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ISSUES
Want a Nurse? Get in Line!
A Legislative Report
Twila Brase, R.N.
President, CCHC
December 2000
Hospitals and nursing facilities across the nation are severely
short-staffed. So heard legislators at the Minnesota Workforce
Task Force in December. In fact, at one point in the previous two
months, four Minnesota hospitals were closed for discretionary
admissions at the same time because there was not enough staff to
care for patients, according to the Minnesota Nurses Association.
Testimony from various organizations revealed that enrollment
in nursing programs has declined for two decades across the
nation, over 1,700 nursing positions remain unfilled in Minnesota,
the average staffing in the state's nursing homes in year 2000 was
dangerously low, and 8,000 positions for various health care
workers in Minnesota were left vacant in 1999.
According to Lyle Wray, Chair of the Citizens League, the
health care industry is "on the edge of panic" because of the
nursing shortage. According to Mary Ryan, from the Minnesota
Hospital and Healthcare Partnership, additional shortages exist in
ultrasound technicians, X-ray technicians, pharmacists, health
information technicians and health unit coordinators. She
testified that the health care industry is unique because it
cannot draw from the pool of unskilled labor to meet its needs.
Nurses Leaving the Profession
The Journal of the American Medical Association (June 2000)
reports that: 1) the nursing occupation is dominated by "early
boomers," 2) the actual number of working RNs younger than 30
years old decreased by 41% from 1983 to 1998, and 3) the RN
workforce will be 20% below requirements in 2020.
In Minnesota, Wray noted, 1.3 million babyboomers are "heading
for the exits" while only 30,000 new immigrants are taking their
place in the workforce. Ironically, as the retirees reach an age
where they are in greater need of health care services, there will
be fewer health care workers to meet their needs.
A report from the Minnesota Nurses Association, "Registered
Nurses: Supply & Demand", concurs, finding that 50 percent of
the nation's Registered Nurses will be 50 years old or older by
2007. In 1997 in Minnesota, only 1668 nurses were between the ages
20 and 34 while 4,681 were age 35 and older.
According to the report, enrollment decline in nursing is due
to more attractive career options, work redesign and layoffs in
the 1990s resulting from managed care, stress and burnout,
mandatory overtime requirements, and legal concerns because of
insufficient staffing. In addition, a report out of the Pew
Charitable Trust once recommended closure of 50 percent of all
nursing schools.
Temporary Agencies Add Cost
The cost of providing health care has risen as a result of
temporary employment agencies which employ nurses for hire.
Because of the shortage, long term care providers say that
agencies can name their price for supplying nurses to desperately
short-staffed nursing homes and home health agencies.
The health care facility pays these agencies up to $50 per
hour for a registered nurse, while on-staff nurses are paid only
$18 - $20 per hour. Although each agency carves out a healthy
slice of the payment for themselves, agency nurses receive higher
wages and better benefits than on-staff nurses, causing many
nurses to accept temp agency positions, rather than regular staff
positions.
Solutions
In response to the presentation, Rep. Mike Jaros (D-Duluth)
proposed a top-heavy approach to the issue, stating, "The Citizens
League and employers should demand that we produce the workers
that are needed in the state because the taxpayers are paying for
it."
Other solutions offered include the reallocation of tax money
into workforce training, health curriculum for secondary schools,
recruitment of retirees, changes in licensure requirements,
increased compensation, expanded loan forgiveness for rural
hospitals, repeal of health care taxes, and the creation of a
"universal worker"&emdash;workers allowed to work outside their
specific duties.
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