Hospital administrators are essentially saying that the bad economy is coercing more nurses to stay on the job. Since some nurses’ husbands or wives have lost their jobs in other sectors, nurses are hanging on to their own jobs and delaying retirement.
But while the economy is taking a toll, the nursing shortage remains a serious problem.
To cut their budgets, most hospitals are not hiring enough nurses to adequately care for the kind of intensely sick patients that fill so many hospital beds today. These patients may not be getting the attention they need because nurses are assigned so many patients – six to eight on the day shift, and nine or maybe even more at night. (The optimal ratio is one nurse per four patients on medical-surgical units.) What’s more, hospital hiring policies are plugging the pipeline, as few hospitals are hiring newly minted registered nurses today. All over the country, they are reporting difficulty finding jobs, as hospitals seek out experienced nurses to cover the heavy patient load.
This creates a patient care Catch-22. If hospitals won’t hire new graduates, they can’t get experience. And if they can’t get experience, there will be no one left to hire when the experienced nurses leave their positions. Since the average age of a registered nurse is 47, a lot of nurses will be retiring in a few years, no matter how bad the economy is.
To make matters worse, hospitals, to save money, are not expeditiously filling positions left vacant when a registered nurse quits or retires. As one nurse manager at a major hospital in the Northeast told me, “They won’t allow us to fill a position once we know someone is leaving. We can only fill it when they’ve left. Then it can take up to a year to go through the search and paperwork to get someone in that position. So we’re working short for an entire year.” These practices are bound to produce another catastrophic nursing shortage in only a few years.
The fundamental problem is that politicians, policymakers and health-care administrators don’t seem to understand that it takes years – at least eight to 10 – to produce a truly expert nurse, the kind you really want at your bedside. Hospitals seem to think you can turn on the spigot and get hot and cold running nurses. Then, when your budget gets tight, you can turn it off and, when it’s convenient, turn it on again.
That’s the kind of magical thinking that got us into trouble in the 1990s.
Unless hospitals are forced to change their ways, there may not be anyone there to answer the buzzer. And if you’re the one ringing the buzzer, good luck.