| Registering Nurses:
Compounding Interest in the Nursing Shortage |
| A running
gag in the recent film "Meet the Parents" is that the male suitor
is a nurse. His prospective in-laws find his choice of careers somewhere
between amusing and appalling. For the higher education leaders assembled at the Ingram's industry outlook, there was nothing at all amusing about the current state of the nursing profession, a profession caught in the transition of changing gender roles in the workplace. What further troubled the administrators is that an individual institution can do little to address the underlying problems by itself. As KU Chancellor Bob Hemenway noted with some frustration, "Frankly, I'm not sure the we are the people most in control of image and conditions of that profession." The fact is that women are finding professional opportunities in previously restricted fields, and too few men are taking their place in nursing. The result is a shortfall of new nurses. This shortfall would not exist if men entered the profession at the same rate as women. But they don't, and if there are more movies like "Meet the Parents," they never will. Although the proportion of male nurses has been increasing in recent years, they still make up less than six percent of the current nursing work force. How serious is the problem? Research has shown that women graduating from high school in the latter part of the 1980s and in the 1990s were 35 percent less likely to become registered nurses (RNs) than women were as recently as the 1970s. Today, women who are interested in health care might just as well choose to become a medical doctor, a dentist, an EMT or a chiropractor. Nearly half of the students in medical school are now women, as are more than half of the students at law school. Compounding the problem, as Hemenway also noted, is the issue of managed care. Controlled, cost-cutting environments may introduce certain efficiencies into health care, but they do little to stimulate either the financial attractiveness of the nursing profession or its image. The result is a shortage of nurses at the hospitals, including the university teaching hospitals, and a shortfall of new students. "I'm very concerned about the shortage of nurses in this country," said Baker president Dan Lambert. According to Lambert, the profession is 30 percent under need, and nursing school enrollments are down six percent. "The health-care industry is calling for more help." It is not easy to find reliable data on the shortage locally. A survey done in the fourth quarter of 1999 by the local not-for-profit Health Resource Partners found 300 full-time nursing vacancies in the 12 responding hospitals. But the Kansas City area has 45 hospitals, and there does not seem to be any entity responsible for assessing the number of nurses employed or the number needed. The problem will likely get worse before it gets better. According to the Missouri State Board of Nursing, the average age of today's nurses is 48. To complicate matters, many nurses are retiring early, especially those who work in hospitals. The academic leaders assembled at the Industry Outlook have particular reason for concern because of the impact that the shortfall has on teaching institutions. "The present shortages are not only affecting patients and their families," Karen Miller, Ph.D., R.N., dean of the School of Allied Health and dean of the School of Nursing at the University of Kansas Medical Center, recently revealed to the AAMC Reporter, "they are also impacting the way academic health centers operate." Miller acknowledged that the "interdisciplinary-team approach" is compromised when vital members of that team are missing. As Miller explained, shortages in a particular area tend to disrupt "the delicate balance of the duties of academic health centers." "I talk to physicians a lot about what they can do to bolster the recruitment of nurses," she says. "Without a sufficient nursing work force, our research and practice missions are greatly compromised." Recruiting nurses, however, is not like recruiting soldiers. No one organization can make a comprehensive decision as to how or even whether such an effort should be made. Nationally, some 22 of the nation's leading nursing and health-care organizations have formed the coalition "Nurses for a Healthier Tomorrow" and launched a TV advertising campaign aimed at enhancing the image of nursing as a challenging and fulfilling career choice. But this cannot have the force or the focus of a sustained "Be all that you can be" Army campaign. Locally, no real collective, comprehensive effort has been made to recruit either nurses or nursing students. Speaking for higher education Baker's Dan Lambert noted, "I,m not sure we have addressed [recruitment] as an industry." The Industry Outlook session, however, provided a forum for this issue, the one issue not originally on the agenda that forced its way on through its very urgency. As the participants understood, universities may very well hold the key to resolving it. The fact is that hospitals will never succeed in recruiting nurses unless the universities create a sufficient pool of recruits. One real possibility, already in practice at KU, is to create distance-learning programs to attract potential students in outlying areas. KU Vice Chancellor Don Hagen readily acknowledges that the nursing shortage "pushes us in the area of innovative technology." In western Kansas, KU has strengthened its bonds with community colleges in that region to create "pipeline programs," so-called because they eventually funnel the nursing students to KU. But as Hagen and the others understood, no one institution could address the larger issues by itself. The real challenge in recruiting nursing students is not to persuade them of the virtues of a given university, but to persuade them of the virtues of the profession. As the session unfolded, participants began to sense that collective action held promise for them all. Through it, they could address nursing's image problems and possibly even fortify Kansas City's nascent position as a life sciences center. Based on closing comments by a number of participants, the session might have spurred the group to some form of collective action or at least the first steps thereto. Time will surely tell. |
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