Vital signs

The nursing profession still has a pulse but health care administrators are instituting resuscitation measures nowBy

The nursing profession still has a pulse but health care administrators are instituting resuscitation measures nowBy

May 12, 2002|BY KEVIN CLAPP

All is quiet in the intensive care unit on the second floor of Washington County Hospital.

On duty nurses flutter around the triangular wing tending to patients, recording information into computers or grabbing a moment's respite in the bread box that passes for a kitchen/lounge.

In green surgical scrubs, stethoscope hanging around her neck, registered nurse May Hoffman changes an IV for one gentleman on a ventilator. She is three and a half hours into a 12-hour shift and will care for several more patients in ICU before punching out around 7 p.m.

Hoffman, a 24-year veteran, loves her job. L-O-V-E-S, loves it. But she's 47, likely closer to the end of her career than the beginning.


And when she is gone, who will step in to take her place? With talk of a nationwide nursing shortage percolating the last few years, not even she is sure.

"When I get old," she admits, "I don't know if there will be enough (nurses) to take care of me."

Taking the temp

As National Nurses Week concludes today with the 182nd anniversary of Florence Nightingale's birth, there's a bad moon risin' above the world of health care. It casts a long shadow that promises to grow longer as the decade progresses.

An aging general population, a lack of nursing faculty at schools across the country, increased health care opportunities beyond hospital walls and insufficient funding have each conspired to create an unstable nursing environment.

And staffing concerns swirl around more health care professions than registered nurses. Pharmacists, imaging technicians, laboratory technicians - even doctors - figure to experience similar crunches, if the fields aren't already feeling the pinch.

Lest we all think the end is nigh, RN staffing at Washington County Hospital is at more than 99 percent. Of available nursing positions, only three full time equivalents were unfilled last week.

In the intensive care unit, for example, there is a full complement of 25 nurses, including new graduates on their way.

But the outlook is not as rosy elsewhere in Maryland and across the country, where roughly half of the RN work force will reach retirement age in the next 15 years.

If the nursing crisis were a wave, Maryland Nurses Association Executive Director Kathryn Hall, RN, MS says it is not quite at its midpoint but certainly beyond the initial ripple.

"Nursing has always been predominantly a female profession. For years, most women in the work force were moving into jobs as teachers, nurses and a third area, social work," Hall says. "We've seen a movement of these very bright and talented women going into other fields. It's not uncommon for women to be attorneys, physicians, engineers."

Which, it is important to point out, is not a bad thing. It has just created a slight vacuum in the nursing ranks.

Because while women have excelled in moving to traditionally male fields, not as many men are transitioning into the historically female professions. According to figures from the Maryland Board of Nursing, 5 percent of the state's nurses are men, compared to 6 percent nationwide.

New initiatives

If only the solution was as simple as recruiting more people.

Unfortunately, addressing the nursing situation is much like tending to an ER patient riddled with gunshot wounds. Clamp one bleeder and another hemorrhages as multiple wounds slowly suck the life out of an entire system.

Not that the health care industry hasn't been trying.

Earlier this year, the Bush administration began promoting nursing as a career on the heels of a 2000 National Sample Survey of Registered Nurses that illustrated the alarming trends plaguing the industry:

n While the U.S. population increased by nearly 14 percent in the 1990s, the rate of nurses entering the work force in the latter half of the decade was 4.1 percent;

n Fewer than 10 percent of RNs were younger than 30 in 2000, compared to 26 percent in 1980.

The Maryland Hospital Association launched a Web site earlier this year,, as a resource for those searching for jobs and people.

Grant money from The Robert Wood Johnson Foundation has been used since 1996 to create the Maryland Colleagues in Caring Collaborative, a more than 400 member group that studies work force supply and demand.

Among the group's initiatives is "Today's Nurse," a new, eight-minute video issued to every middle and high school in the state to promote nursing as a career.

In 1997, Hall says roughly 2,000 students were enrolled in nursing programs statewide; today, enrollment is less than 1,050 and represents in part a failure of the field to promote itself to youngsters looking for a career path.

"We have not done a good job of getting the message out," Hall says. "They're mesmerized by all these high-tech jobs, and don't realize nursing can put them in touch with some of the best technology in the world."

"Today's Nurse" aims to show teens how diverse nursing can be, from hospitals to private practice, corporate positions to schools.

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