Thesis on "Future of Healthcare Workers"

Thesis 6 pages (1902 words) Sources: 4 Style: APA

[EXCERPT] . . . .

Future of Healthcare Workers

Running Page: To Cope with Shortage and Diverse Consequences

The shortage of nurses has been a global phenomenon but, for the first time in the history of nursing, nurses have been retiring at a faster rate than new nurses could move in and replace them (Watson, 2002). The National Sample Survey of Registered Nurses estimated the population of licensed Registered Nurses or RNs in March 2000 at 2,696,540, 58% of whom were employed full time. The average age of nurses was 45.2 years old and only 31% of their population was under 40. Critics projected that the increase in the number of retiring RNs and the aging U.S. population would result in a greater demand for nurses in the face of a rising number of patients needing health care professionals, particularly nurses (Watson).

Thesis statement - this continuing shortage is likely to continue unless and until a major overhaul of the U.S. health care system is made.

The Shortage and the Evolving Needs

The Aging Population and Healthcare Needs

The American population is not only increasing but also aging and the population of older adults has grown faster in recent times than ever before (Watson, 2002). In the year 2000, more than four million Americans were aged 85 or older, or 43 times more than those in 1900. Because people live longer, they need long-term health care and assistance in handling chronic illnesses of older people. The issue of aging Americans has remained a priority for the U.S. Department of Health and Human Services. The Department said it would continue to focus on medication benefits, reducing payment errors and fraud, enhancing patient safety, improving preventive medicine and promoting health as a response to the situation (Watson).

The Aging Healthcare Workforce

It is not just the general American population, which is aging, but also the practicing nurses. The nursing shortage was predicted as many registered nurses reached 50 and would eventually retire (Beyea, 2002). The shortage would be most significantly felt at the operating rooms. Experts believed that registered nurses' age would increase by 3.5 more years in the next decade so that RNs would be between 50 and 69 (Benjamin, 2000) and that the trend would peak in 2007 and decline steadily thereafter. This would significantly impact the quality of patient care provided in hospitals and nursing homes throughout the country. The aging of the nursing workforce would also be distinct in the number of nurse educators who would likewise become older (Benjamin, Beyea).

The shortage of nurses and other health care professionals was most significant and acknowledged for hospital peri-operative services, which, Gallup Organization surveys revealed, averaged 1.4 unfilled full-time positions (Watson, 2002). Surveyed hospitals said that these resulted in vacancies, cancellation of elective procedures, and closure of operating rooms. The average age for peri-operative nurses was 47, indicating that there would be fewer and fewer replacements for those retiring. The current shortage is, hence, likely to continue and get worse (Watson). From a shortage of 6% in 2002, the U.S. Department of Health and Human Services predicted a 29% increase in the year 2020 (Keels, 2004). The American Association of Colleges of Nursing alone predicted that 44% of the District of Columbia would run short of registered nurses. The American Hospital Association also reported in 2001 through its publication, Trendwatch, that 75% of national hospital vacancies would be positions for nurses (Keels).

The Problem in Educating New Nurses

Another factor was the decline both in the number of nursing teachers and nursing students (Keels, 2004). Majority of these educators moved towards retirement. Nurses with doctoral degrees and qualified to teach and prepare new nurses were difficult to find. Students who finished a Bachelors degree did not tend to opt for teaching as academic goal. They felt that they could make more money by doing other things than teaching (Keels). The American Association of Colleges of Nursing said that nursing schools were said to have refused to enroll 11,000 qualified applicants throughout the U.S. In 2003 because of the lack of faculty, clinical sites and classroom space (Nevada RNnformation, 2004). Another study conducted by the Southern Regional Board of Education in February 2002 said that a combination of large faculty vacancies and newly budgeted positions account for a 12% reduction in the number of required nurse educators. The study concluded that these vacancies, resignations, projected retirements and the shortage of enrolment would sharply pose a threat on the nursing workforce in the coming years. A third survey on vacant nursing positions conducted in 2003 revealed an 8.6% increase from the 2000 survey's 7.4%. Most of the vacancies required a doctoral degree. Inadequate compensation, lack of the required master's and doctoral programs in nursing, in turn, accounted for the shortage in nursing educators. Aging educators could productively teach only for a number of years. Their median age is 51.2 and the average ages of those who held a doctorate degree were 56.6, 54.2 and 50.5 years for the ranks of professor, associate professor and assistant professor, respectively. The average for teachers with a relevant master's degree was 48.8 years. These educators were also among those aiming at retirements expected to occur throughout the U.S. In the next decade. The average retirement age for the nurse faculty was 62.5. It was projected that 200 to 300 nurse educators with a doctorate degree would become eligible for retirement from 2002 to 2012 and those with a relevant mater's degree would become eligible between 2012 and 2018, driving them away from teaching. Furthermore, higher pays were attracting nurse educators to clinical and private sector settings, which offered these. The 2003 National Salary Survey of Nurse Practitioners reported that a nurse educator with a master's degree received a salary of $60,831, while the average salary of the same nurse educator working at an emergency department would be $80,697. Lastly, current master's and doctoral programs were not attracting or producing sufficient numbers of potential or future nurse educators to meet the large and intense demand. The American Association of the College of Nursing reported in 2003 that graduations from their master's programs decreased by 2.5% and 9.9% from their doctoral programs (Nevada RNnformation).

The Problem of Working Conditions

Working conditions and environment were another factor. Nurses complained of mandatory overtime, inadequate staffing, questions and issues of morale, weak leadership and poorly trained assistant personnel (Watson, 2002). The acute shortage of RNs was noted especially in the emergency room, intensive care and the operating room. Other factors, which contributed to the shortage, included the rise of many home health care agencies, new and more convenient community settings and health care services, which brought higher salaries and greater benefits than those offered by hospitals (Brown, 2003). Research showed that the decrease in interest in the general hospital since the early 1990s was not linked with the nurses' educational level, experience or performance but with their work shift. Dr. Georges Benjamin, secretary of the Maryland Department of Health and Mental Hygiene, reported to the U.S. Senate Health, Education, Labor and Pensions Subcommittee on Aging in February 2001 that the shortage was due to insufficient nurses entering the profession, not staying in it and not happy in their jobs (Romig, 2001). The report of the Congressional Research Service suggested that it was due to a mal-distribution of labor rather than a shortage of RNs, such as poor personnel decisions. The report of the General Accounting Office said that job dissatisfaction was the root of the problem and that the dissatisfaction was, in turn, the result of inadequate staffing, heavy workloads, increased overtime, insufficient support staff members and inadequate wages (Romig).

Other Factors that Scream for Attention

Other factors are economics, consumer demands and technology. Less and less people are able to pay for health insurance and health care costs have increased to a point, which necessitated the reclassification of hospitalized people into the acutely ill and the chronically ill who can be cared for at home, at the hospice or the community center (Brown, 2003). These changes within the health care delivery system influenced nurses to change or move to other places or employments and leave the general hospitals. Nurses needed a better work environment. The emergency room was neither a safe or pleasant place to work in with people's undiagnosed illnesses and violence putting nurses' lives in peril. They also put in more than 40 hours of work per week without the appropriate support staff yet found it difficult to take scheduled leave and vacations because of the nature of their work. Consumers also demanded more educated nursing personnel who would give full attention to doctor's orders and medication and answer their questions about their health conditions (Brown).

Geraldine Bednash, a prominent nursing researcher, pointed to the long-term trend of declining interest in nursing among women today because of the emergence of a wide range of career opportunities open to them (Benjamin, 2000). More and more women have taken to careers in business, law,… READ MORE

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