Crippling nursing shortage looms on the national horizon

Published Sunday, November 28, 2004 at 1:00 am
by John Johnston

The common sense physics of “what goes up must come down,” also applies to the nation’s looming nursing shortage, according to a national expert.

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Peter Buerhaus, Ph.D., a Valere Potter Professor of Nursing and senior associate dean for Research at the School of Nursing, says that the coming nursing shortage “threatens to cripple the entire health care system.”
Florida Atlantic University President Frank Brogan told the Palm Beach County Legislative Delegation this week that he is more than aware of the problem. “There’s a graying of faculty in our nation’s colleges,” he said. He specifically requested Delegation help with increasing nursing school faculty.

Up Then Down
The number of nurses will actually increase in the short-term, according to Dr. Buerhaus, “The workforce is projected to peak at a size of 2.3 million in 2012,” he said, but shrink to 2.2 million by 2020 owing to retirements.
The increase will come from promotions to encourage young persons to enter the profession. Men entering the workforce have also been growing at a steady rate over the past two decades, increasing from 5 percent in 1983 with about 60,000 RN’s in the workforce, to nearly 9 percent, or 160,000 in 2003, according to the U.S. Department of Labor.
“Both of these groups are probably responding to higher wages and opportunities in nursing driven by publicity about the nursing shortage, and many have just graduated from associate degree nursing education programs,” said Buerhaus. “The research shows older women and foreign-born women are still a factor and account for a large share of the growth.”
But these increases will not provide enough new nurses to solve the projected long-run shortage, Dr. Buerhaus added – a shortage that will total about 800,000 nurses by the year 2020, according to the Health and Resource Service Administration. “Thus a very, very large shortage still looms on the horizon – a shortage so large that it could easily cripple the entire health care system, not just hospitals,” Dr. Buerhaus warned.

Largest In Nation
“And that’s where we might be able to help,” said Pat Layton.
Layton, an RN and Executive Vice President at Medical Staffing Network (MSN), says her firm might be an uncalculated “but important” element in the upcoming shortage equation. MSN is the largest provider of per diem nurse staffing in the nation. Begun in 1998, the Boca Raton firm is now led by one of its founders, Kevin Little, who was named President and Chief operating officer in May of this year.
Layton agreed that the nation is facing a growing shortage, but said that per diem nurse staffing firms, such as MSN, offer “nurses some flexibility, without sacrificing patient care.” She explained that “many nurses, especially those over 40” need the flexibility of part-time work. “We can provide that,” she said, and in doing so, “we keep nurses available for patients.” This also provides flexibility for hospitals, she said, as it addresses fluctuating staffing needs without requiring hospitals to take on the expense of additional full-time staff.
However, such programs are only part of the solution, according to Dr. Buerhaus. He said replacing the large number of RNs born in the baby boom generation, who will retire between 2010 and 2020, will require a rapid expansion in the number of graduates from nursing education programs, “particularly from baccalaureate programs.”
“Nursing education programs will have to overcome capacity constraints in order to expand and meet the demands, which calls for decisive action and resources. Congress should fund a study to investigate the prevalence and severity of capacity constraints and determine the best ways to quickly resolve them,” he suggested.
In the meantime, Layton advised that “bedside manner” be reinforced in new nurses. “Technology will never replace that,” she said.

John Johnston can be reached at 561-893-6616, or at