel and a shortage of staffing as prime contributors to the alarming rise in medical errors (Kohn, Corrigan, & Donalson, 2000). Past solutions to reverse nursing shortages, such as increases in salaries, huge sign-on bonuses, relocation allowances, availability of continuing education funds, or even a new car for a year of night shift will have little or no effect on this crisis. Previously, hospitals and nursing homes increased their hiring of unlicensed assistive personnel to supplement their workforce. However, with low unemployment rates throughout the country, even this pool of workers is less available and many facilities are reporting a shortage of support staff, such as sec-retaries, nursing assistants, and other allied health professionals. Previous shortages were a result of economic cycles mainly driven by hospitals. Hospitals would expand and need more nurses, salaries would increase, more nurses would come back to 200 Current demographics of the nursing shortage are presented and discussed. Issues of this particular nursing crisis are explored relative to past nursing shortages. State and organizational responses to the current crisis are listed relative to the following key areas of nursing concern: mandatory overtime, whistleblower protection, reporting of nursing-sensitive quality data, and patient classification systems