Nurses Wanted… Autoworkers Could Do
The United States is facing a major nursing shortage that differs from those of bygone days. This new beast is borne of demographics: as baby-boomers grow older, the nurses at their bedsides are aging alongside them. It’s not only the nurses who are ripening; their teachers are too.
“We’ve had cyclical nursing shortages in this country for some time, but now we have this aging population,” explains Patricia Ford-Roegner, CEO of the American Academy of Nursing. The average age of a nurse is 48 and the average faculty member is pushing mid to late 50s. Meanwhile, “the number of nurses under 30 is extremely low compared to what it used to be.”
There are currently 2.4 million nursing jobs in this country, making nurses the largest population of healthcare workers. The nurse is the patient’s lifeline, administering medication, monitoring vital signs, staying at the bedside through the dark hours of the night. Nurses educate and counsel patients and families about coping with illness. As a patient lies naked in a crepe gown, under the cold fluorescence of an operating table, it is the nurse’s hand he squeezes in fear or pain.
Nurses are invaluable and we don’t have enough of them. Hospitals in this country are short 118,000 nurses, according to a 2006 report by the American Hospital Association, and community health centers are even more drained, says a recent article published by the Journal of the American Medical Association (JAMA).
If the present situation seems dreary, the future is downright dismal. If current trends continue, the nationwide nursing shortage will reach 1 million by 2020, according to the Health Resources and Services Administration (HRSA).
When nurses are scarce, patients suffer. Numerous studies have linked nursing shortages to increased medical errors, patient dissatisfaction, and overall inferior care. Without a sufficient supply of nurses, those who are working are burdened with heavy patient loads, longer hours, and this often means that they are working tired.
Patients are more likely to die when nurses are overworked. A recent study in JAMA found that the odds of mortality for surgical patients increased by 7% for every additional patient in the average nurse’s workload. Another study in Health Affairs estimates that 6,700 patient deaths and 4 million inpatient days could be avoided if hospitals increased their nursing staffs.
In the past, women in their 20s filled the voids left by retiring nurses, but now career opportunities for women have exploded and they are lured into other professions. Men, comprising a wee 7% of the nursing population, are not compensating for the loss. Minorities are also underrepresented. Although the population of minority nurses tripled from 1980 to 2000, these numbers lagged far behind the growing diversity of the country at large. In 2000, underrepresented minorities constituted 12% of the registered nurse population, less than half of their representation in the general population.
Recruiting youth and diversity is paramount, but simply beefing up the supply side will not heal this problem. What’s ironic about this nursing shortage is that each year, thousands of would-be nursing students are rejected by nursing schools that do not have enough spaces for students. Last year, 32,323 qualified applicants were turned away from entry-level baccalaureate programs in 449 nursing schools across the country, according to preliminary data collected by the American Association of Colleges of Nurses. Bursting at the seams, these nursing programs have reached their carrying capacity. The limiting factor: nursing faculty. No matter how many eager students pound on the doors of admissions offices, there cannot be more nurses unless there are teachers to train them.
It’s not surprising that nurses with advanced degrees don’t jump on teaching positions, because they can earn much more using their degrees in clinical settings. Jean Ann Seago, a PhD with 30 years of experience, earns an annual base salary of $76,800 as an associate professor at the University of California, San Francisco’s School of Nursing. Compare that to a starting six-figure salary for a nurse practitioner in certain clinical settings or $80,000 for a bedside nurse working the night shift.
In addition to the bottleneck created by the shortage of nursing faculty, there is also an issue of retention. Nursing is physically arduous, emotionally and intellectually taxing, and sometimes unrewarding. “The clinical nurse’s job is so demanding,” Ford-Roegner explains, causing feet and back problems for many people. On top of the physical exhaustion from standing on one’s feet for 12 hours, nursing brings plenty of emotional tribulations.
“It’s a very thankless job,” says an emergency room nurse at New York’s Saint Vincent’s Hospital who prefers to remain anonymous. “Sometimes you have these little interns straight out of medical school, and I say ‘Hi, my name is [name],’ and they say ‘Hi, I’m Dr. Smith,’” not even condescending to give a first name. “I’m a professional too.”
“There is a lot of sexism between doctors and nurses” and “it’s not just hitting on, it’s hitting,” Seago says. It’s hard to fathom, but physicians sometimes “abuse nurses, yell at them, throw things.” On top of all these other problems, the whole healthcare system has changed since the mid-90s, when there was a real push to cut cost, she explains. “It really is like an assembly line. It’s not good for nurses, and it’s not good for patients.”
“In the last ten years, it’s become a business, instead of a place where you can take care of people,” the ER nurse says.
Shortages only aggravate the preexisting hardships of the job. When nurse-to-patient ratios are low, nurses are more emotionally exhausted and dissatisfied with their work and thus prone to deserting their careers. A recent JAMA study found that 43% of nurses who say they are burned out and dissatisfied with their jobs intend to leave their current position within the next year. And thus a nasty cycle perpetuates itself. Disenchanted nurses abandon the wards and clinics, and the nursing vacuum enlarges to create more work for the nurses left behind. Those nurses become disenchanted. And the loop of discontent goes on.
Can the cycle be stopped? The state of Michigan has come up with some creative and inspiring plans to solve its nursing woes. Like the rest of the country, Michigan is facing a serious nursing shortage that is only expected to worsen as baby boomers move into old age. The shortage is expected to reach 7,000 nurses by the year 2010 and 18,000 by the year 2015. The state also has an abundant supply of displaced autoworkers: assembly line workers, information technology specialists, engineers, and others. In the past five years, some 90,000 workers have been laid of by the Ford, General Motors, and Chrysler.
And who says autoworkers can’t become nurses?
Michigan educators, politicians, and policy specialists see an opportunity and they are jumping on it, creating programs to help Michigan’s displaced workers launch careers in nursing and other healthcare fields.
Hospitals and universities are launching recruitment programs and are offering free training specifically tailored to the autoworker looking to make a career change. Governor Jennifer Granholm has poured millions of dollars of federal and state funds into an accelerated healthcare training initiative, which provides fast-track professional education programs for displaced workers from the automotive and other industries.
In her recent State of the State Address, Granholm unveiled Michigan’s Nursing Corps initiative, a plan to provide training for 500 additional nursing instructors and graduate more than 3,000 additional nurses over the next three years. As part of this proposal, 200 additional slots in the accelerated nursing degree program are reserved for displaced workers.
“It does create what we call the perfect storm,” says Jeanette Klemczak, Michigan’s Chief Nursing Executive. “We have all these nursing jobs, if you will, positions that are just waiting, begging for somebody and we have these unemployed displaced workers—autoworkers and others in some other industries.”
But checking vital signs and changing IV’s is quite a switch from working on the assembly line. Les Jenkins, an information technology specialist and Michigan native who has spent his entire career working for Ford and GM, is skeptical. “I don’t know that you’re suddenly going to have a lot of people putting down their wrenches… and deciding to take up being a nurse.” But Jenkins thinks the transition would be smoother for engineers, IT workers, and administrative assistants cast aside by the auto industry.
Klemczak agrees the autoworker-to-nurse transformation is far from a breeze. Nursing is not for everyone, and many autoworkers, assembly line workers for example, may not have the basic math and science background essential for beginning a nursing training program. However, there is a palpable opportunity for engineers, IT workers, and other employees from the automotive industry who already have college degrees. Some people may be better candidates than others for these accelerated nursing degree programs, but anything is possible, Klemczak says. “We have to start somewhere.”
For those displaced workers who have pursued nursing careers, their stories are inspiring. “The hospitals love them. They are a little bit older, they’re mature workers, they sort of know how to be in the workforce,” Klemczak says. “The other neat thing about this group is, for some reason, they tend to have a much higher representation of minorities and males. In these special programs, about 18-25% of the participants, the nursing students, are minority or male.” These people “are literally and figuratively changing the face of nursing.”
Other states might take a few tips from Michigan.
Coco Ballantyne is an editorial intern at ScribeMedia.Org and is pursuing her Masters at Columbia University’s Graduate School of Journalism.
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