Nurse shortage still a major work force issue in Indiana

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
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

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

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
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

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.


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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