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Dealing with reality: Confronting the global nursing shortage

Nurses, take the lead!

by Brenda B. Petersen

Brenda Petersen

As one who changed careers in my 30s to become a nurse, I am passionate about the profession and enthusiastic about promoting nurses and nurse education. I entered the field at the end of the last nursing shortage, when health care delivery was undergoing the radical changes associated with managed care.

As a graduate student studying the policies and politics that affect health care delivery, I chose the current nursing shortage as an issue to investigate. From my research, I learned that what affects supply and demand of nurses is well-documented in the literature—aging baby boomers, more opportunities for women who have historically filled the role of nurse, and aging nurse faculty members.

Most Americans have heard about the nursing shortage. In the years after I became a nurse, one of my hobbies has been to read the classified advertisements and assess the myriad of opportunities offered anyone possessing a license to practice as a registered nurse. Over the past 18 months, I have noticed an interesting trend.

In 2005, opening a newspaper that serves the New York-Northern New Jersey metropolitan area would yield pages of advertisements for nurses. A new graduate with no experience could easily step into a position in high acuity areas such as the neonatal intensive care unit or critical/emergency care. The words “no experience necessary” were prevalent.

Slowly, there has been a change. In 2006, I noticed fewer advertisements and, more often than not, the words “experience preferred.” Today, newspapers in my area publish few, if any, advertisements for nurses, and the majority of them stipulate “experience required.” Often, the ads specify two to three years of experience. Recently, I heard about a large suburban hospital in New Jersey that is currently fully staffed, with just enough full-time RN positions available to keep contract commitments made two years ago with nursing students graduating this year.

I tell my students that our profession has much work to do. We have not been good at projecting shortages in the past, and a cursory review reveals that most literature describing the nursing shortage was published before 2004. My RN-to-BSN students, many of whom represent the aging nurse workforce, tell me they had planned to retire, but insufficient health care and retirement benefits make it prohibitive.

To address the issue, this group of students started a small coalition to lobby state and federal legislators to fund health care and retirement programs for nurses in New Jersey. Many states have already done this for teachers and firefighters. One student said, “We have spent our careers taking care of others, and now we have nothing to ensure that we will be cared for.” Our profession has not done a good enough job of forecasting or protecting our future.

I do not believe the shortage is over, but I tell my students that now is the time for nurses to seize opportunities that abound for us. There is no question that delivery of health care in America is shifting to the community, with a focus on disease prevention and health promotion. Nurses are highly qualified to deliver this care. Americans spend billions of dollars each year for alternative therapy. Nurses need to be entrepreneurs and claim a share of that market.

Teaching good health practice is paramount to the future of our communities, nation and world, and nurses must take the lead. Although opportunities for professional nurses may fluctuate in the short term, long-term opportunities abound. To take advantage of them, nurses must unite and support each other.

I was a mature, idealistic woman and mother when I entered nursing, and I expected to find camaraderie and support in every area of the profession. As a student nurse and now a clinical instructor, I have found something quite different. The statement “they eat their young” can be found throughout the literature. I have seen unfortunate examples of this with my students in the clinical setting, and I myself have observed times when those who should be mentoring nurses new to the profession treat their “young” dreadfully. We all need to be accountable and nurture our future nurses.

There are more than 2 million nurses in the United States. I look forward to a day when we are unified and work together to provide the high quality care every human has the right to receive. We must expect nothing but the best from ourselves and from our profession and work together to improve the image of nursing.

We need to look at nontraditional ways to provide professional nurse services, based on each state’s nurse practice act. Nurses are licensed to deliver care and are valued members—indeed, the most trusted members—of the health care team. Demanding excellence of ourselves will allow the health of individuals and communities, both locally and globally, to thrive. RNL

Brenda B. Petersen, RN, MSN, CPNP, is faculty associate, Department of Family Health, at Seton Hall University College of Nursing in South Orange, New Jersey, USA.