Category Archives: Shortage of medical or nursing personnel
This is part of the November 2013 issue of Sharing Nursing's Knowledge.
More male nurses are needed to diversify the nursing workforce and help curb a looming shortage of nurses, but U.S. TV producers aren’t helping.
That’s the conclusion of a recent study of male nurse characters on televised medical dramas in the United States. Shows including Grey’s Anatomy, HawthoRNe, Mercy, Nurse Jackie, and Private Practice reinforced stereotypes, often in negative ways, about men in nursing, the study found. It was published in August in the Journal of Advanced Nursing.
“The men were often subject to questions about their choice of career, masculinity and sexuality, and their role usually reduced to that of prop, minority spokesperson, or source of comedy,” the authors write.
Men are joining the profession in increasing numbers, but negative portrayals of male nurses on television undermine efforts to recruit and retain male nurses, they add.
This is part of the December 2013 issue of Sharing Nursing's Knowledge.
“Nurse practitioners, health aides, pharmacists, dietitians, psychologists and others already care for patients in numerous ways, and their roles should expand in the future. The rise of nonphysician providers will enable more team care. Skilled health aides will monitor patients at home and alert a doctor if certain medical parameters decline. Nurses will provide wound care to diabetic patients, adjust medications like blood thinners and provide the initial management of chemotherapy side effects for cancer patients. ... Policy changes will be necessary to reach the full potential of team care. That means expanding the scope of practice laws for nurse practitioners and pharmacists to allow them to provide comprehensive primary care ... Most important, we need to change medical school curriculum to provide training in team care to take full advantage of the capabilities of nonphysicians in caring for patients.”
-- Scott Gottlieb, MD, American Enterprise Institute, and Ezekiel J. Emanuel, MD, PhD, University of Pennsylvania, No, There Won’t Be a Doctor Shortage, New York Times, December 4, 2013.
“Let me put it this way, we have over 1,200 pre-nursing students. I can only take about 108 a year. In the fall, we had over 600 applicants for 44 positions. Realistically, we are turning away people with 3.6 and 3.7 GPAs. And I think that story is playing out on CSU campuses everywhere.”
-- Dwight Sweeney, PhD, California State University, San Bernardino, Nursing Students Being Turned Away Amid Faculty Shortage in Cal State System, Los Angeles Daily News, December 1, 2013
Mirroring national trends, the California State University (CSU) system is turning away qualified nursing school applicants due to faculty shortages, reports the Los Angeles Daily News, and CSU officials fear that the situation will worsen the nurse shortage in a state that already has one of the country’s lowest numbers of nurses per capita.
This fall, CSU Long Beach had a nursing program acceptance rate of 18 percent, having received 450 applications for 82 slots. CSU Northridge had a “very highly qualified” pool of 300 applicants but could only accept 60. CSU Chico had to turn down 86 percent of its fully qualified applicants, while CSU San Marcos turned away nearly 89 percent.
“Let me put it this way, we have over 1,200 pre-nursing students,” Dwight Sweeney, interim chairman of nursing at CSU San Bernardino, told the Daily News. “I can only take about 108 a year. In the fall, we had over 600 applicants for 44 positions. Realistically, we are turning away people with 3.6 and 3.7 GPAs. And I think that story is playing out on CSU campuses everywhere.”
Foreign-educated and foreign-born health professionals play a vital role in providing patient care in this country, but strategic shifts such as changes in immigration laws may be needed to stabilize the nation’s health workforce, according to a new RAND Corporation study.
The two groups fill important gaps, particularly among primary care physicians, nurses in hospital settings, and other areas with worker shortages, according to findings published in the November issue of Health Affairs.
However, continuing to rely on foreign-educated and foreign-born health workers may reduce incentives for the nation to address problems such as the inadequate supply of primary care physicians. This, in turn, could lead to a less-stable U.S. health care workforce, researchers said.
Rural counties throughout the United States may be hardest hit by the country’s anticipated shortage of primary care physicians (PCPs), according to a new study from the WWAMI (Washington, Wyoming, Alaska, Montana, and Idaho) Rural Health Research Center at the University of Washington School of Medicine.
Researchers point to several factors that have implications for rural counties: PCPs deliver the majority of health care in those areas; a substantial percentage of primary care providers in the United States are approaching retirement age at the same time that fewer new medical school graduates are opting for primary care specialties; and demand for health care services is expected to increase as the population ages and millions gain health insurance coverage as a result of the Affordable Care Act.
The study, which used data from the American Medical Association and the American Osteopathic Association 2005 Physician Masterfiles, found a higher percentage of PCPs near retirement in rural counties than in urban ones, with the percentage increasing as the degree of rurality increased. (Physicians 56 or older in 2005 were considered to be near retirement and were the primary focus of analysis.) The 184 counties in the top 10 percent of near-retirement PCPs were characterized by lower population density and lower socioeconomic status, as measured by low education, low employment, and persistent poverty.
Staffing company AMN Healthcare has released the results of its 2013 Survey of Registered Nurses, highlighting generational differences that have implications for the imminent nursing shortage and the shape of the profession in years to come.
Among key findings, nearly 190,000 nurses may leave nursing or retire now that the economy is recovering, and nearly one in four nurses age 55 and older (23 percent) say they will change their work dramatically by retiring or pursuing work in another field.
Fewer than half the RNs with an associate degree or diploma who were surveyed say they will pursue additional education in nursing. However, younger and mid-career nurses are more likely to do so. The landmark Institute of Medicine report The Future of Nursing: Leading Change, Advancing Health, recommends that 80 percent of the nation’s nurses have BSN or higher degrees by the year 2020.
While nurses of all ages say they are very satisfied with their career choice, younger nurses (19-39) are much more positive than nurses 55 and older about the quality of nursing today. Sixty-six percent of nurses 55 and older say they believe that nursing care has generally declined.
“The younger generation is more optimistic about the profession and more receptive to the changes the industry is experiencing,” Marcia Faller, PhD, RN, chief financial officer of AMN Healthcare, told Advance for Nurses. “These are differences that health systems must understand as they work with multiple generations of nurses.”
This was the fourth annual RN survey conducted by AMN Healthcare, which emailed 101,431 surveys in April to opted-in members of NurseZone.com and RN.com. The company received 3,413 responses, reflecting a response rate of 3.36 percent. Statistical analyses were run with a 95 percent confidence threshold.
What do you think about the survey findings? Do they reflect your views about the future of nursing? Register below to leave a comment.
Michael Hochman, MD, MPH, is medical director for Innovation at AltaMed Health Services, a 43-site federally qualified health center in Southern California. He completed the Robert Wood Johnson Foundation (RWJF) Clinical Scholars program at the University of California, Los Angeles, and the U.S. Department of Veterans Affairs in 2012. While a Clinical Scholar, Hochman co-led a primary care demonstration that was published last month in JAMA Internal Medicine. He recently published, 50 Studies Every Doctor Should Know.
Primary care in the United States is at a crossroads. As health care becomes increasingly disjointed and costs continue to rise, primary care providers face increasing pressure to take charge of the health system. Indeed, we know that health care systems with more developed primary care infrastructures are more efficient and of higher quality than those with a weaker primary care foundation.
But at the same time, more and more health care professionals are shying away from careers in primary care. Not only is the work challenging (late-night phone calls, numerous tests and studies to follow up on, ever-increasing regulatory requirements), but the pay is lower than in other fields of medicine.
Human Capital News Roundup: The cost of disposable diapers, toxins in fish, fast food calories, and more.
Around the country, print, broadcast, and online media outlets are covering the groundbreaking work of Robert Wood Johnson Foundation (RWJF) leaders, scholars, fellows, alumni, and grantees. Some recent examples:
WNYC in New York City broadcast an interview with RWJF Community Health Leader Joanne Goldblum about families reusing disposable diapers due to economic hardship. Goldblum, who is founder and executive director of the National Diaper Bank Network, conducted a study that shows how the practice leads to a range of problems for families living in poverty.
When it comes to digital health and new ways to deliver care, the focus should be on the consumer and improving outcomes, not on the technology, according to experts at a recent Connected Health Symposium in Boston, Massachusetts. Mobile Health News reports that Propeller Health (formerly Asthmapolis) CEO David Van Sickle, PhD, MA, an RWJF Health & Society Scholars alumnus, pressed for greater emphasis on outcomes. Read more about Van Sickle’s work here and here.
An American Thoracic Society panel of experts, including RWJF Interdisciplinary Nursing Quality Research Initiative (INQRI) grantee Richard Mularski, MD, is calling for better care for those who suffer severe shortness of breath due to advanced lung and heart disease. The Annals of the American Thoracic Society reports that the panel recommends patients and providers develop individualized actions plans to keep episodes from becoming emergencies, Medical Xpress reports.
In the latest installment in its “Quest for Care” series that looks at the country’s shortage of health care providers, NBC News reported over the weekend on the nursing workforce. As the nation struggles to train enough nurses to care for an aging population and the influx of patients who will be newly insured because of health care reform, one thing is holding them back: a shortage of nurse faculty.
“Just as the country needs nurses the most, a shortage of professors is curbing the capacity of nursing schools to crank out graduates with advanced degrees,” the story says, citing data from the American Association of Colleges of Nursing that nursing schools are turning away tens of thousands of qualified applicants because they lack the faculty to teach them.
The College of Nursing at the University of South Carolina is turning away a few hundred students each year for that very reason, its dean, Jeanette Andrews, told NBC. Andrews, PhD, RN, is an alumna of the Robert Wood Johnson Foundation (RWJF) Executive Nurse Fellows program.
But nurse faculty are hard to find: they need advanced degrees, and leaving the field for the classroom often requires nurses to take a pay cut. Hospitals and other care settings are competing for the same skilled nurses that colleges need, experts say.
“I have five faculty positions open right now,” Andrews added. “It is really hard to find qualified, doctorally prepared faculty who are willing to relocate or to move out of a higher-paying salary in the field.”
Linda H. Aiken, PhD, FAAN, FRCN, RN, is the Claire M. Fagin Leadership Professor in Nursing, a professor of sociology, and director of the Center for Health Outcomes and Policy Research at the University of Pennsylvania School of Nursing. She conducts research on the health care workforce and quality of health care in the U.S. and globally. Aiken is a research manager supporting the Future of Nursing: Campaign for Action and a National Advisory Committee member for the Robert Wood Johnson Foundation Interdisciplinary Nursing Quality Research Initiative.
The May 16, 2013 issue of the New England Journal of Medicine features two very different examples of policy analysis on the important issue of the primary care workforce, plus a thoughtful editorial. John Iglehart, a national correspondent for the Journal and a widely acknowledged neutral and astute observer and reporter of contemporary health care, wrote an immensely valuable synthesis and integration of research and published professional opinion on the risks and rewards of expanding the role of nurse practitioners to address the perceived national shortage of primary care. Iglehart organized succinctly the themes and sources of agreement and disagreement emerging from a comprehensive review of 62 published research papers, policy reports, and professional and stakeholder opinions and positions.
In contrast, the second article by usually thoughtful polling enthusiasts seems off the mark and of questionable usefulness. How surprising is it that two-thirds of a very small sample of U.S. primary care physicians agree with the statement that primary care physicians provide a higher quality examination and consultation than nurse practitioners? Is this an example of cognitive dissonance? Nurse practitioners who are required to have a minimum of a Master’s degree have as many years of education as primary care physicians in many peer countries with better health outcomes than the U.S., which must be disconcerting to some U.S. primary care doctors.