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

[den1953]

You may get more nurses if the lawyers would lay off the commercials about suing every nurse that works in health care field there are TV ads virtually every 2 minutes about any person that had basically any ailment can get money!

[koppenberg]

I'm sure you've got a ready link to a study showing that the reason people don't get into nursing or leave nursing is fear of being sued. It can't be low pay and poor working conditions/hours.

Or a study showing that tort reform in various states has had any impact on malpractice insurance rates as opposed to stock market fluctuation.

Let's see the free market health care system put its money where its mouth is and address the shortage of labor by increasing wages and improving working conditions. How can it be that there's such a huge shortage, but no corresponding increase in wages?

Is it government interference suppressing nurses wages? Is it collusion by employers? Both?

[TXfemmom]

Lawsuits are not the reason nurses leave nursing. I was in the field as an Advanced Nurse Practitioner for over 25 years and NOT ONCE DID I SEE ANYONE LEAVE BECAUSE OF THAT, except for two RN's who were sued because they were drug addicted and made mistakes. THEY should have been out.

The real reason is that the hospitals refuse to have enough staffing, they require nurses in the hospitals to almost all work twelve hour shifts which is quite difficult for those with small children, and spend way too much to finance medical and residency programs in physician fields not even needed, instead of funding nursing faculty and expansion of nursing slots.

Personally, I think that every hospital should have to pay $1 for every patient seen in the ER, admitted for surgery, and for every day they spend in the hospital. All that money, with say a 50 cent fee for every patient a physician sees, should be directed to a fund to enlarge nursing programs and to give GRANTS to the students pursuing nursing degrees which would not have to be paid back if they graduate, pass their boards and practice in a hospital based program for at least the length of their training.

[dayala]

my step-daughter is a Registered Nurse on Long Island, she says she has all the shifts she can handle and then some...the shortage is tight and they need every nurse they can find.

she says the doctors come to her asking for her advice on patient diagnosis and medications...she knows more than they do...go figure.

[t9chi]

I have been a Nurse for 31 years and I have yet to hear anyone suggest raising nursing salaries and improving working conditions. Instead they bring over foreign nurses and pay them at a lower rate. I guess it's because it's a female dominant profession. I think we are as valuble as teachers but we don't get the same press.

[fairandjust]

I hear ya. Nurses in my family report similar problems.

It is ALL about the FOR-PROFIT Health Care system that we currently have. We Need REAL Health Care Reform - call your Senators - Toll Free Capitol switchboard 1-800-828-0498

We need to stop the for-profit system - and make it about good patient care and paying Nurses and Providers better.

[deviantdevil]

I've been around nurses allot for a long time. I can attest to the fact that only about 15% of RNs (and RTs) are worth any more money than they currently make, most being quite overpayed. I can also attest to the fact that there would be more RNs if the cost of the training was not so high. Nurses do not need to be degreed; They are simple technicians as are all the skills inside of hospitals. But like all things touched by the education(?) system in the United States, what use to be relatively inexpensive to do, such as educate a person to be a nurse, is now very expensive and obtusely bloated with not much to do about anything but making money for the educational system. The solution is simple; Training Hospitals (like there use be). Take away the silly requirements enacted for the sole purpose of supporting the pretension that a college or university has to be the place to get the required education to be a nurse. That is and of itself, the removing of the false requirements, would open up nursing to many more... Some who might actually turn out to be good nurses.

[plummaddie]

You couldn't be more wrong. If you want a technician, hire a nurse's aide. I wouldn't want someone with an education such as you describe for my nurse. If you knew the decision making, judgment calls, and level of responsibility that a nurse employs all shift long, you would call for MORE education, NOT less. You do not know what you are talking about.

[Cardrvr2002]

I totally agree. I don't want someone administering medications to me (or any of the other many duties of a nurse) that has not had a strong education is science.

[hellenhat]

Au contraire. Hospital trained nurses ( my sister was one) have 3 years of intense training, plus required supplemental education to keep their license. In addition to the sciences, anatomy, medicines, etc...they worked on the floor under supervision of registered nurses, doctors and their instructors. She went on to open the first intensive care unit in the hospital she worked at in Virginia and the first cardiac care unit at the hospital she worked at in Florida, became charge nurse of the unit and eventually supervisor of all ICU and CCU.

You would have considered yourself lucky indeed to have landed in one of her intensive care or cardiac care units. It is not lack of education, it is the quality and availability of the education.

[ImmanuelGoldstein]

Speaking as a former STNA I'm here to tell you that a nurse aide isn't even a technician.
Most actual technicians are at least graduates of a 2 year degree program.
There are some types of certification that are only 9 months though, if these seems confusing , it's because it is. The term 'technician' in the med field is used promiscuously to cover a wide range of types of certifications, duties ,both breadth and depth of training.
But a mere aide is little more than a specialized laborer. Aides do not due sterile procedures, perform injections or draw blood,administer drugs. Typically the STNA certification (called a CNA in most states is a paltry 80 hour intensive course. This is about 30% more hours than a single 5 credit university classroom course for one quarter.
And aides duties are pretty much providing direct physical care needs. We were specialized butlers,valets, maids (although few butlers will change your daipers for you) Virtually anything actually 'technical' or actual decisions about patient care requiring any but the most general high-school-health-class knowledge is done by a REAL technician or by an RN.
Of cours the RNs didn't really have time to do their job. Like almost everyplace, the facility I worked at

[apoyo]

You obviously have no clue what nurses are actually responsible for.

Hope when you get sick you get more than "simple technician".

[Human-Being]

A nurse literally has your life in her hands, we aren't simply technicians, we have too think on our feet every second, or you lose your life.

My nursing class started with 65 students, we graduated with 28, it was the most gruelling education I have ever had, but it prepared me for the responsibilities I have today. If you think being a nurse so simple you have no idea of what a real nurse does. God help you the day you need one and they don't get it either.

[viewfromuphere]

you don't want the nurse looking after you to know why she is doing such and such a procedure or looking for this or that lab result..

you just want some tec who can push a button...

uhh...no you don't.....

by the way RN for 20 years....

[Jeffrey Marion]

Senator, I think we also need to address the burnout rate among nurses. My wife is a surgical nurse, and spent some time as the charge nurse at her hospital. She doesn't define the crisis as a "shortage," but as a high turnover rate issue.

Nurses are supposed to be patient advocates. Unfortunately, they are fighting hospital bureaucracy, insurance bureaucracy, and their own doctors to provide the best patient care. Some nurses are unionized, and are able to fight for better working conditions, and some are not. We need to find solutions to the high turnover rate, and I think you'll find the problem sorted.

That said, I appreciate your posting and leadership on this issue.

[drkazmd65]

As a Adjunct Professor at a local community college - who last semester taught the 'zero' level course that prospective nursing students without a science background must pass in order to take Anatomy & Physiology or Microbiology in later sequence - The solution to the 'nursing shortage' needs to start quite a bit earlier than the Representative advocates.

Most of the 17 students I had in this class worked their butts off trying to learn the material. 14 of them finished the course, and 12 of them passed. In post mortem after the class, the combined staff of Adjuncts / Regular Professors teaching the course agreed on one thing.

The biggest problem isn't the students wanting to learn the material - the motivation to get a nursing degree is very high.

The biggest problem is the underwhelming science education that most of these students got during High School. They just start too low on the learning curve.

Start focusing on learning and teaching science earlier,... the problem will start to take care of itself in less than 10 years.

[drkazmd65]

Sorry,... Lost my head for a second and forgot that Ms. Gillibrand was 'Senator' - not Rep.

[llisa]

Quite true. Our requirements for science for high schoolers are abysmal. When I was teaching, I had seniors in my General Science class, the only science class they took their entire four years of high school. I am fairly sure none of those kids could have made it through a nursing program, though some may have tried.

In grade school, science is shoved aside to teach to the No Child Left Behind test. There is just no time for science. So students do not become interested in it and do not sign up for it in high school

i agree, this has got to change.

[winchestereast]

Is the Senator aware that many hospitals were for years replacing US trained nurses with cheaper foreign trained nurses - non-union, barely comprehensible english-speaking women from the phillipines, other countries - a response to ever diminishing insurance and medicare payments - ask any nursing supervisor with 20 years in the field what's been happening - and ask them about the dwindling number of physicians willing to see hospital patients, about the dwindling number of primary care physicians - board certified internists and family practice doctors are retiring and not being replaced by new physicians - every year the legislature postpones the threatened 10 or 15% pay cut for these health care providers - and enacts a 1 or 2% raise that barely keeps up with office overhead -

[schatsie]

this bringing in foreign nurses has been going on over 30 years....so much for globalization, it has restricted the nursing salaries....as some one said earlier, if we have a nursing shortage where is the increase in pay?

[FoonTheElder]

In America, there aren't many shortages of workers, there are shortages of a willingness to pay for these workers.

Employers love to talk about supply and demand when it is to their advantage, but they ignore it when it costs them money. Medical employers have been complaining about nurse shortages for decades, but they've done little to fix it. If there is such a big shortage of nurses, then the market should be paying top dollar for nurses, which will supposedly attract more and more people into the profession.

But that isn't what happens in America. The employers will keep wages as low as they can, whine about a skills shortage and claim they need to go overseas to get their workers at a low wage rate. This is just another example of the race to the bottom of the wage scale, only it is done at a higher employee skill level.

This isn't a government issue, it's a supply and demand issue where medical employers want the government to bail them out of the situation they've created. Just what we need, more big employer welfare.

[Waltfl]

Did anybody ever bother to ask why there is a nursing shortage? There are plenty of young people who'd like to become nurses, but it is not that easy. In my opinion, the shortage is mainly because our education system is a s broke as our health care system. My sister-in-law and my aunt both are nurses. They went to school 25 years ago. Both have a decent income, today. Times have changed.

Our baby sitter is finishing nursing school this August. The girl is 25 years old and will start her career with $ 90.000 in debt for student loans, despite the fact that she was always working part time, while in College. Now she has to go through clinical education, which is basically working in a hospital for free from 6 am to 2 pm and two hours riving time every day. The only reason why the girl can do this is because she lives with her parents, who are still willing and able to financially support her.

Not everybody is that lucky. Education in this country has more and more become a privilege. If we want qualified nurses, scientists and engineers, to compete with those in China and European countries, where education is mostly free, we need to change the system. But that's considered "socialist", I guess.

[larry278]

Sen Gilligrand is making it clear that she wants to stay in the US Senate. If she can get better pay for RN's & other hospital care workers, she has a chance of staying in the Senate. If nurses are paid well, more people will study nursing & become nurses. Low pay=no nurses.

[coolmaiden]

Graduating nurses won't help one lick if the places of employment are horrid or are implementing a hiring freeze. I'm fortunate to work in an academic setting where nurse/patient ratios are taken VERY seriously, but most nurses aren't. Many have to put their licenses in jeopardy by practicing at unsafe ratios, all the while fighting off manipulative/abusive patients and/or families with little or no support from management, and long, exhausting hours without uninterrupted lunch or bathroom breaks. There is no other occupation that asks so much that gives so little in return.
I know graduate nurses who can't find jobs anywhere in their states; few are willing to locate elsewhere. I believe retaining nurses is a far larger problem than educating them. This sounds like a decent start though, Senator. Please listen to us. We are tired. We are hungry. We have to go to the bathroom. None of these things matter while we're at work.

[suegar]

Brava! Too many people ignore this crucial aspect of healthcare delivery. We nurses are the actual providers of care and could be much more active in primary-preventive care if there were more NPs. Thank you, Senator.

[dkavanagh]

Sen. Gillibrand, You're missing perhaps the most important part. People don't want to work for nothing! My finance is a nurse with 20 years experience. She makes less than half of what I do as an IT Consultant. Is her job any less important? Does it require less training? Isn't she on the front lines in monitoring the health of people we care about? While the population may be aging, there are a lot of RNs not working because of poor pay. Budgets for nurses salaries continue to get cut, and fewer nurses are expected to do more, leading to poorer patient care and faster burnout, and a general lack of job satisfaction. Who wants to sign up for that? Make nursing an attractive profession and make nurses feel like we care about the invaluable service they provide. Make it a respected job and you will have your new nurses.

David

[draikow]

hear, hear

[t9chi]

Thank You David.

[lilian101]

Try comparing the historic salaries of physicians and teachers--for some reason educators are at the bottom of anyone's list. We in America love educators don't we?

[lizletzler]

Another great example of Senator Gillibrand doing what she is supposed to do, addressing the issues before us and working to make New Yokers' live better.