Nursing shortage by liamei12345


									Darius Brown
Margaret Reeder
Joann Rivas
Dr. Hunt
20 April 2010
                                   United States Nursing Shortage

       The United States' medical field has been suffering greatly due to a severe nursing

shortage. This suffering is even worse locally since Georgia’s nursing woes to the rest of the

nation the numbers are relatively bad. Georgia’s nursing supply ranks 42nd in the U.S., and

hospitals and nursing homes report vacancy rates as high as 15% at or above national rates. Also

one out of eleven nursing positions in Georgia is unfilled because schools don’t have the money

to expand their nursing program.

       There are several possibilities for this shortage including lack of awareness of this job

opportunity, the recession our country is currently facing, the lack of faculty to provide nurse

alumnus, the advancement of women in the working field, and the retirement of a great

percentage of workers.

       Due to the lack of awareness of the different nursing opportunities, the differences among

LPN, ADN, and BSN will be clarified. Next, Georgia, in comparison to the rest of the United

States, will be analyzed. Then several nursing shortage theories will be examined for

probability. Nursing incentives provided for schooling or for nursing will then be examined

using primary research gather from twenty nurses of the Columbus, Georgia metropolitan area.

By configuring all of the listed data, a plan will be implemented to increase the number of

American nurses.
        In the nursing field there are various types of nurses ranging from certified nursing

assistances to registered nurses. The nurse that may be least mentioned and fading rapidly is the

licensed practical nurse. An applicant must have a clean criminal record and must have

graduated from an approved twelve month practical nursing program to earn a nursing


        An LPN is a nurse who is licensed to do task-oriented duties, such as giving medication,

checking vital signs, and drawing blood, while under the supervision of a registered nurse at all

times. An LPN most commonly works in nursing homes. Since they legally need to be

supervised, they have lost their popularity in hospitals due to being more troublesome than

beneficial. The U.S Department of Labor Statistics estimates that there are 700,000 persons

employed as LPNs.

        Above licensed practical nurses are registered nurses. In order to earn this title one must

earn either an associate's degree in nursing or a bachelor's degree in nursing. Nurses who earn an

associate's degree receive a brief, two-year training for the nursing field.   These nurses usually

return to school to earn their bachelor's degree. With a BSN nurses are able to gain leadership

skills and specialize in a particular part of the medical field, and also earn $36,000 to $45,000

annually. Regardless of a two-year associate's degree or a four-year bachelor's degree, both are

considered registered nurses and must pass the National Council Licensure Exam (NCLEX) in

order to be recognized.

        Georgia’s demand for registered nurses greatly outnumbers the current supply and the

predicted supply for the future. The Georgia Board of Regents Task Force on Health Professions

Education (Rahn, 2006) identified nursing as “the most fragile and in need of attention” of all

health related professions in GA. Nearly 20,000 additional registered nurses will be needed in
Georgia by 2012; however, the current graduation rates are producing only 2/3 of Georgia’s

annual needs. This rate of graduations will produce only 12,000 additional nurses by 2012 (and

assuming all graduates will pass the NCLEX-RN exam, stay in Georgia, and work full time). In

2004-2005, the USG and DTAE programs graduated 1096 associate degree nurses and 935 BSN

nurses (2031 new RN’s for the state). HRSA Supply and Demand Projections for RNs in Georgia

indicate a supply shortfall of 37,700 RNs by 2020.

       This is very detrimental to people who are seeking medical care. A Journal of the

American Medical Association (JAMA) study on patients at hospitals implied “the odds of

patient mortality increased 7 percent for every additional patient in the average nurse’s workload

in the hospital” and “that increasing a nurse’s workload from 4 to 8 patients would be

accompanied by a 31 percent increase in patient mortality.” It concluded: “These effects imply

that, all else being equal, substantial decreases in mortality rates could result from increasing

registered nurse staffing, especially for patients who develop complications. In addition, a 2007

Health and Human Services report, prepared by the Minnesota Evidence-based Practice Center,

concluded, “Higher registered nurse staffing was associated with less hospital-related mortality,

failure to rescue, cardiac arrest, hospital acquired pneumonia, and other adverse events. Greater

registered nurse hours spent on direct patient care were associated with decreased risk of

hospital-related death and shorter lengths of stay.”

                       50000                                     RN Supply

                       45000                                     RN Demand
       A major issue contributing to the problem is an inadequate number of qualified nursing

faculties to educate the pool of potential nurses eligible for admission to Georgia nursing

programs. A total of 219 full time faculty, including deans and directors, were/will be retirement

eligible between 2007 & 2015. This represents 45% of Georgia’s experienced nursing educators.

(Goyne, 2007 Nursing Faculty Survey: Results USG, TCSG and Private Institutions of Georgia).

“The combined effect of faculty vacancies and projected retirements has the potential to reduce

the current capacity of 10,260 {according to the April 2006 survey conducted for the USG Task

Force on Health Professions} to just over 7,500 students . . . a reduction of over 2,700 students

or 26 percent.” (Morris & Nabors, 2007, p. 5).

       Georgia’s academic settings are unable to compete with better paying clinical nursing

opportunities for masters and doctorally prepared faculty. Average salary for a faculty member

with a master’s degree is $48,000; with a doctoral degree the average is $65,000 (9-month

contracts). In practice settings, average salaries for charge nurses (requiring ONLY a

baccalaureate degree or less) average between $63,000 and $78,000 annually. In practice

settings, advanced practice nurses in jobs requiring a master’s degree earn incomes in excess of

$90,000 annually ($67,500 adjusted to a 9-month equivalent).

       The gap has widened since 2007 when advanced practice nurses in jobs requiring a

master’s degree earned in excess of $80,000. The average salary for a faculty member with a

master’s degree is now $26,000 LESS than the average salary for an advanced practice nurse

with a master’s degree (both salaries adjusted to 9-month equivalents).

         The best way to increase the nursing faculty would be to increase salary to an equal or

greater pay than nurses receive in a hospital setting. This means there will need to be at least a

$20,000 increase. By doing so, nurses will be motivated to join the educational sector. In
addition to this change, there will also need to be a 20% increase in the nursing faculty. A way

to keep those considering retirement would be to create incentives, such as extra benefits or a

greater salary. Thirdly, monies will be needed to increase space to fit the increase of nursing

majors. The number of pre-nursing majors has tripled at Columbus State University. By having

funding for infrastructure and resources (e.g., simulation, skills lab equipment and space) it will

support expansion of currently accredited and approved nursing programs.

       On a student level, it would be beneficial to increase the amount of scholarships,

stipends, and service cancelable loans to nurses who desire to become nurses or nursing faculty.

Bachelors degrees, masters, and doctoral degrees will then become easier to access financially,

and Georgia will see a great increase.

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