An aging nursing population, the growing need for nursing services and an insufficient number of facilities to train new nurses are coming together to create a ‘nursing crisis’, according to a recent article in The Iowa Independent. The congruence of factors will lead to dramatic shortages of nurses both in Iowa and on a national basis.
The American Health Care Association estimates the the nursing shortage will explode in coming years. Among the nursing shortage numbers predicted by the AHCA include:
- July, 2009: 116,000 vacant nursing positions in hospitals and 19,000 vacant nursing positions in long-term care facilities.
- 2010: 275,000 vacant nursing positions
- 2020: an anticipated shortage of more than 1 million nurses in hospitals and long-term care settings
The shortage of qualified nursing educators is the crux of the issue according to Dr. Rita A. Frantz, of the University of Iowa College of Nursing. “We have a national shortage of nurse faculty as well as a shortage of practicing nurses. The two are intricately intertwined. That is, without the appropriate number of nurse faculty, we can’t admit all the qualified applicants to our nursing programs.”
Unfortunately, the number of nurses in teaching positions is also expected to decline at a time when they are needed the most. At the University of Iowa, the average age of the nursing faculty is 56 years-old, and the average age of professors at the school is 59. “We’re going to have large numbers of them leaving the academic environment to retire in a fairly short period of time,” according to Frantz.
The final factor coming into play is the aging population and the inherent nursing demands placed upon it. Along with the increase in aging population comes a larger proportion of the population turning to public health coverage to pay for their care. In the case of Medicare or Medicaid, the reimbursement rates offered for many services do not cover the facilities expenses. How do facilities cope? The only way they can, by keeping nursing staff to a bare minimum.
The article does not specifically address the nursing shortage in nursing homes or other long-term settings–in these situations the nursing shortage is likely even more dire as many nursing facilities pay substantially less and demand longer hours than hospital based nursing.
Under-Staffing In Nursing Homes
Nurse shortages in nursing homes are believed to be a primary factor related to poor patient care. Although, federal regulations stipulate to minimum staffing levels, many of these requirements are insufficient for residents who may require substantial help for daily living needs. Under-staffing in nursing homes is routinely blamed for: falls, medication errors, bed sores, elopement and general neglect.
Many nursing home experts believe the the number one predictor of patient care is the number of hours spent by staff tending to residents needs per day. A great resource to find this information is the Medicare compare website where you can see how facilities rate in this area.
There is no current federal standard for the ideal nursing home staffing levels in all facilities. Nonetheless, federal laws do require nursing home must have at least one RN for at least 8 straight hours a day, 7 days a week, and either an RN or LPN/LVN on duty 24 hours per day. Individual states may have additional staffing requirements.
U.S. healthcare system pinched by nursing shortage, Reuters.com, March 8, 2009