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.

Comments

[tbone99]

The nursing shortage will not be alleviated by purely increasing graduating more nurses. as long as hospitals overload nurse patient loads, , do not pay commesurate with expertise and life and death responsibility and discard nursing know-how in favor of top down solutions to undercut what nurses need to make their jbs more tolerable .Nurses will continue to leave the profession after two or three years because the stress level is not compatible with personal health.

Every month I went to a meeting and every month at least 3-5 new regulations or paperwork requirements were added, never did I see any deleted. After a while it became impossible to accomplish 16 hours worth of work in a 12 hour day and the of course the patients took the brunt of neglect. After a while it is difficult to live with oneself when you are no longer capable of doing your job well and so many nurses move on.

[Terri Watt]

Thank you for this blog post Sen. Gillibrand. While I would encourage all indiviuals to consider this career that I have enjoyed for the last 15 years, nursing is a profession. I believe schools "dummy down" to get more people into the program. We are not helping anyone by entering indiviuals that are not able to be a nurse. While we can still do the low skill task as bedpans and changing sheets we are also leading the charge in health care today.
We need to encourage only the best and brightest to continue to lead our profession as we evolve and transition. We need to organize and prepare for what is coming over the next 10 years. Our patients and families need us now more then ever to still produce highly skilled and professional nurses not just anyone who can pass an entrance exam. Let's not take the easy way out!!

[Chaimirija]

Then you need to pay nurses as professional and not let physicians treat them poorly. As for dummies...­huh? Even two year programs are competative!

[Marie62866]

I never let a doctor treat me poorly, I put them in their place and let them know I am charting everything they tell me! I will not cover their butt!! I cover mine!

[tbone99]

Geting into nursing school is highly competitve - there are not enough slots for all the applicants - I don't think to many "dummies " are getting in.

[Marie62866]

There are a lot of dummies getting in, I assure you, I see a lot of nursing students that sit at the desk and text their friends!

[hjo4]

How about going into schools and talking to students, asking them to volunteer in hospitals and learning the nursing profession from cradle to grave (so to speak). We have many inner city youth who would jump at the chance to participate in a program like that, we don't have to look to foreign lands for others to do jobs Americans are willing and able to do with some guidance and encouragement or complain about a shortage that we have created. Something can be worked out where the students can be given credits and receive help with the entrance exams into nursing school. We have the work force it's that some elected officials can't see the forest for trees.

[Flavor]

First nurses are tired, short staffed and underpaid. like one of the other bloggers stated our country is something else because they would rather opt out a nurse from another country who can barely speak english and pay them less wages to take care of the american people. Nursing can be rewarding and should be a job one would love to do because it is a job to serve the people but because of neglect, money, understaff most of the time it burns people out. We first have to clean house and establish that the nurses are needed badly all over america.

[tbone99]

Hospitals bring in nurses from other countries because they know they won't advocate for patient care or working conditions and they will never threaten to unionize. All they want is that green card .

[floridagal2]

I've been a nurse for 30 years and will be retiring in January, 2010. Too bad. Too bad the work is so physically demanding. No help, never any help, and the patient acuity is growing it seems day by day. I'm tired. I can hardly walk by the time my 12 hours are over, and I haven't had a raise in pay in two years. That's nursing as I know it. Our managers praise us as being "angles" because we are a hospice, but there's never any money that backs up that praise.

Those are my comments.

[AngelaQuattrano]

The reason why our schools have not graduated enough nurses for years is because it is government policy to import foreign labor from third world countries to depress wages of American workers.

[medicontheedge]

STOP THE MADNESS!!
the whole "nursing shortage" is a SHAM perpetuted by the nurses themselves to manouver themselves into more power positions than they already have.
NURSES rule the ROOST IN HOSPITALS, and have great influence on every medical policy written in them.
every step they take puts nurses higher on the pedestals they have created for themselves. remember when every major hospital had a "school of nursing"? NURSES have seen to it that they no longer exist. so NOW, instead of graduating nurses who actually know one end of the bedpan from the other, college educated nurses have to be nurtured, and mentored, and precepted, for as much as a YEAR by NURSES.
so, what exactly does a BSN have over an ASN? a BIGGER PAYCHECK!
and stop the sobsister stories about the bed pans! techs and patient care aides are providing THAT care for patients now.

[floridagal2]

You are completely wrong in everything you just bloviated about. You must be a doctor ... or a CNA with a chip on your shoulder.

[medicontheedge]

no, i am not wrong, nor am i a doctor or a "cna with a chip on my shoulder". that statement sounds like you are a nurse with a holier than thou attitude.

exactly where is my statement wrong?

[Terri Watt]

There is a big difference between a BSN and ASN. We learn leadership, professionalism, directing health care, etc. BSN nurses are much better prepared to lead organizations as we do in many cases. Professional nursing is not about bed pans although as a BSN nurse I can certainly still assist a patient in this function however, I can also direct care, write processes and keep an organization on budget.

[medicontheedge]

and you make my point! you all are doing all the "leadership" and "directing" and other stuff that is not bedside nursing!

nurses have become so entrenched in controlling everything that they no longer NURSE.

[lonecrone]

That's not what I observed as a frequent patient. Those nurses and nursing technicians were overworked and badly treated. The patient load was too great and the work is backbreaking.

Yes, a lot of nursing is done by nursing technicians, who are very highly trained and can perform bedside tests, such as EKGs and blood draws as well as basic nursing care. However, they are allowed little time to take actual care of patients as they run from room to room at top speed.. They are also exploited, underpaid and under appreciated.

What they don't do is the mountain of paperwork required by pointless insurance requirements. The highly skilled, degreed nurses are expected to do that instead of what they really want to do, which is taking care of patients.

It's not the nurses who demand higher degrees, it's the hospital administration. You're barking up the wrong tree.

You nurses out there - your sisters and brothers saved my life three times this year. I salute you.

[medicontheedge]

the hospital administrators are predominantly NURSES! in my position, i have 3 levels of superiors to the hospital president. every one of these people are NURSES.

while they cry about the "shortage" they set up obstacles to getting more nurses on the floors.

and, i certainly am NOT "exploited, underpaid and under appreciated".

and the "mountain of paperwork" is also a myth, as far as nurses are concerned, anyway. what "paperwork" they are responsible for is called "charting", and it is recording medical CARE. and part of the job.

[Laura Conant]

I'm not sure what makes you an authority on the Nursing Profession. I have been a nurse for 13 years. I graduated with an Associate Degree. The institution where I practice DOES NOT discriminate against Associate Degree Nurses! NONE of my co-workers are on some sort of POWER TRIP as you imply. We are ALL dedicated individuals with two goals: Providing excellent patient care and excellent patient satifaction. I RESENT your generalized statement that nurses "Rule the Roost" in hospitals. We have a collabrative relationship with the adminstration, doctors and other member of our health care team, social services, case management, etc. I guarantee that our staff knows one end of a bedpan from the other!!! Obviously, you must not be working in an environment that respects their nursing staff OR maybe you need to find a different profession!

[smj32]

I had considered training to be a nurse, but changed my mind after learning how nurses are being imported from other countries to fill US jobs for less pay. I am looking to leave a job that I went through years of training for and is now being offshored to India. I am not going to start a new career that looks to be headed in the same direction but by a different means. Look what has happened with IT and H1b visas. Maybe the congress needs to consider this.

[Mugzi]

Excellent point! I'm sure the nursing shortage is not just isolated to NY. With healthcare reform and preventative care, we need more healthcare providers in nursing, physicians assistants, technicians - all of which earn a livable wage. JOBS!!!!!

[karela]

Nursing is a lot of responsibility and liability and the pay has traditionally been low.Hospit­al administrations and physicians have traditionally treated nurses without respect. Hospitals put tremendous pressure on nurses to work in areas that they are not trained in or proficient in and to work far more hours than they agreed to. For example, I worked in a neonatal unit. The hospital tried to force me to work a week-end in the adult intensive care. I had never worked with adults after nurses training. I didn't know adult drugs, adult equipment, adult critical care and had never worked an adult arrest code. When I refused, the hospital threatened to fire me and didn't back down until I threatened to sue them back. Other nurses who felt they couldn't afford to lose their jobs, did what they were told. This is dangerous! The combination of pay, respect, hours, liability, pressure and of course the stress of seeing people suffer and die result in nurses often changing professions. If America wants the nurses they need, then they need to admit that nursing is an important profession and worthy of being treated as such. Nursing requires a high degree of intelligence, skill, technical education and practice. Women have more choices than nurse or teacher now. We still care about patients, but we're also practical and have families to raise, often on one paycheck.

[NABNYC]

You know why people compete from kindergarten on to get into medical schools? Because it pays well, and it's got great status and benefits. Doctors are Gods, they earn obscene amounts of money, everybody thinks they're great.

But while doctors' and hospitals' and drug companies' paychecks keep going up, the income of nurses is frozen and their working conditions keep getting worse. That's because nurses are mostly women, are disrespected, and are cut out of sharing into the rather obscene amount of money made by the Medical Industry. They have more patients to handle, fewer if any aides, more work to do, frozen paychecks, bad shifts. American nurses are treated poorly to drive them out of the field. Hospitals have entire sections dedicated to bringing in foreign nurses by the boatload so they can fire the Americans get even cheaper labor to do the nursing work. Slave foreign labor means more money for the already overpaid doctors and hospital owners.

It's quite simple. Raise the pay, increase the positions available in school, pay for people to attend the school, you'll have enough RNs to serve the entire country. The Medical Industry has created this shortgage by crushing nurses, just like all other businesses in our country have been crushing all the other workers.

[VA Jill]

One thing that is seriously stupid is states having their own licensing and not being part of the Nursing Licensure Compact.. I used to be a travel nurse, but after my first assignment I stopped working in other than compact states because of the hassle and expense of obtaining all those different licenses. It's insane to allow nursing licensure to be someone's private petty fiefdom, which is exactly what it feels like. Being part of the compact enables a state to check licenses easily, enables nurses to go where there is need without a lot of hassle, and possibly even to settle in another compact state where they find they like the area and opportunity. That's what I did, moving from TN to VA after I'd worked here for awhile.

Incidentally, some of the states with the greatest needs have the most expensive and time-consuming licensing procedures. New York is one of them.

[jsalspach]

I am an RN and this is the first time I have posted here.
First, yes RN are underpaid and overworked but most of us wouldn't do anything else because there are other benefits (helping the patients and going home feeling like you've done something for someone).
Second, I just finished my Masters' degree in nursing education and can't find a teaching job that is full time and has benefits. I've worked as a nurse for almost 20 years and I would love to pass on what I see as a the best profession in the world, but I can't give up what I have at my age. Now I have sunstantial student loans to repay on top of everything else.
Third, if you want to know why healthcare is so expensive ask my collegues and myself. We spend half of our day arguing with insurance companies to get them to pay for the medications that our physicians prescribe. Why are they paying a nurse to argue with a pharmacist to second guess a doctor? Managed care means managing to never have to pay for patient care.

[LDKRN1]

First, yes RN are underpaid and overworked but most of us wouldn't do anything else because there are other benefits (helping the patients and going home feeling like you've done something for someone).

That's a farce, and a major reason why we don't get the respect we deserve. Nurses are expected to do it because it's a calling rather than a job-something we would do for nothing if only we could. Survey after survey shows many nurses are actively working to change their professions, and that a substantial number of us would not recommend the profession to our duaghters. We are dispirited and disillusioned and would CERTAINLY do something else, despite the other benefits.

I can verify it is not the pay-it is the working conditions that drive most of us from the bedside. I am a nurse with 20+ years of experience and an advanced degree who is working FT in education. I could make probably $15,000 more in a direct care role and $50,000 more in administration, but the job I have is worth the pay cut because of the quality of life it affords. Until working conditions are addressed, direct care and management will continue to be merry-go-rounds as nurses flee for jobs that offer greater quality of life and more respect.

[fran20]

Thank you for focusing on this critical health care issue Senator Gillibrand. I live in rural NY, and the small hospitals have to fight for nurses, offering signing bonuses, and trying to retain the nurses they have. It's a continual struggle. If anyone has ever been in a hospital, you know that the bulk of the care is done by nurses. Keep up the good work!

[jimsnyc]

From personal observations: Hospitals are notoriously ineffiecient. Perhaps it is regulation, perhaps it is fear of liabilitly, perhaps it is just plain bad management. Nurses are asked to make up for these inefficiencies on a moment by moment basis:
1. the machines don't stop beeping until a nurse attends to it
2. the soiled sheets don't change themselves until a nurse knows about it
3. the pain doesn't stop until the nurse can tell the doctor.
There are countless other examples, the causes may be complex, but the answer should begin with more and better compensated nurses.
"There but for the grace of God go I." Put yourself in one of the 3 scenarios above and lets see how long you would want to wait for your turn - the politics disappear.