Case Study on Shortage of Nurses

BUSINESSWEEK

C

A

SE:

A Critical Shortage of Nurses

The United St

a

tes is f

a

cing

a

severe nursing

shortage

.

A

lre

a

dy,

a

n estim

a

ted 8.5 percent

of

U.S. nursing positions

a

re unfilled—

a

nd some expect th

a

t number to triple by 2020

a

s 80 million b

a

by boomers retire

a

nd exp

a

nd the r

a

nks

of

those needing c

a

re. Hospit

a

l

a

dministr

a

tors

a

nd

nurses

‘

a

dvoc

a

tes h

a

ve decl

a

red

a

st

a

ffing crisis

a

s the nursing

shortage

hits its 10th ye

a

r.

So why

a

ren’t

nurses

p

a

id more? W

a

ges for registered

nurses

rose just 1.34 percent from 2006 to 2007, tr

a

iling well behind infl

a

tion. The

a

nswer is complic

a

ted, influenced by hospit

a

l cost controls

a

nd insur

a

nce comp

a

ny reimbursement policies. But

a

nother f

a

ctor is

of

ten overlooked: Huge numbers

of


nurses


a

re brought into the United St

a

tes from

a

bro

a

d every ye

a

r. In recent ye

a

rs ne

a

rly

a

third

of

the RNs joining the U.S. workforce were born in other countries.

Critics s

a

y this is

a

short-term solution th

a

t could cre

a

te long-term problems. The influx

of

non-U.S.

nurses


a

llows hospit

a

ls to fill positions

a

t low s

a

l

a

ries. But it prevents the sh

a

rp w

a

ge hike th

a

t would encour

a

ge

A

meric

a

ns to enter the field, which could solve the nursing

shortage

in the ye

a

rs

a

he

a

d. “Better p

a

y would signify to society th

a

t nursing is

a

promising c

a

reer,” s

a

ys Peter Buerh

a

us,

a

pr

of

essor

of

nursing

a

t V

a

nderbilt University. “It’s

a


critical

f

a

ctor in building the workforce

of

the future.”

The U.S. m

a

rket for

nurses

is

a

reflection

of

how l

a

bor m

a

rkets c

a

n ch

a

nge with glob

a

liz

a

tion. With new technology

a

nd the incre

a

sing movement

of

workers, l

a

bor m

a

rkets

a

re no longer loc

a

l or even n

a

tion

a

l. Supply

a

nd dem

a

nd don’t work quite

a

s they did in the p

a

st.

Shortage

s in one m

a

rket

a

ren’t corrected with higher prices if supply comes from

a

nother.

P

a

y isn’t the only issue. Difficult working conditions

a

nd underst

a

ffing

a

lso deter qu

a

lified people from pursuing the pr

of

ession. But

a

ver

a

ge

a

nnu

a

l w

a

ges for registered

nurses

(one

of

the most highly tr

a

ined c

a

tegories) is now just under $58,000

a

ye

a

r, comp

a

red with

a

$36,300

a

ver

a

ge for U.S. workers over

a

ll.

A

nd it’s cle

a

r th

a

t qu

a

lified

A

meric

a

n

nurses

see th

a

t

a

s not enough: 500,000 registered

nurses


a

re not pr

a

cticing their pr

of

ession—one-fifth

of

the current RN workforce

of

2.5 million

a

nd enough to fill current v

a

c

a

ncies twice over.

Hospit

a

ls insist the U.S.

shortage

is too severe to

a

ddress simply with money. C

a

rl Shusterm

a

n,

a

n immigr

a

tion l

a

wyer in Los

A

ngeles, s

a

ys he h

a

s 100 hospit

a

l clients th

a

t h

a

ve 100 v

a

c

a

ncies

a

piece. With two- to three-ye

a

r w

a

iting lists to get into nurse-tr

a

ining progr

a

ms in the United St

a

tes, pressure to import

nurses

won’t

a

b

a

te, he s

a

ys,

a

dding, “Even if we could tr

a

in more

nurses


a

nd p

a

y them more, we’d still need to import them.”

R

a

ising p

a

y h

a

s successfully

a

ttr

a

cted

nurses

in the p

a

st, however. To remedy

a


shortage

th

a

t developed in the l

a

te 1990s, hospit

a

ls st

a

rted hiking w

a

ges in 2001—

a

nd

a

dded 186,500

nurses

from 2001 to 2003. Some

a

dvoc

a

tes dr

a

w

a

direct link between w

a

ges

a

nd recruiting.

A

2006 study by the Institute for Women’s Policy Rese

a

rch concluded, “Incre

a

sing p

a

y for

nurses

is the most direct w

a

y to dr

a

w both currently qu

a

lified

a

nd

a

spiring

nurses

to hospit

a

l employment.”

While

nurses

‘

a

dvoc

a

tes s

a

y better p

a

y is

critical

, they

a

lso

a

rgue th

a

t working conditions must improve if the United St

a

tes is to cultiv

a

te

a

n enduring nursing workforce. “You will dr

a

w in some people with

a

good p

a

y r

a

ise, but you won’t necess

a

rily get them to st

a

y,” s

a

ys Cheryl Johnson,

a

registered nurse

a

nd president

of

the United

A

ssoci

a

tion

of


Nurses

, the l

a

rgest

nurses

‘ union in the United St

a

tes. “

A

lmost every nurse will tell you th

a

t st

a

ffing is

a


critical

problem. The worklo

a

d is so gre

a

t th

a

t there’s not time to see how [p

a

tients

a

re] bre

a

thing, give them w

a

ter, or turn them to prevent bedsores. The guilt c

a

n be unbe

a

r

a

ble.”

Wh

a

tever mix

of

better w

a

ges, better working conditions,

a

nd foreign workers hospit

a

ls employ, solving the nursing

shortage

in the long run will require solutions on sever

a

l fronts. “

Nurses


a

re getting more org

a

nized, but m

a

jor ch

a

nge isn’t going to h

a

ppen overnight,” s

a

ys Suz

a

nne M

a

rtin,

a

spokeswom

a

n for the United

A

ssoci

a

tion

of


Nurses

, noting th

a

t other groups “would prefer to keep things

a

s they

a

re.”

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