Nursing Shortage

Running head: THE IMPACT OF THE NURSING SHORTAGE

The Impact of the Nursing Shortage

Cori

University of Phoenix

Contemporary Issues and Health Policy

NUR 478

Deborah W. Ayers-Facilitator

Jun 21, 2006

The Impact of the Nursing Shortage

The nursing shortage has had a cyclical pattern in the United States for many years. There have been brief periods of time with too many nurses and even longer periods with too few nurses. Previous efforts to increase the nursing population have been made in the past. One such effort included the Nurse Reinvestment Act, signed into law by President Bush in 2002. This act provided loans and scholarships, public services for recruitment, and more, in an effort to alleviate the nursing shortage, the funds were distributed by Health Resources and Services Administration (HRSA). Continuous legislative efforts are being made by the ANA, AHA and other healthcare organizations. Currently, efforts to secure passage of Bills S.71 Registered Nurse Safe Staffing Act of 2005 and H.R. 1372, Quality Nursing Care Act of 2005 are being made by the ANA and their sponsors in Congress. These bills would require the development of staffing systems. With the aging of the nurses and the baby boomers, there is an increase in demand for quality healthcare. With the dawning of the shortage, nurses have to deal with an increase of legal and ethical dilemmas. Some of these issues include an increase in work load, decrease in staff, staying within the parameters of standards, abiding the codes of ethics and giving quality care. Regardless of the shortage, a nurse has a commitment to beneficence and nonmaleficence while maintaining autonomy to him or herself as well as the patient. Nurses have a professional obligation and legal duty to their patients to provide safe and competent care regardless of the current situation one faces. They must put the patient's needs before their own.

Why the cycle of the shortage in nursing? In the early to mid-90's, nurses were laid off and there was a downsizing of hospitals with a decrease need for nursing staff. This was due to the decreasing of Medicare reimbursements and the increased numbers of patients being cared for by the home care nursing agencies. Then in the later 90's, during the Clinton Administration, there was the failed healthcare reform and an increase in managed care companies, which lead to hospitals losing

money. Once again there was down sizing and a reduction in budgets for nursing. Today, there is a nursing shortage once again but the current shortage is different from the rest. "The difference is that, for the first time in the history of nursing, nurses are retiring at a faster rate than new nurses are moving into the profession" (Watson, 2002, p. 1). Recruiting and retaining new and experienced nurses is critical to the survival of the healthcare system, patient care, and safety.

Nursing leaders, such as the ANA, have been making efforts toward solving the problem. Though, there is no single solution to fix the problem in nursing and healthcare, they have taken a stand on better staffing. They are taking steps to protect the patient as well as improving the work conditions to end the shortage of nurses. In 2002, the Nurse Reinvestment Act addressed the nursing shortage by setting allowances for recruiting of new nurses and retaining the current nurses. The current Bills S. 71 and H.R. 1372 are both bills aimed at securing a staffing system. If passed, this system would increase nursing staff for a safer nurse to patient ratio. This in turn would hinder the practice of mandatory overtime on an already physically and mentally drained nurse. A Provision would be made for the nurse so as not to be forced to float to a specialty area that he or she is not qualified to give the professional care required. "The first approach is to require and hold hospitals accountable for the development and implementation of a nurse staffing plan" (American Nurses Association [ANA], 2005).

What will happen to the nurse if these bills are not passed? What legalities will the nurse face? "Law is based in an interest to control the behavior of members of society and in certain situations to offer remedy..." (Lagana, 2000, p. 13). As nurses, we are responsible for knowing the rules, regulations, statues and standards that pertain to the practice. Ignorance of the law is not an excuse nor is it an acceptable defense if one violates the law. The laws that nurses are held to are state's licensing laws, nursing standards, the Code of Ethics, Patient's Bill of Rights, and the facility's policies and procedures. The shortage is inevitable but is not an excuse to cut corners or bend the rules. "When nurses make decisions outside these guidelines, difficulties arise" (Trott, 1998, p. 38).

The facts are real, the population is getting older and so are the nurses. The new nurses, or there lack of, will