Health Care and Nurses and Opinion and Health Care Reform and Health Care Providers and Health Care & Life Sciences and Health Care & Insurance

Nurse shortage still a major work force issue in Indiana

November 24, 2008

What's the No. 1 "hot job" in Indiana and expected to remain so for at least a decade? As the bedrock of the United State's health care delivery framework, the nursing profession represents the top need for open health care positions across Indiana and much of the nation.

Already facing acute demand for qualified nursing professionals, Indiana's hospitals and primary care practices will see open positions for registered nurses increase by as much as 30 percent by 2014, according to the Indiana Department of Workforce Development.

Critical profession

Just how important are registered nurses to health care delivery? As Washington's Health Work Force Institute points out, hospitals "cannot function without their high skill level." Nurses serve in the critical role as the professionals most closely linked directly to patient care.

To be sure, nurses toil on the front line of any hospital or health care delivery system. To stave off a real crisis from the shortage of professionally trained nurses, dramatic transformational changes are beginning to appear.

Here's the challenge: While the aging baby boomer generation is driving up the demand for certain aspects of health care delivery v especially medical practices that require additional professional nurses — the number of new registered and specialty nurses entering the field is actually declining on a nationwide basis.

Soft skills, technical know-how

While many people often think of licensed physicians as their primary health care provider, the nurses working with them are the ones who provide minute-by-minute soft skills of emotional support and fulfill other critical needs. In addition, nurses must operate complicated medical equipment, deliver physician-ordered injections and other pharmaceuticals, and provide the bulk of inpatient monitoring.

On top of this, in today's managed care environment where hospital inpatient time is minimized, nurses remain under considerable pressure to provide complex care in a variety of high intensity short-term settings. Their job is further complicated by the fact that two invisible but nevertheless present forces effectively look over their shoulder: insurance companies and regulatory agencies.

In addition to providing critical quality care, nurses are expected to help hold up high health care standards while helping hold costs down.

Job pressure becomes even higher when open positions are not quickly filled and nurses have to double up workloads.

In short-term, the health care industry must deal with the fact that record numbers of experienced nurses are retiring or switching jobs, just as demand rises sharply. Limited admissions to nursing schools aren't really helping either, as the number of students is dependent in large measure on available qualified faculty. Many of the latter are actively out in the work force instead of being on a nursing school staff.

Changes needed

To respond to a shortage that will only become more acute, health care leaders must contemplate major changes. In the coming years, nursing tasks will change within the industry and be re-assigned, with professionals carefully creating and transitioning new roles to maintain high levels of service. Deployment of high-tech information systems and advances in medical technology will also be required to maintain high standards.

While the industry considers many of these transformational advances, what can be done in the interim, especially as some Indiana hospitals face open positions as high as 10 percent?

Registered nurses, clinical nurse specialists and nurse practitioners remain in high demand across the nation and can essentially pick wherever they want to work. To attract and retain qualified nurses, hospitals will do well to create work place distinctives that nurses want. To attract and retain nurses, providers must be open to accommodating workday changes, listening carefully and finding out what nurses value in their positions.

Deploying effective technology coupled with necessary training represents one of those distinctives. Nurses realize that they work in life-or-death situations that truly require critical information and decisions that often must be made in seconds. Providing nurses with state-of-the-art equipment and training is a highly attractive job feature.

Finally, administrators must realize and appreciate that a highly qualified nurse remains a professional who can pick up stakes and move almost anywhere they want. Online employment sites across the nation generally have many more positions open than they do applicants.

The point? Hospital executives must make sure that their nursing professionals are supported and appreciated, and truly know that they are appreciated.

The bad news is that the shortage in nursing professionals may not end until 2020. The good news is that Indiana offers numerous attractive qualities that current nursing professionals desire. Maximizing these qualities will go far in minimizing the shortage of nurses in Indiana.

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Wessic, a long-time registered nurse and nursing administrator, is vice president of nursing services at Major Hospital in Shelbyville. Views expressed here are the writer's.

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