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This article by Michele Alperin was prepared for the October 25,
edition of U.S. 1 Newspaper. All rights reserved.
Hiring Nurses In a Tight Market
New Jersey is facing a shortage of 14,000 registered
nurses by the year 2006, according to a forecasting model developed by
New Jersey Colleagues in Caring. "This shortage is a little different
than in the past, because it is related to the demographics of the
nurses themselves," says Catherine Cardea, director of
professional practice and quality initiatives for the New Jersey
Hospital Association. "The average age of nurses is increasing, and
they are not being replaced with younger nurses coming out of nursing
schools." Shortages are particularly evident in certain specialty
areas, like operating rooms and critical care.
Both outside economic forces and factors within the nursing
environment itself have come together to create this nursing shortage.
"The change in Medicare funding within the state has put many of the
health care agencies-both home health and hospitals-in dire straits,"
says Geri Dickson, project director of New Jersey Colleagues in
Caring. As a result, hospitals are unable to pay nurses adequately for
their services. To make things worse, the working environment of
nurses has deteriorated.
As the financial incentives in nursing have declined and the emotional
stresses have increased, women also have far wider opportunities for
employment, both within healthcare and outside. Cardea says, "In the
old days, women went into teaching or nursing. Now the sky is the
limit in terms of what women can go do."
To provide data on supply and demand forces in this nursing shortage
as well as potential solutions, the New Jersey Hospital Association
and the New Jersey Colleagues in Caring are cosponsoring a conference
entitled, "Nursing Workforce Issues: Acting Now to Shape the Future,"
on Tuesday, October 31, 8:30 a.m. to 3:30 p.m. Both Cardea and Dickson
will be speaking at the conference, which takes place at the New
Jersey Hospital Association, 760 Alexander Road. The cost is $85. Call
609-275-4113 for information.
Because the economic factors affecting nursing are not likely to
change in the short run, many of the proposed solutions to the
shortage focus on improving working conditions in order to retain
current nurses, particularly in hospitals:
"You can’t necessarily afford to pay the most money, but you can
afford to create an environment that people want to work in." For
example, the opportunity for regular staff meetings, where nurses can
express their ideas on patient care, makes them feel like their ideas
are important and valuable. To promote a range of improvements in
nurses’ working environment, the American Nurses Association has
established the magnet hospital program, which grants special status
to hospitals whose nursing departments promote the growth and
development of nurses.
Due to mergers and downsizing, support for floor nurses has
diminished, both in terms of clinical nurse specialists and staff
"Often a nurse is promoted," says Dickson, "but does not have the
necessary leadership skills. Leadership training is important in
retaining nurses. "
traditional eight-hour shifts. Possibilities include creating six-hour
shifts for nurses who want to be home for their children by 3 p.m. and
paying more to nurses who prefer to work nights and weekends.
L.P.N.’s, and R.N.’s work together to deliver patient care.
increasing violence seen in emergency rooms and hospitals.
hepatitis. Recent legislation requires hospitals to install
systems, so that nurses will not risk pricking their fingers with a
needle or IV containing contaminated blood.
systems to ensure that technology, like IV pumps, is working
correctly. "Increased technology that is not working increases
stress," says Dickson.
effect on retention of current nurses. Another contributing factor to
the current shortage, however, is the decreasing enrollment in nursing
Dickson elaborates, "Nursing schools in New Jersey have reported
declines in entry-level graduates of 12 per cent from ’97 to ’98 and
’98 to ’99." Both to recruit new nurses and to retain existing ones,
the industry is working on a marketing plan to improve the image of
nursing and to advertise changes in the working environment. For men
and women considering the nursing profession, what matters, says
Cardea, is "where the job is going to take you in terms of personal
and financial growth."
Cardea earned her R.N. degree at the Thomas Jefferson University
Hospital School of Nursing in 1970, her BSN. from Stockton State
College, and her master’s from LaSalle University. Dickson, currently
an assistant professor at the Rutgers College of Nursing, earned her
BSN (Bachelor of Science in nursing) at Alverno College in 1974, her
master’s from Marquette University, and her PhD from the University of
Dickson suggests that changes in health policy also revolve around
financial allocations that would support collaborative planning. She
would like to see legislation to establish a collaborating center for
nursing in New Jersey that will continue the work of Colleagues in
Caring. "The center would help stop the cycle of too many and too few
nurses," claims Dickson. It would monitor supply and demand to support
master planning in the state and would ensure sufficient nurses as
well as the "right type of nurse, with the right education,
competency, and specialty."
Resolving the nursing shortage will require a multi-pronged attack at
the local, state, and national levels. Planners, administrators, and
policy makers must resolve the inconsistencies between supply and
demand and improve the working environment of nurses as well as their
— Michele Alperin
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