So far, we’ve simply been unable torecruit, train, and place new nurses at the same rate that our veteran nurses are retiring or moving on to other positions.”
Aline Holmes tries to maintain a hopeful tone, but it isn’t easy. The United States is in the midst of a nursing shortage, and New Jersey is in the thick of it. A registered-nurse vacancy rate of 10 percent is generally considered critical; in 2004 the New Jersey Collaborating Center for Nursing reported a vacancy rate of 14 percent. The NJCCN estimates that by 2020 half the nursing jobs in the state could be unfilled.
In most businesses, the normal rules of supply and demand apply. Holmes, a registered nurse and senior vice president of clinical affairs for the New Jersey Hospital Association, says nursing is different. As aging baby boomers increasingly suffer the slings and arrows of declining health, the demand for nursing services obviously grows. But the supply of nurses is not keeping pace.As a result, the existing nursing corps is stressed. Many are being asked to spread their attention over a greater number of patients.
If the jobs are there—and they are—where are the people to fill them? Decades ago, career options for women were limited: teacher, secretary, nurse.
“As opportunities evolved,” says Holmes, “women enjoyed more choices of profession.” Healthcare, like law, was transformed. It’s been ages since anyone raised an eyebrow at the idea of a woman pediatrician, surgeon, radiologist, oncologist, dentist—you name it.
But stereotypes linger, at least in nursing. While the number of men entering the field has grown, the male nurse is still a rare breed. According to the U.S. Department of Labor only 8.7 percent of registered nurses in the country are men.
Nursing managers are trying tomake the best of a vexing situation. Linda Gural, president of the New Jersey State Nurses Association and an intensive-care nurse at the Community Medical Center in Toms River, says teamwork is more important than ever.Gural, a 1983 graduate of Ocean County College, says she chose nursing because of the flexibility it allowed her with her three children. To retain nurses who might otherwise leave the profession, some hospitals today offer even more flexible scheduling—fewer days per week with no night shifts, for example. That’s a departure from the past. (Though somebody, of course, is always working the night shift.)
How is the nursing shortage affecting patient care? Linda Flynn, an assistant professor at Rutgers College of Nursing, is determined to answer that question. In September she launched a study of how (or whether) nurse staffing, work environment, and safety technology affect the frequency of medication errors at seventeen New Jersey hospitals.
Anxiety, depression, and burnout— words once foreign to the field—have entered the climate, ultimately affecting patients. “We are talking about really important issues such as assessment, patient surveillance, and patient management,” Flynn says.
Yet the irony is, people who want to be nurses are being turned away. Although enrollments have increased each year since 2002, in each of the last three years more than 1,400 qualified high school and college graduates have been denied admission to New Jersey nursing programs because the schools lack the resources to educate and train them. The problem has a chicken-and-egg aspect. The schools don’t have the money to hire more faculty, but even if they did, nurses qualified to teach are in short supply and can make more money as clinicians than as academics.
“There are plenty of young people—as well as older people and men—who want to enter the nursing profession as a second career,” says Gural. “Without the faculty to teach them, we can’t produce the nurses.”