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news
6A the university daily kansan
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wednesday,may 5,2004
NURSING: Shortage leads to more stable demand for nursing students
CONTINUED FROM PAGE 1A
"I'm not optimistic about what's in store for patients," Buerhaus said. "Healthcare could be almost rationed by the availability of nurses."
Calm under pressure
Carmine presents For Tilson, nursing is about more than pain medications or IVs. Nurses must treat the emotional needs of their patients too
People are in the ER because they're in some sort of crisis, Tilson said, and they may be as scared as they have ever been in their lives.
"You need to remember that you've seen a whole bunch of people come in with right lower-abdominal pain that very well could be appendicitis, and it's like well, it's another appendicitis for us," Tilson said. "But it that person's appendicitis, so you always have to
remember that people are afraid." Nursing is also hard physical labor. In the ER, Tilson is constantly lifting people out of cars or from wheelchairs to their beds.
hospital is sicker because you can't stay in the hospital anymore if you're not really sick. Insurance won't pay for it."
"Ithe people in our hospital are a different group of people than they were 10, 15 years ago." Tilson said. "Everybody in the
Nurses at Lawrence Memorial are assigned around four patients at a time, but those patients are in worse shape than they used to be, Tilson said.
Patients undergoing procedures such as a hysterectomy, which used to warrant a week in the hospital, are now allowed only 24 hours. Tilson said. She said recuperating patients who used to be part of a nurse's patient team would now be on the couch at home, taking care of themselves
from wheelchairs.
"Typically in a 12-hour shift, I don't sit down," Tilson said. "I'm literally on my feet for that long."
home, taking care of you "You can almost make a case that you may have been able to
This opportunity to deal with so many different types of people and situations in the ER is what attracted Steven Lee to nursing.
At any given moment, she could be responsible for monitoring the vital signs of a patient with chest pains, while teaching a teenager to walk with crutches, as a car accident victim awaits his next two milligrams of morphine. And as soon as she has discharged one of these patients and replaced the sheets on the bed, another one arrives.
attach "You go into work, and you don't know what's going to come through the door," the Olathe senior in nursing, said. "I don't like things that are repetitious, and it always forces you to think."
ber of faculty we have in the School of Nursing, which doesn't make sense in a time when we actually need more nurses," Miller said. "But that's how it works."
The University is not alone in its plight. The American Association of Colleges of Nursing reported in 2003, that U.S. nursing schools turned away 15,944 qualified applicants to entrylevel baccalaureate nursing programs. Schools do not have enough faculty, clinical sites, classroom space or money to
take care of more people as a nurse in the past because several of your people would have been pretty much self-care by the time they were here," Tilson said.
Nurses work in a highly charged environment, said Karen Miller, Dean of the School of Nursing.
"It's very different from other professions because it's touching lives in an intimate way," she said.
Many nurses burn out and leave the profession because they can't handle the stress of it anymore, compounding the shortage, Miller said.
"I know more nurses who have stepped away from nursing than who are still practicing," said Molly Mitchell, South Haven junior in nursing.
But this hasn't stopped Mitchell, or hundreds of other KU students, from pursuing a nursing degree.
Each year the KU School of Nursing admits 120 new students to its program. The school receives four applicants for every one of those 120 available slots, Miller said. But because of state-wide budget cuts, the school has been unable to grow.
"I've had to decrease the num-
Maxed out
accept all qualified candidates,
said Robert Rosseter,
director of public affairs for
the association.
Last year overall
enrollment in entry-level baccalaureate nursing programs increased 16.6 percent from the previous year, according to the association. But that's not enough new nurses to meet the demand.
In a report published in the November/December 2003 issue of Health Affairs, Buerhaus and his colleagues reported that "because the number of young RNs has decreased so dramatically over the past two decades, enrollments of young people in nursing programs would have to increase at least 40 percent annually to replace those expected to leave the work force through retirement."
Colleges are forced to turn away qualified applicants at a time when 50,000 new nurses are needed each year, said Buerhaus.
MORE FACTORS IN THE NURSING SHORTAGE
"Congress has been painfully inadequate in dealing with this problem," Buerhaus said. "They need to allocate some serious dollars to really address the issue of nursing education."
Nursing the public's opinion
By the year 2020, it is estimated that the United States will be short more than 800,000 registered nurses needed to provide patient care.
That's not the only change needed. Nursing also has an image problem. Nurses are seen as the expendable members of the healthcare system and not viewed in a professional capacity Mitchell said.
American Association of Colleges of Nursing
The average age of a working registered nurse, 43.3 years-old, is increasing at a rate of more than twice that of all other work forces in the United States. Journal of the American Medical Association
There are roughly 21,000 fewer nursing students today than there were in 1995.
— American Association of Colleges of Nursing
all other work forces in the United States
—Journal of the American Medical Association
"While we don't wear suits to work every day or make $300,000 a year, we're still professional and still important," Mitchell said.
In 1999, five percent of female college freshman and less than 0.5 percent of men identified nursing as being among their top career choices
Three out of four vacant hospital positions are for registered nurses.
sun importance. In the early '90s, potential nursing students were left with the impression that nursing was not a secure career path, Rosseter said. Hospitals downsized their staffs in response to pressure brought on by the emergence of managed care. The number of nursing school enrollees took a sizeable hit, Rossetter said. Hospitals soon realized their costly mistake, but not before the damage had been done.
American Hospital Association
"In the '90s nursing kind of got a black eye in the public opinion," Buerhaus said.
As part of its "America's Nurses: They Dare to Care" campaign, Johnson & Johnson recently conducted nationwide focus groups of children to find out why fewer young people were choosing careers in healthcare, Miller said. The company found that children get most of their information about the healthcare field from television, and especially the show ER. Although they said they enjoyed the show, Miller said the children were turned off by how difficult the character's jobs seemed to be.
Negative images of healthcare professions often start at an early age. Miller said.
Now, more new job opportunities are expected to be created for registered nurses than for any other occupation through 2012, according to the U.S. Department of Labor. But high school graduates are 35 percent less likely to go into nursing than they were 30 years ago, Buerhaure said.
"They say that they would never want to grow up to do that kind of work because it looks hard," Miller said. "The people are working 24/7, the public doesn't appreciate them, they don't even have time to go on a date—all those things that make TV great but are a twist on what is accurate about those jobs."
Lauren Bauer, Rogers, Ark., junior in nursing, said she had her own misconceptions about the field back when she was debating whether to be a doctor or a nurse. Doctors receive both higher pay and status than nurses, and she said it was a "rude awakening" to find out how highly trained nurses actually are.
nurses actually "Nurses have as much responsibility as many doctors do at times." Bauer said. "We're the ones monitoring those patients."
Having enough nurses to monitor and accurately relay patient conditions to doctors is a critical role that is beginning to garner more respect, Lee said.
"Some people view nursing as giving bed baths and the maintenance of patient's bowels," Lee said. "That's part of the job, but not all of it."
Nurses are critical to patients' survival.
"It's the kind of thing we all need to be concerned about because we're all going to be patients someday." Rosseter said.
survival. "There no longer any kind of question in the scientific community of do nurses matter," Buerhaus said. "When you have low staffing in hospitals, patients are at an increased risk for some kind of adverse outcome or complication."
It also found that every additional patient in an average hospital nurse's workload increased the risk of death in surgical patients by 7 percent.
thousands of lives could be saved each year just by having more nurses at patient bedside, according to a study in the Journal of the American Medical Association. The study found that the odds of dying for patients who undergo common surgeries increase up to 31 percent in hospitals with high nurse-to-patient ratios. The average ratio is one nurse for every four to 10 patients, depending on the hospital unit.
The shortage does have its advantages for nursing students.
"They get recruited for jobs before they're even finished with school," Miller said. "Salaries are better than they've ever been, so I think the sky's the limit for people who are entering now."
Hospitals know that they can't afford to lose potential nurses, and in an attempt to ease the shortage, many are offering students signing bonuses in
Silver lining
charge for a two-year contract. Seniors at the KU School of Nursing often hear from recruiters, especially those representing the military and rural hospitals, Lee said.
ter eventually won out.
"I live for patient contact," she said. "Even if I have to spread myself really thin; knowing that there are going to be patients depending on me will be worth it."
Lee said. Lee said he had accepted a job with the University of Kansas Hospital, which offers tuition reimbursement rather than a signing bonus. He said he thought the publicity the shortage had received affected the number of people entering the profession.
people moving around "The working conditions are getting better every year, and salaries are going up," Lee said.
satisfied with Valerie Flick, Macksville junior in nursing, she said she liked the options she had within nursing.
"I could start out in pediatrics day one, and five years down the road I could switch to something else with a relatively small amount of training." Flick said.
Flick, who decided to go to nursing school after graduating with a degree in biology from the University in spring 2002, said she saw how frustrated her friends became as they set out to find jobs.
She said she had also been comforted by the stability that accompanies nursing.
"I feel like I could go anywhere and get a job," she said.
Mitchell said she was initially hesitant to become a nurse because of what she had heard about high burnout rates. But her interest in healthcare and her need to help people feel better eventually won out.
Edited by Abby Mills
Lori Tilson took items from a sutures cart in preparation of giving a patient stitches. Tilson graduated from the KU School of Nursing and has worked in the emergency room at Lawrence Memorial Hospital for 17 years.