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The Truth Behind the "Nursing Shortage"

By       Message Donna Zuk Adley     Permalink
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I have been a nurse for 20 years. I shake my head when I hear the cries regarding the nursing "shortage." Do they really know the real story?

 President Obama may have called nurses the “front lines of the health care system,” but while teachers have been on pedestals for years, nurses have been peeking in from the back door for respect and improved working conditions. Most of us cannot even join unions!

 Why is there a nursing shortage? While it may be true in some instances that many are retiring, there is another story. Many are leaving the nursing field because of the lack of respect, not just on the part of family members, but on the part of upper management, repetitive injuries, copious amounts of work at breakneck speed and the inability to ‘eat, drink, and pee merry’ on the job, as well as physical abuse and injuries from patients.

   Many jobs such as clerks and secretaries are now taken on by the nurse. In fact, nurses wear many hats the entire shift. She is not only responsible for the care of many patients, she fixes TVs, phones, cleans floors, refrigerators, unplugs sinks and toilets, runs down hallways -- and sometimes streets -- after runaway patients, referees between family members, becomes a sounding board, and many other holistic functions for family members.  New laws forbid restraints to thwart falls even among confused fall-risk patients who have no concept of safety. With no increase of staff to accompany this, a nurse finds herself doing legal paperwork simultaneously with a one-on-one with constant distractions to make sure they don’t fall. Moving the medication cart down the hallway at the same time as a patient’s wheelchair because there is no other way to make sure the patient is safe is not uncommon.

 Despite a tenfold in paperwork requirements and the aquity of care increasing, nurses are expected to do it in the same amount of hours. You will be written up if you work overtime to do it, and you will be written up if you dont do it. This paradox forces many nurses to complete their work off the clock.

  Other reasons for nurses leaving the field are the decrease in Medicaid funds causing a lag in cost of living wage increases, as well as facilities forcing nurses to take on more work. In fact, sometimes they illegally have them work more than one floor at a time as well as count them as part of the quota for nurse’s aides and use them as such at the same time as doing their nursing duties. This puts patients in danger and nursing licenses in jeopardy, as well as breaks the law. New nurses and conscionable nurses don’t put up with it and many play “job checkers” in search of the Holy Grail of decent work conditions; many new nurses leave the nursing field altogether within 4 years if not sooner.

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  In addition to injuries from patients, medication carts force you to bend up and down incorrectly from the waist. Despite the fact that the cart weighs over 1,000 pounds, frequent problems with the mobility of the cart causes many back and wrist injuries and facilities do not rush to fix them. Yet, the chances for finding weapons of mass destruction are better than OSHA coming to the workplace.

  Yet, despite all this, in some aspects, a nursing shortage is a misnomer. Overall, we have an RN shortage. Many LPNs are unemployed, but so are some RNs. Some of the shortage is self-inflicted because facilities try to cut costs, hire less and cut hours and consolidate work to the remaining staff. Facilities have the more experienced nurses train new nurses, then dispose of them so they don’t have to pay for their experience. LPN nurses do the same floor work as RNs in nursing homes, and sometimes teach them how to do certain nursing skills. They pass out medications, do treatments hanging IV’s, do admissions, and any delegated work given them by the RNs. LPNs get paid less, yet many nursing homes seek RN’s, not LPNs. 


 Hiring LPNs are cost-effective in a bad economy. Qualifications requiring RN’s and not LPNs to do certain jobs need to be revisited, especially when an LPN has years of experience. More programs need to be offered to LPNs to become RNs, and at a reduced cost, if necessary. RN programs are usually fulltime and unforgiving if one has a family. This prevents many potential students from entering if they need to be employed. These programs and instructors need to change and adapt to those who have families or have to work. Financial aid should be offered for living expenses while in school instead of just student loans. Once one is out of school, one has money to pay student loans. It is the living expenses while IN school that makes it difficult, if not impossible to attend school, study, attend facilities after school to do care plans at any given time. If a student doesn’t have to work while in school allows them to concentrate on being the best nurse possible, and we all win.

 I am by the way, back in school getting my bachelors in legal studies.

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