Nursing Shortage in America
In the most basic sense, the current global nursing shortage is simply a widespread and dangerous lack of skilled nurses who are needed to care for individual patients and the population as a whole. The work of the world's estimated 12 million nurses is not well understood, even by educated members of society. But nursing is a distinct scientific field and an autonomous profession whose skilled practitioners save lives and improve patient outcomes every day in a wide variety of settings. In the Truth's view, the vast gap between what skilled nurses really do and what the public thinks they do is a fundamental factor underlying most of the more immediately apparent causes of the shortage. These causes include nurse short-staffing, poor work conditions, inadequate resources for nursing research and education, the aging nursing workforce, expanded career options for women, nursing's predominantly female nature, the increasing complexity of healthcare and care technology, and the rapidly aging populations in developed nations. Because studies have shown that an inadequate quantity of skilled nurses in clinical settings has a significant negative impact on patient outcomes, including mortality, the nursing shortage is literally taking lives, and impairing the health and wellbeing of many millions of the world's people. It is a global public health crisis. (See The Global Shortage of Registered Nurses: An Overview of Issues and Actions, International Council of Nurses (2004) ("ICN Report").)
In the 1990's, a number of factors combined to produce a nursing shortage in the United States and many other nations in the world. (See ICN Report; Suzanne Gordon, Nursing Against the Odds (2005); Dana Beth Weinberg, Code Green: Money-Driven Hospitals and the Dismantling of Nursing (2003).) During this time in the United States, some nursing positions were actually cut due to the demands of managed care, which had curtailed public and private sector insurance reimbursement rates and placed many hospitals and care facilities in difficult financial positions. Many hospital decision makers, who did not seem to understand or value nursing highly, implemented restructuring plans that had the effect of drastically increasing the workloads of individual registered nurses. Many nurses, who remain sadly underpowered in the current health system, lacked the professional resources to fight effectively against these threats to their patients and themselves. Many tasks formerly performed by nurses--tasks that enabled nurses to perform critical nursing assessments--were now performed by unlicensed assistive personnel, or not performed at all. Short-staffing and restructuring drove away many nurses who could no longer face their growing burnout and/or the realization that they could not meet their professional responsibilities to their patients. By 2005, roughly half a million U.S. registered nurses (about one-fifth of the national total) had chosen not to work in nursing. (National Sample Survey of Registered Nurses.)
