COL Nurse shortage deadly

Results in patient deaths, injuries

At a time when health care problems are multiplying exponentially, the shortage of hospital nurses looms as one of the most serious crises and one of the most difficult to solve.

There are 126,000 nursing positions vacant nationwide -- 12 percent of the total -- and that figure is projected to grow to the astonishing figure of 500,000 by 2020. The trends are clear: Only 12 percent of registered nurses are under 30 and many more are leaving the profession than entering it.

It is not an abstract problem, but has a dangerous impact today. The current shortage is blamed for 24 percent of the errors or accidents that kill or injure hospital patients. That figure is based on a careful study of 1,609 deaths or injuries of patients since 1996, according to a report in The New York Times. The study was conducted by the Joint Commission on Accreditation of Healthcare Organizations.

The commission president, Dr. Dennis O'Leary, said, "We knew that some unanticipated deaths and permanent losses of function were related to inadequate numbers of nurses, but 24 percent surprised everybody."


Solutions are elusive because of powerful demographic trends. A large number of nurses are expected to retire in the next few years and hospitals have little expectation of being able to recruit enough replacements in time. In addition, the approaching retirement of the Baby Boom generation will greatly increase the number of patients needing treatment. Patients numbers also will be increased by the continued development of drugs and medical procedures that help to prolong life.

The American Hospital Association has identified a number of causes for the shortage. They include the mergers of many hospitals, costs-cutting and increasing workloads.

The accreditation commission has suggested three remedies:

Creating a higher quality program of nursing education, including a postgraduate residency program similar to that used in training doctors.

Action by the federal government to relate Medicaid and Medicare reimbursements to improvements in the quality of nursing care.

Improvement in the work environment for hospital nurses.

The last recommendation was applauded by Mary Foley, a former president of the American Nurses Association. She said nurses are doing their best but object to the long work day and mandatory overtime practices.

Obviously there are many other problems with the health care system, including double-digit increases in costs each year, escalating prices for prescription drugs and the inability of many patients to afford health insurance. However, adequate nursing care is a service to patients that is indispensable and it should not be allowed to deteriorate further.


A combined public-private program must be created to encourage more nurses to enter the profession, to set appropriate pay levels and to create a less stressful work environment. If the nurse shortage continues to grow as predicted, hospitals will have a very difficult time maintaining a safe level of operations. ;

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