Purdue University
English Composition II – Eng 105
Fall 1988, Dr. Bolduc
Grade: (B+)
Nursing Shortage
There is a severe nationwide nursing shortage today. Staffing is so poor in critical care units that patients’ lives are at risk. Hospitals have had to resort to using nurses from temporary agencies; they have to pay about four times a staff nurse’s salary for an agency nurse; the agency nurse gets one and a half to two times what a staff nurse gets. At Loyola university hospital, for example, it would not be unusual to find one staff nurse and 6 agency nurses in a critical care unit.
A nationwide survey done by RN magazine showed that 90% of nurses think their patient’s lives are at risk and are dissatisfied with the care they are able to give – all due to the shortage.
Nursing school enrollments are down drastically across the country; Northwestern University closed its nursing program due to a lack of enrollments; the University of Illinois had only eight students starting out this September. A college freshman today could earn more money majoring in almost any other field, so why get a bachelor’s in nursing? This leaves the immediate future without much hope for new nurses. For the short term, there will not be any more nurses.
In the past (and present) hospitals have treated nurses like assembly line workers; they see them as easy to replace, quite dispensable, and pay them the least they can. They see nurses as easily manipulated females and take advantage of the fact that most nurses care about and are dedicated to their patients. Hospitals slowly but steadily decreased staffing budgets and thought it would be more cost-effective to only call-in help when things got desperate; this may have been cost-effective in the short term, but in the long term it is costing them a fortune; more and more nurses are working for agencies. Their thinking is as long as I must work my ass off, I may as well make the most money I can.
Nursing lacks strong leadership and unity. Nurses are very non-supportive to one another; whether this is a coping mechanism to deal with their stress and anger is up for debate. If the individual nurses on a unit are at each other’s throats, how can they unite and become a powerful constructive force to get what they want for their patients and themselves?
Nursing salaries are insulting when measured against the awesome responsibilities they have. There are no rewards for giving TLC (tender loving care), it is expected that a nurse gets into a patient’s room and does only what she has to do so she can get on to the next one. This so-called efficiency will keep them from getting in trouble for running into overtime.
Hospitals have salary ceilings. It does not pay for a nurse to stay at a hospital for more than 5 years because she will only get cost of living raises after that time. A nurse must change jobs to get more money for the experience gained. This makes retention difficult and gets in the way of a nurse accumulating benefits.
I see two possible solutions, the first one being that nurses should run nursing. I mean total control, even the budget! Each nursing unit should decide how many nurses are needed to give safe care; the unit should then decide what if any ancillary help is needed. Nurses should obtain equipment and supplies that only they are experts on. Nurses should be involved in designing construction and reconstruction so they can set things up to fit practical needs. The nurses should at the end of the year split the profits among themselves. I am aware of a pilot study done at Lutheran General using these ideas; at the end of the first year, each nurse got a profit check for $5,000.00. The unit’s morale was up, they gladly worked overtime and helped one another. They learned (or should I say showed) how to give safe cost-effective care. The nurses and the patients won.
Since I doubt most hospitals would ever relinquish control to nurses, I think nurses should stop working for hospitals in mass. For example, all the critical care nurses in Chicago quit their hospitals and form a corporation; they hire themselves out to hospitals at a fee they set themselves. They refuse assignments that are unsafe. They are real professionals using their judgments. They split all profits equally and can write off expenses like other professional business corporations.