Chatting With Chapey
by Dr. Geraldine M. Chapey
A complex and compelling issue appearing on the horizon is the severe
shortage of nurses. Locally, Peninsula Hospital and Jamaica Hospital are affected by this. This is a nationwide phenomenon which demands our attention and our best efforts. It concerns a fundamental nursing issue that is basic to our public protection.
Areas hardest hit by the nursing shortage will be the emergency rooms, labor and delivery services for newborns and their mothers and long-term care facilities. Thirty percent of the hospitals in the greater New York metropolitan area report that it takes three months or more to fill RN positions in their critical units. Statewide, in the fall of 2000, 92 percent of the hospitals reported vacant registered nurse positions in their units and 71% reported vacant LPN (licensed practical nurse) positions. What is at stake is the quality and the safety of our health care for the young, the adults and seniors.
The New York State Board of Regents is calling for a system wide review of all the factors relating to this crisis situation. Deputy Commissioner Johanna Ducan Portier of the Office of the Professions, New York State Education Department conducted a study of this statewide problem. Nursing education, recruitment, workplace, demographic and economic factors are all elements that contribute to the shortages.
Several factors cause this shortage to be different from other shortages that were projected including: the nationwide aspect of this crisis; the current perception of the nursing field; the effect of the HMO's and other price-capping measures; the opening of new professional opportunities for women; the difficult work setting and the general problem of a decreasing pool of younger people to fill these professional positions.
Attempts to address this problem will require the efforts of many groups working together. A band-aid approach will not solve the problem. It will need the cooperation of hospitals, nursing homes and other organizations where nurses are employed.
The New York Times has highlighted this issue in several articles including one on March 23, 1999 entitled "Registered Nurses (Are) In Short Supply at Hospitals Nationwide". In this most recent article it highlighted the fact that most acute-care facilities are experiencing shortages.
The National League for Nursing reports that enrollment in nursing programs is decreasing. The professional nursing and medical associations will need to work in tandem with our colleges and universities to increase their recruitment efforts. These efforts will also need to address the shortage of nursing faculty to teach in these programs. This shortage will affect the expansion of the knowledge base for nurses. In addition, the shortage of nursing faculty will curtail their involvement as leaders in the medical profession who are an integral part of shaping the health and education policy in our city, our state and in the nation.
The nursing crisis is even more dramatic because of our demographic shift - currently one in nine persons in the U.S. is retired - but by the year 2025 one in three persons will be retired. This will increase our need for nursing professionals who can guide people to live healthier and more productive lives.