Barbara Blakeney, MS, APRN,BC, ANP
President
American Nurses Association
Remarks
President's Economic Forum
Waco, TX
August 13, 2002
Mr. President, Secretary Thompson and other guests, I am pleased to be here today representing the American Nurses Association. The American Nurses Association represents the interests of the nation's registered nurses. RNs comprise the largest group of health care professionals in the United States, with more than 2.2 million nurses employed in health care. Nurses literally underpin the health care system.
Nursing Shortage Overview
As we gather here today, the U.S. is experiencing a nurse staffing crisis and a growing shortage of registered nurses. In July, the Department of Health and Human Services released data confirming that a nursing shortage already exists in the United States and that it is expected to grow. According to the HHS study, in 2000, there was a shortage of 110,000 nurses (6 percent). Without changes in the system, the HHS study predicts that shortage will grow to 12 percent by the year 2010, 20 percent by 2015, and 29 percent by 2020.
Although this is not news to those of us in health care, particularly nurses, who have been struggling to maintain a basic standard of care for several years as their workload has intensified, there is an increasing body of evidence that inadequate nurse staffing is contributing to a decline in the quality of health care. Just last week, the Joint Commission on the Accreditation of Healthcare Organizations issued its report on the nursing shortage, concluding that "When there are too few nurses, patient safety is threatened and health care quality is diminished." In May, the New England Journal of Medicine published findings from a study on nurse-staffing levels and concluded that a higher proportion of hours of nursing care correlate with better patient care.
Clearly, a national nursing shortage undermines our nation's ability to provide high quality health care services, and ultimately, affects the health of the nation.
Several converging factors have fueled this shortage, making it more complex and difficult to solve than previous shortages. These factors include: an aging nurse population (the average age of nurses in our nation is 43); more career options for women; and a decline in the working conditions of nurses, leading to an exodus of nurses from hospitals, nursing homes and other health care facilities.
To make matters worse, nurses' concerns about their ability to provide safe, quality care to their patients are driving some to leave the profession. This exacerbates a vicious cycle. When there are too few nurses to deliver quality care, nurses experience high stress and low job satisfaction – leading to burnout, high turnover rates and in some cases, to leave nursing altogether. These conditions discourage young people from considering nursing as a career choice, thereby further reducing the number of people in the pipeline who will be available to replace the cohort of nurses who will reach retirement age in the next 10-20 years.
Of greatest concern to the public, of course, is that the shortage of nurses already has negatively affected access to and quality of care. According to a recent First Consulting Group survey of hospitals across the nation, shortages of nurses are causing ambulance diversions and emergency room overcrowding, increased wait times for surgery, scaled back or discontinued patient-care programs, delayed discharges and canceled surgeries. In addition, the JCAHO report found that nearly 25 percent of the unanticipated complications that resulted in death or injury to hospital patients arose from the nursing shortage.
These factors underscore a need to act now – to bolster nursing recruitment and retention – in order to ensure future high-quality health care services. Today I would like to highlight two current initiatives that provide opportunities to take action to stem the shortage.
Nurse Reinvestment Act
The Nurse Reinvestment Act, legislation that supports both nurse recruitment and retention, passed Congress in July. President Bush signed it into law on August 1. Nursing appreciates the bipartisan support this important legislation received; however, in order to make the law meaningful so that it has an impact on the shortage, it must be sufficiently funded.
The measure includes provisions for federal funding for scholarships and loan repayments for nursing students who agree to work in shortage areas after they graduate. In addition, it includes funding for public service announcements aimed at promoting nursing as a career, grants to encourage facilities to implement best practices for excellence in nursing services, loan cancellations for nursing faculty and grants for geriatric care training. These are all critically important programs to resolving the nursing shortage. Therefore, the American Nurses Association is requesting that the Nurse Reinvestment Act receive $250 million in funding for FY2003. We believe this is the minimum amount needed to make a meaningful impact in terms of nurse recruitment and retention. When you consider that federal support of physician education runs in the billions of dollars, $250 million is a modest and wise investment in the nation's nursing workforce – an investment that will reap significant returns in the near future in response to increased demand for health care services by aging baby boomers.
Magnet Recognition Program
The second, and equally important initiative, is to improve working conditions for nurses – thereby ensuring that people who are recruited into nursing choose to stay in the profession. One program in particular, the American Nurses Credentialing Center's (ANCC) Magnet Recognition Program, focuses on excellence in nursing services. Currently, 56 acute care hospitals have earned Magnet recognition. Facilities designated by ANCC as "Magnets" have proven track records for retaining nurses, even during times of national shortages, because they put a high premium on nursing services.
Average nurse retention in Magnet facilities is twice as long as that of non-Magnet institutions. Furthermore, patients in Magnet facilities experience fewer negative outcomes, shorter lengths of stay, and increased satisfaction with their health care services. The Nurse Reinvestment Act provides incentives for institutions to meet Magnet criteria – thereby creating an environment that is supportive of nurses, and ultimately leading to better patient outcomes. The Magnet program has been cited in reports by the American Hospital Association, JCAHO and others as a example of an innovative program that enhances recruitment and retention of nurses at the facility level. I encourage you to learn more about the criteria that undergird the Magnet program and to look to Magnet-designated institutions as leaders in promoting high quality nursing and health care. In the near future, I believe that Magnet recognition will become the quality standard for all hospitals to meet.
Thank you
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