1. By: Jessica Klahm & Christine Nguyen
Nursing Shortage
By: Jessica Klahm & Christine Nguyen

2. What comes to mind when you think about, “Nursing Shortages?”
Ask the class this question and let them give their answers and reasons for a few minutes.

3. There are many reasons for nursing shortages! There is no single reason.
All those answers are valid.
There isn’t a SINGLE reason of why there is a low # of nurses around the world. Shortages could be caused by ANYTHING.
There has been a shortage in nurses for as long as we can remember.
Even as the profession of nursing grows and develops, there is still a shortage of nurses globally. Why??

4. History of Nursing Shortages
There have been shortages of nurses in this country since the 1960's
This nursing shortage, which began in 1998, not only persists but is expected to get a lot worse
Number of NCLEX takers has declined consistently since 1994
(Fackelmann, 2001)
ICN considers this global shortage of nurses a serious crisis
There have been: Shortages before todays have always resolved themselves fairly quickly.
ICN stands for The International Council of Nurses
Largest international health professional organization in the world
Considers today’s global shortage of nurses a serious crisis that continues to adversely impact health care for everyone

5. Present Nursing Shortage
Registered nurses are at the top of the list in employment growth (Fox, 2009)
Shortage is lack of filling vacant spots
The Registered Nurse Safe Staffing Act H.R 1821 (Nursing Shortage, n.d)
Committees for nurse staffing
Unit by unit placement based on several factors
Place limits on “floating nurses”
Keeps RN’s in areas they are experienced in
Cut costs
Nearly $3 billion; 4 million avoided extra stay days
Keep patients safe
Adding RN’s to unit staffing eliminate nearly ⅕ of all hospital deaths
The Registered Nurse Safe Staffing Act is a bill was sent to legislature in May of 2013
Commitiees: This bill would require hospitals to institute committees that would create unit by unit nurse staffing plans based on multiple factors such as the number of patients on the unit, severity of the patients’ conditions, experience and skill level of the RNs, and availability of support staff.
Costs: Increasing the number of RNs yields a cost savings of nearly $3 billion, which is the result of more than 4 million avoided extra stay days for adverse patient events, such as infection and bleeding occurring in the hospital
Keeping: Adding… and to reduce the relative risk of adverse patient events.

7. Future Projections Need for more nurses in the coming years
Generation of aging nurses
Aging population
Recent Healthcare Reforms
More nurses and health professionals needed
Anticipated strengthening of the economy
Aging of nurse faculty
Impacts ability of nursing schools to accommodate sufficient numbers of students
Enrollment in nursing programs would have to increase at least 40% (Nursing Shortage, n.d)
There are fewer nurses available to replace those who retire or leave for other opportunities
Expected to get a lot worse
Bureau of Labor Statistics’ Employment Projections
Employed nurses will grow from 2.74 million in 2010 to 3.45 million in 2020, an increase of 712,000 (26%) (Potera, 2009)
Need to replace 495,500 = 1.2 million by 2020 (Potera, 2009)
Need for more
The median age of nurses is 46. More than 50% of the nursing workforce is close to retirement.
America is also seeing increases in the number of people over 65. This age group has many medical and health
needs, and will put a strain on our health system.
Recent reforms
Will give millions of people access to the healthcare system
Anticipated
Recent reforms combined with an anticipated strengthening of the economy, will create a continued shortage for
nurses. When people have a higher income, they tend to go to their healthcare providers, and tend to their health
more readily
Nurse faculty
According to the American Association of Colleges of Nursing (AACN), nursing school associate professors and
assistant professors are an average age of 52 and 49 years.
Enrollment: 40% annually to replace the nurses expected to leave the workforce through retirement alone
There are: Currently, the ratio of RNs in their 40s to RNs in their 20s is four to one
Expected to get a lot worse
By 2020, there will be at least 400,000 fewer nurses available to provide care than will be needed
Bureau of Labor
RN workforce is the top occupation in terms of job growth through 2020
495,500, bringing the total number of job opening for nurses from to growth and replacements to 1.2 million by
2020

10. So what trends have we seen throughout time that has caused or influenced nursing shortages?

11. Everyone is susceptible to media influences...
Like mentioned before, what “really” is the main determinator of the nursing field?
Ask the class: “how many of you have watched a commercial promoting something and want to go out and buy it or try it too?”
Everyone, no matter if they realize it or not is influenced by the media.
And almost all of our beliefs, ideas, and perceptions are somehow influenced by social media.
Unfortunately, this is how our society is and frankly, we are more concerned about who won the voice than politics - things that actually matter.
This includes how the world views nurses which affects how many people enter the field and how governments and society supports the nursing profession.
The way society as a whole views the nursing profession makes a huge impact on the shortage of nurses.
The media alone affects how many people enter the field and how willing the government and society is to increase the nursing workforce.

12. Common Social Perception of Nurses
Nurses do the dirty work, they only clean people
Nurses have no autonomy - submissive helpers
Nurses are only and should only be females - male nurses are all “gay”
RN’s are MD wannabes (failed doctors)
Being a nurse is way too stressful
All these negative social viewings of nurses makes a huge impact on how people view nurses and the number of people who actually want to enter the field. Many people think being a nurse is a dirty job because we are tasked with cleaning, bathing, touching, and coming into contact with so many people.
Many are discouraged because they feel there is no autonomy with being a nurse.
With mostly only girls entering the nursing field, that cuts the # of people that can enter the field in half.
No one wants to be a failure - not as smart
As much as I hate to believe it, i really think the government’s decisions as well as hospital decisions are influenced by the social media as well. They don’t realize how essential nurses are to patients that they undermine them and look past the idea of increase the number of nursing jobs. Nurses influence the health of a patient more than a doctor does - nurses are with a patient the entire time.

13. This image shows the most common stereotype of an all female profession

14.
The image i liked the most was the one of what the hospital thinks - which is another big reason why there is a nursing shortage.

15. Nursing Stereotypes Male Nursing Stereotypes:
General Nursing Stereotypes:
As you can see, these are everyday shows that we watch and the stereotypes are subtly embedded within the shows.
Some of the shows were filmed recently such as the clip from glee which shows that even today those same stereotypes persist and exist.
Notice how sue clearly says “Being a female football coach is like being a male nurse, sin against nature”
In the 2nd video, the very first clip was probably filmed ages ago and even back then you can see how people thought nurses were unimportant and went around unnoticed

16. Extremely Demanding Profession
Everyone knows that nursing is one of the most stressful and demanding jobs
Although it is extremely rewarding, many cannot handle it
Stress causes many people to leave the profession
So out of all the stereotypes mentioned, this is one stereotype that most can say is actually true.
Because the jobs is known to be stressful, many try to avoid this job.
Many enter the field and end up leaving because they cannot handle it
Nurse’s stress is caused by hospitals overworking them and their peers expecting too much out of them with little appreciation.
If there were more on staff nurses, the workload would lessen, therefore lessening the stress.

17. Here’s a cartoon that represents how many nurses feel

18. Shortage of Nursing Faculty
The #1 reason why qualified students are turned away (McDermid, 2012)
The shortage of nursing school faculty is limiting the number of students able to attend nursing school
In , U.S. nursing schools denied 75,587 exceptional applicants from entering a baccalaureate and graduate level nursing program (McDermid, 2012)
Causes:
Aging population of faculty, reducing hiring of younger faculty
Lack of faculty, clinical sites, and inadequate education budget
Another major contributor to the nursing shortage is the limited number of seats in nursing programs.
There are plenty of qualified applicants that get denied from nursing school each year.
AACN officials found a study showing 1,181 faculty jobs open at 662 nursing schools.

19. Baby Boomers
The U.S. projects a massive nursing shortage as baby boomers age and the need for new health care providers grow.
Aging of Nurses
RN’s median age is 43.3 (Rosseter, 2012)
RN’s less than 30 y/o represents only 10% (Rosseter, 2012)
Besides the media, there is another major contributor to the projected spike in nursing shortage.
This new spike in needed RN’s will create one of the biggest shortages US has seen
As baby boomers begin to age and retire, they will leave the workforce and depend on the next generation to care for them.
This will cause a huge increase in the number of jobs available, further increasing the shortage.

20. This chart basically sums up the past few reasons why there has been a shortage.

21. The Effects on Nursing
Patient health and wellness is the primary goal of a nurse.
Relationship between adequate nurse-to-patient ratios and safe patient outcomes
However, that goal is not met when a hospital is short in staffed nurses.
Research shows that patients are 10% more likely to die if there is a shortage of nurses (Buerhaus, n.d.)
It is estimated that approximately 20,000 patients die a year when brought into an understaffed hospital (Buerhaus, n.d.)
Because of these media influences, it greatly diminishes the nursing field.
As a result, there are a plethora of tolls taken on nursing shortage but one of the main ones that goes against the definition of a nurse is reduced patient care.
There is less time spent with the patient and many times they are neglected.
The nurse only goes in to do what is on her work order and then leaves without thinking about what the patient needs.
Because the nurses are so busy, there is a big chance for mistakes to be made - nurses are rushing to get to patient to patient
Many times the nurses are working long hours and are fatigued which can impair their judgement, reduce their reaction speed, loose the ability to catch small details which all ultimately contribute to fatal mistakes.

23. The Effects on Nursing Ensuring sufficient staffing levels results in:
Reduce medical and medication errors
Decrease patient complications
Decrease mortality
Improve patient satisfaction
Reduce nurse fatigue
Decrease nurse burnout
Improve nurse retention and job satisfaction
RN’s have long acknowledged and continue to emphasize that staffing issues are an ongoing concern, one that influences the safety of both the patient and the nurse.

24. The Effects on Nursing
Many studies have been done on the impact that a high nurse to patient ratio paired with working overtime has on nurses
University of Pennsylvania (West, 2007)
Overworked nurses leads to inability to provide optimal nursing care
Harvard-Vanderbilt Study (West, 2007)
⅕ patients who developed serious complications after surgery died
With increase in nursing staff, approximately 75,000 patients could be saved from problems related to short staffing
Reduce the risk of complications by up to 12%
Reduce the risk of dying after surgery by 6%
Other studies and common findings
Health problems that resulted from inadequate nursing care tied to staffing shortages
Example: Overworked nurse might not have time to clean a urinary catheter frequently and the patient develops a urinary tract infection
Example: Nurse doesn't have time to turn a bedridden patient, secretions build up , moisture accumulates and patient develops bed ulcer
U of PN
A study by a team at the University of Pennsylvania suggests overwork has burned out a record number of
nurses who say they are unable to provide many aspects of essential nursing care.
Harvard-Vanderbilt Study
1/5: Records suggested that people died because an overworked nurse didn't catch a deadly problem, like
pneumonia or an infection, until it was too late

25. The Effects on Nursing
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Here is a short clip on how the shortage of nursing affects patient care.

26. The patient looks neglected - very poor health care services.
Just like the video, this picture shows that the patient is very ill, but the nurse flying by doesn’t have time and barely notices because she has another 100 patients to worry about.
The patient looks neglected - very poor health care services.
The nurse is there in body but not in mind.

27. Differing Opinions on Nursing Shortages
Many people argue that there are plenty of nurses
A survey of recent nursing grads by the National Student Nurses’ Association found that More than ⅓ of newly graduated BSN nurses cannot find a job (Nevidjon & Erickson, 2001).
“Save the Grads” program (NSNA) to help newly minted nurses find work
“We got hundreds of hundreds and hundreds of people contacting us saying we can’t find jobs, we’ve got tens and hundreds of thousands in student loans,” said Ronnie Black, a spokesman for the society.
Nurses will soon be replaced by technological advances
Graduates do not want to apply to rural areas
With the availability of experienced nurses, nurse leaders in hospitals are more cautious about employing new graduates when they do have vacancies
More than 75% of respondents said employers were filling jobs with experienced RNs, not new grads.
Many argue that there is a shortage of nurses while others say otherwise

28. Differing Opinions on Nursing Shortages
Let’s say there is an abundant amount of nursing graduates, why is there still a shortage?
WHY??
The World Runs
On Money
Taking these other viewpoints into consideration, why is there still a shortage of nurses even with the increase in BSN graduates?
The biggest reason for this is that there just isn’t enough money to hire the right amount of nurses
- No one wants to pay for more nurses, failing economy
- everything is already so expensive and everyone is knee high in debts.

29. Differing Opinions on Nursing Shortages
Many hospitals are refusing to hire new graduates mostly because they are in debt or have a low budget
Hospitals don’t have the budget to hire the number of nurses they actually need
Healthcare is becoming more and more expensive and healthcare programs are receiving less funding by both the government and public
Growing Demand
Bad economy = population puts off getting health care
Good economy = increase in demand due to ability of people to afford getting healthcare

30. Strategies to Address the Nursing Shortage
Attract new people to the profession
Recruit bright young people - especially men
Recruit “inactive” nurses
In 2000, about 12% of the nations nurses were “inactive” (Nevidjon & Erickson, 2001)
Many chose a different career or were taking a career break
Educate more nursing educators
Create incentives that will attract graduates to pursue education
Increase educator salaries
Improve nursing’s image
Educate the public about the nursing profession
Eliminate inaccurate stereotypes about nurses
Improve salaries and benefits
Changes the way the government and society views nursing – support nurses more

32. Conclusion
The 21st century nursing shortage is more severe than any other previous nursing shortages.
We must act quickly to correct it otherwise it will cause catastrophic health care issues
Many hospitals and healthcare organizations cannot function without nurses
If the shortage worsens, more and more people will be denied access to healthcare
The nursing shortage is not something to take lightly
It can greatly influence the quality of healthcare given to a patient
Many people will suffer if there aren’t enough nurses

33. References Alphabetical order
Borland, S. (2013, January 21). Shortage of nurses is 'killing thousands a year': Patients in overstretched hospitals developing fatal complications which could have been cured. Retrieved from complications-properly-monitored.html
Buerhaus, P. (n.d.). Impact of the nursing shortage on patient care. Retrieved from
Egenes, K. J. (2012). The nursing shortage in the U.S.: A historical perspective. Chart, 110(4),
Fackelmann, K. (2001, June 26). Nursing shortage imperils patients. USA Today. Retrieved from
Fox, R., & Abrahamson, K. (2009). A critical examination of the U.S. nursing shortage: contributing factors, public policy implications. Nursing Forum, 44(4), doi: /j x
Long, B. (2011). 21st century nursing shortage. Retrieved from
McDermid, F., Peters, K., Jackson, D., Daly, J. (2012). Factors contributing to the shortage of nurse faculty: A review of the literature. Nurse Education Today, 32(5). doi:
Nevidjon, B., Erickson, J. (January 31, 2001). "The Nursing Shortage: Solutions for the Short and Long Term". Online Journal of Issues in Nursing. Vol. 6 No. 1, Manuscript 4. Available
NursingShortageSolutions.aspx
Nursing Shortage. (n.d.). American nurses association. Retrieved October 1, 2013, from
Potera, C. (2009). The nursing shortage. American Journal of Nursing, 109(1). doi: /01.NAJ b
Rosseter, R. (2012, August 6). Nursing shortage. Retrieved from
West, R., Griffith, W., & Iphofen, R. (2007). A historical perspective on the nursing shortage. MEDSURG Nursing, 16(2),
Alphabetical order