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Nursing Shortage Examined by House Committee

The House Education and the Workforce Committee held a September 25 hearing to discuss the nursing shortage. Committee Chair John Boehner (R-OH) opened the hearing saying, “If ever an issue demonstrates the lifeblood connection between education and the workplace-this is certainly it. Nurses make up the backbone of our health care system.”

Congresswomen Sue Kelly (R-NY) and Carolyn McCarthy (D-NY) testified before the committee. “The shortage of nurses in our nation’s hospitals and the pending retirement of many RNs should be worrisome to us all,” stated Rep. Kelly, adding: “Hospitals cannot run without nurses.”

Speaking from her 30-year experience as a nurse, Rep. McCarthy urged the committee to take action. “Let’s be honest, right now we are in the middle of a national nursing shortage crisis,” she said, adding: “Of the estimated 2.5 million licensed nurses in our country, 400,000 have left the profession for other pursuits.”

Rep. McCarthy noted that women have dominated the nursing profession but that professional opportunities available to women have grown over the past 20 years, resulting in fewer women entering the field. “Many women who years ago would have gone into nursing in the past are now breaking new ground in technology, business, and politics,” she said.

Mary Foley of the American Nurses Association (ANA) stated that a recent ANA survey found that “75 percent of nurses feel that the quality of nursing care at the facility in which they work has declined over the past two years.” Additionally, the same survey revealed that nearly 55 percent of the nurses surveyed would not recommend the nursing profession as a career for their children or friends.

In offering solutions, Ms. Foley stated that acute care facilities should be required to use a “valid and reliable staffing plan based on patient acuity,” saying that the ANA supports “efforts to enact upwardly adjustable, minimum nurse to patient staff ratios in skilled nursing facilities.”

She also argued in support of eliminating madatory overtime. “Our concerns about the use of mandatory overtime are directly related to patient safety. We know that sleep loss influences several aspects of performance, leading to slowed reaction time, failure to respond when appropriate, false responses, slowed thinking, and diminished memory,” she said.

Speaking on behalf of the Service Employees International Union, AFL-CIO, Carolyn McCullough agreed, saying, “There is one step we can take today…to stop the hemorrhaging-and that’s to put a ban on mandatory overtime.”

She added that additional problems facing nurses, include the increasing difficulties in filling vacancies, understaffing, and deteriorating working conditions. George Lynn of the American Hospital Association detailed a hospital’s perspective, “Mandatory overtime is a hospital’s tool of last resort. It is expensive and unpopular, but the only alternatives would be reducing or shutting down services, which is unacceptable to us and the communities we serve.” He urged hospital administrators to use innovative recruitment and retention strategies, including flexible hours, child care assistance, relocation bonuses, pay differentials for weekend and holiday hours, more attractive benefits packages, transportation assistance, housing allowances, and competitive salaries.

Jean Bartels of the American Association of Colleges of Nursing discussed the decline in the number of students enrolling in nursing school, saying that “enrollments in entry-level baccalaureate nursing programs are down 21 percent since 1995” and that the number of nursing school graduates who took the national licensing exam decreased by 26 percent between 1995 and 2000.

Ms. Bartels urged Congress to consider long-term solutions. “While concerns about salary must be addressed, steps must also be taken to evaluate and improve the practice environment. Simultaneously, schools of nursing must be adequately funded to strengthen and expand the capacity to educate the nursing workforce for the coming century.”