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New York's Nursing Shortage
As Congress focuses on comprehensive health care reform, one thing needs to be clear: We cannot fix health care if we do not address America's nursing shortage. If we're going to be able to provide access to quality, affordable health care to every American - we need to have the trained health care professionals inside hospitals to provide that care.
We have a serious nursing shortage in New York State and right here in New York City. Hospitals and other health care providers are experiencing vacancies today, and over the next 10 years, we're on a path for the problem to only get worse as the need for nurses grows.
The numbers are startling. My office recently released a report showing that in New York City, we'll need 59,694 more nurses over the next 10 years to provide quality care for our families.
Part of the problem is that our nurses population is getting older. When we studied the boroughs we found that in Brooklyn and Queens, almost 19 percent of the nurses are over the age of 55 and will likely enter retirement over the next decade. But we lack a sufficient number of incoming nurses to take their place upon retirement and there is already a 7.5 percent vacancy rate across the city.
New York is not alone. Communities in every corner of America struggle to fill nursing vacancies to provide care for everyone who needs it.
According to the Center for Health Workforce Studies, New York has substantially fewer registered nurses per capita than the national average. The root of the problem is that nursing institutions just do not have the faculty and physical space available to train the nurses we need.
When my office reached out to the College of Staten Island in Staten Island, they reported that their college admits about 125 out of 400 applicants. While many applicants are not qualified, many other applicants are turned away because there is a lack of classroom space and inadequate faculty supply.
In fact, Brooklyn's own Kings County Hospital has not graduated a class of nursing students since the late 1970s. This fall will mark the first class of nursing students the institution has had in decades.
Earlier this month, I unveiled my plan to make sure we have the amount of trained nurses we need to be able to provide quality care to children and families for the long term.
First, we'll increase nursing faculty by offering 100 percent loan repayment for nurses who choose a faculty role and train the next generation of nurses.
Second, we'll provide grants to nursing institutions so they can accept more qualified students -- and we'll make sure these institutions have the space to train them.
Third, we'll incentivise nurse practitioners and other providers to work in undeserved areas. President Obama's economic recovery plan included $300 million for the National Health Service Corps to recruit more nurses. I'll continue the charge in the Senate and work for more investments, and encourage more nurses to work in areas that need new nurses the most.
And as the last step in my plan, we'll make smart, long term investments to develop a robust nursing workforce to make sure we're on a sturdy path to our health care future.
Nurses are on the front lines of our care. And they need to be at the foundation of health care reform. Let's get health care done - and done right - by ensuring the amount of nurses we need to provide quality care for all.
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nurses wages are LOW? not where I work. nurses are making great wages and benefits. as they should.
i think a lot of the crying about the hard back breaking work is a lot of whining from folks who want to see themselves workin' easy street 'cause they went to college.
please.
BE A NURSE!!!
I've been a nurse for 22 years, and I think it is a GREAT profession and I recommend it every chance I get. I worked at the bedside for 10 years--saving lives in ERs and ICUs. There is no amount of pay in the world that takes the place of actually saving a life--or holding a hand, or helping a patient safely transition to home. Yes, it is really hard physical labor, so I am glad I got my BSN right from the start, because it opened doors for me and now I work M-F facilitating clinical teams that are trying to improve care and processes at my hospital. It is interesting, stimulating, and important work that has measurably improved clinical outcomes and patient satisfaction.
You can work full time, part time, or not at all while you raise kids, you can get advanced degrees that take you away from the bedside and into totally different industries if that is what you choose. You can work in a big city or a small town. You can travel and see the country or the world. And yes, we'll never be rich but it is a decent living wage and the benefits are great.
Yes, jobs are tight right now due to the economy (people don't get elective surgeries when they don't have a job or health insurance and that is where hospitals make money) but that will (hopefully) turn around.
BE A NURSE!
I've been a nurse for thirty years and the pay has always been low, but two changes have made nursing a career I would recomment for no one. I have always worked in inpatient psychiatry. Thirty years ago I had three, four, or five patients per shift. I spent all my time with the patients and not more than an hour doing paperwork or other things at the desk. Today, I can easily have fourteen, fifteen, or sixteen patients, but the real crime is that the amount of paperwork has increased so that I spend at least four and often five hours at the desk. This is not useful paperwork; it is perfunctory, meaningless documentation of irrelevant minutiae that is demanded by the various bureaucracies like JCAHO that have had such a negative impact on nursing care. An example: I work with teenagers who are basically healthy; yet I have numerous detailed, lengthy, and irrelevant sets of questions to answer every shift about their potential to fall and their pain. I could tolerate the low pay because the work used to be rewarding, but wasting my time filling out irrelevant questionaires to satisfy some bureaucrat makes nursing a vastly less satisfying vocation. I would not recommend it to anyone.
Apparently, there must only be a shortage of experienced nurses. I have spoken to many new grads such as myself in Manhattan / Queens / Brooklyn who cannot find work in acute care regardless of our educational preparation, as hiring is frozen at several area institutions. I realize it behooves me and others in my situation to persevere given the current economic climate and consider non-traditional work settings, but how are we to gain the experience needed for open jobs (acute care, clinic, community, etc.) if no one is willing to hire us as new grads? Also, how are we to maintain the skills, abilities, and knowledge we worked so hard to attain as we wait for employers to take a chance on us? I understand that hiring new grads is costly for hospitals, in that monetary and personnel resources are needed to smooth new grads' transition from novice to competent. However, the current situation could have a potentially grim ripple effect on the profession as well as current / future shortages, as the lack of positions available to disgruntled, non-working, newly-licensed registered nurses may send the message to those considering nursing careers to reconsider their ambitions.
There is no nursing shortage that can't be fixed by better working conditions. The proof is that the shortages are in the hospitals not doctors offices , schools or clinics.
When California set a reasonable patient / nurse ratio nurses came back to the hospitals way beyond their expectations.
Part of the problem is that hospital administrations undervalue nurses and the care they provide. The simple fact of the matter is that patients are admitted to the hospital for NURSING care. Otherwise, they could be managed as outpatients. This failure to recognize the value of nurses leads to understaffing. Nurse salaries are part of the "room cost" in most cases. There is no separate billing for their services. Even Nurse Practitioners in an inpatient setting face obstacles to having their value in patient management truly seen by administration. In my particular situation, the physicians prefer to duplicate many of the services we provide, so that they can bill instead of us (our services are reimbursed for at 93% of the physician rate). But they still want us to do the admission history and physical, do the procedures, etc. We bill for only a fraction of the work we actually do. Then when we try to say we need to hire more NPs for the patient load we have to manage, we are told that we don't bring in near the revenue to pay our salaries! The last night I worked, I literally did not have time to even go to the bathroom for 16 hours. Fortunately, my fluid intake wasn't very much, and I probably sweated most of that out running from crisis to crisis. Most staff nurses look at our workload and wonder why anyone would pursue our role.
I can solve the nursing shortage pretty quick -- how about increasing their salaries?
The only "shortage" is that of nurses
willing to work long hours
with staggering patient loads
for H-1B wages...
--
One small step towards mitigating the nursing shortage would be to eliminate the requirement, in many colleges, that nursing students take the same Freshman General Chemistry class as the Chem majors. This is an unnecessary stumbling block for so many, otherwise capable, prospective nurses. I cannot name one instance in which a nurse will ever use knowledge such as Heat of Enthalpy or Oxidation Potential.
Maybe you don't understand how important chemistry is in biological processes as well as med interactions. And maybe you don't really understand that nurses do much more than physical labor.
You are talking nonsense. I worked as a nurse aide for 2 years (yeah the reason for the shortage is that the work sucks because it's so grueling due to understaffing) and nobody ever needed any knowledge of theoretical chemistry. Period. It has NOTHING to due with the job.
My doctorate in chemistry and years of experience tutoring struggling nursing students informs my opinion.
As an ICU nurse, I will tell you that basic chemistry does help me understand things like managing the acid-base balance in critically ill patients.
This is very worthwhile. Keep up the good work.
One answer would be to reopen hospital based 3year nursing schools. They have disappeared since the 70s when it was decided that nurses needed to have adegree. These students spent the majority of their time performing direct patient care, under the supervision of instructors and mentors, on all shifts, weekends, summers and all types of specialties andknew exactly what nursing was when they graduated in terms of time and committment. There are enough people out there who could become well qualified nurses this way. I The arguement is that college degrees affords nurses the opportunity to be "leaders" etc,, but college degrees would still be available for those who go into nursing just to move up to management and not everyone wants to follow that path.
The other thing that would help is have the hospitals stop forcing nurses to work 12 hour shifts. That is okay if you want to choose that option, but in lots of places, it is not an option but the only choice. I would hate to be the patient whose condition changes drastically at hour 10 of an overworked RN's shift.
And I would ask that everyone-patient, relative, visitor or doctor (especially)- take a moment during a hospital visit to say thank you to their nurse and caregivers. I could probably count on one hand the number of times that has happened to me and I have been a nurse for a LONG time. It is a small gesture but very appreciated.
Those hospital trained nurses were the best, and I'm old enough to remember them. The nurses trained at Bryn Mawr, PA, hospital were really excellent - everybody wanted them. It's a shame that nursing schools and hospitals can't see the value of hands on training.
I am a RN that was Hospital trained nursing school, I can run circles around those BSN RN's! After 15 years I am now enrolled to complete my BSN! Will not make more money and not interested in being a supervisor! I love floor nursing just hate the long hours!!!
Also give the LPN back their duties. That would help a lot.
I so agree, When I first started my nursing career I worked with LPN's and they taught me everything I know! They shaped me into the nurse I am today! Work hard, patient care and then chart!
As one who has needed to be hospitalized three times this year, I can only tell you what I observed while a patient.
I had great nurses and nursing technicians (that's what they call nurses aides these days) but there were too few. Nobody in their right mind goes into nursing. Harsh working conditions that preclude bathroom breaks and even meal breaks, take their toll. Nurses are subject to uncompensated, mandatory overtime if someone on the next shift is delayed. The work is physically demanding and emotionally draining.
Patient care is neglected as time is taken up with patient emergencies and administrative details. For instance, the current version of a bath in a hospital is a plastic bag of hot, presoaped washcloths and a skimpy towel are tossed on the bed - it's strictly do it yourself.
Our community has nurses who can't get hospital jobs. Corners are cut by exploiting the fewer nurses. Experienced nurses who have suffered physical injuries, such as bad backs and knees, are not hired in any capacity.. The patients suffer while the hospitals and insurance companies profit.
I can't find a word in this article about improving the working conditions of nurses. Maybe if they were treated better, more young people would choose nursing as a career. It's a typical solution from a typical politician.
If there is a shortage it is because many leave
Thank you for your insight from the other side of the bedrail!
Why, Senator Gillibrand, you're starting to sound just like Senator Brownback did, when two years ago he advocated lifting all visa restrictions on the nursing profession.
As a nurse working in California my take is that the "nursing shortage " is a myth perpetrated by the healthcare industry itself in order to have exactly what Brownback was advocating , no restrictions whatsoever on the flow of foreign nurses into the United States. Simple supply and demand labor economics. It's no secret that in countries like the Phillipines there are nursiing schools that train hundreds of thousands of fillipino nurses not to practice in the Phillipines but to practice in the US. Even the graduates of their schools are having difficulty finding work in the U.S. this year as the pace of layoffs in the profession quickens. According to a recent fillipino nursing journal, there are 100,000 graduates from nursing schools there, this year alone, unable to find work in the US , having assumed that they would. The nursing shortage is a myth. Nice try Senator.
Pretty much what I figured; there was supposedly one 20 years ago, too. They say the same about Medical Technologists. And the truth is, it is the working conditions that are a problem...and for medTechs, pay, too.
This post by Sen. Gillibrand is very interesting considering that many new graduates in California cannot find employment. I am a California RN, who has been looking for a hospital job for 7 months now ever since I graduated in Dec. 2008. I think part of the problem is that States have their own regulations and bureaucratic hurdles making it harder for nurses to practice in other states.
I have NEVER gotten a job through submitting to HR even if they run an ad.Hospitals save money by not hiring and overworking the staff. If you want a job - go to the unit manager , with your resume and she/he will force their hand.
I'm surprised by this post for a few reasons. While there may be a nursing shortage in other areas of our state that wasn't true of the New York City area about 18 months ago when I took a refresher class Adelphi in Garden city.
The story was the same for everyone in the room - experienced nurses who were not getting hired.
People in this class had between 10 and 18 years of experience, had to leave the profession for a few years (usually for family reasons) and when they decided to return to work found that the doors were closed.
Adelphi had hundreds of BSN graduates that year and there were only a handful of LI hospitals hiring. The ones that were had only a few positions open.
The insurance companies use the diagnosis to determine how long they will cover a person's hospital stay. So it is not the doctor, not the physical therapist its the insurance companies, Every patient the hospital nurses care for are very ill and they are sent home much too early, with drains in them, wounds that need special care, new moms still healing and with newborns to care for are pushed out the door, etc.
But all this is known - I would not recommend nursing as a profession unless the person is committed to pursuing an advanced degree and is ready to work within a system controlled by insurance companies.
other requirements if you take up nursing - the physical endurance of a bull,ability to mutitask x7 for hours at a time without food or water and live in a place with low housing costs.
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