[NPInfo] Intersesting article on nurse shortage

Tue Sep 4 18:25:24 PDT 2007

A Critical Shortage of Nurses
Low pay for a grueling job keeps many Americans out of the field -- and that  
spells trouble as baby boomers age.
By MOIRA HERBST

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This story is the second in a series examining the  state of the U.S. labor 
market.

The U.S. is facing a severe nursing  shortage. Already, an estimated 8.5 
percent of the _nursing positions_ 
(http://aol.careerbuilder.com/PLI/QuickSrchV2.asp?QSKWD=nurse&siteid=cbaol92nrs)  in the U.S. are  unfilled -- and some 
expect that number to triple by 2020 as 80 million baby  boomers retire and expand 
the ranks of those needing care. Hospital  administrators and nurses' 
advocates have declared a staffing crisis as the  nursing shortage hits its 10th year, 
the longest stretch in 50 years.

So  why aren't nurses paid more? Wages for registered nurses rose just 1.34 
percent  from 2006 to 2007, trailing well behind inflation. The answer is 
complicated,  influenced by factors from hospital cost controls to insurance 
company  reimbursement policies. But another factor is often overlooked: Huge 
numbers of  nurses are brought into the U.S. from abroad every year. In recent years 
nearly  a third of the RNs joining the U.S. workforce were born in other  
countries.

Critics say this is a short-term solution that could create  long-term 
problems. The influx of non-U.S. _nurses_ 
(http://aol.careerbuilder.com/PLI/QuickSrchV2.asp?QSKWD=nurse&siteid=cbaol92nrs)  allows hospitals to fill  positions at 
the low salaries they prefer to pay. But it prevents the sharp wage  hike 
that would encourage Americans to enter the field, which could solve the  nursing 
shortage in the years ahead. "Nurses' wages need to be higher," says  Peter 
Buerhaus, a professor of nursing at Vanderbilt University and an expert on  the 
U.S. nursing workforce. "Better pay would signify to society that nursing is  
a promising career. It's a critical factor in building the workforce of the  
future."

The Effects of Globalization

The market for _nurses_ 
(http://aol.careerbuilder.com/PLI/QuickSrchV2.asp?QSKWD=nurse&siteid=cbaol92nrs)  in the U.S. is a reflection  of how labor markets 
can change with globalization. With new technology and the  increasing 
movement of workers, labor markets are no longer local or even  national. Supply and 
demand don't work quite as they did in the past. Shortages  in one market 
aren't corrected with higher prices if supply comes from  another.

These labor shortages can happen in fields as diverse as _medicine_ 
(http://aol.careerbuilder.com/PLI/QuickSrchV2.asp?QSKWD=medicine&siteid=cbaol92nrs) , 
_construction_ 
(http://aol.careerbuilder.com/PLI/QuickSrchV2.asp?QSKWD=construction&siteid=cbaol92nrs) , _farming_ 
(http://aol.careerbuilder.com/PLI/QuickSrchV2.asp?QSKWD=farming&siteid=cbaol92nrs)  and _technology._ 
(http://aol.careerbuilder.com/PLI/QuickSrchV2.asp?QSKWD=technology&siteid=cbaol92nrs)  One of 
the most  contentious debates over the labor market is playing out in the 
technology  industry. As U.S. tech companies hire more programmers and developers 
from  overseas, American workers complain of the impact on their compensation.  
Meanwhile, companies such as Microsoft (MSFT), IBM (IBM), Google (GOOG), 
Oracle  (ORCL) and Motorola (MOT) have been arguing that the U.S. should let in 
even  more skilled workers from abroad, both on a temporary and permanent basis. 
But  computer scientists and software developers say such moves would 
discourage  American workers from pursuing these specialties and hurt U.S. 
competitiveness  in the long term (see BusinessWeek.com, 2/8/07, '_Work Visas May Work 
Against the  U.S._ 
(http://businessweek.com/bwdaily/dnflash/content/feb2007/db20070208_553356.htm) ,' and 3/27/07, '_Immigration Reform: Americans  First?_ () 
').

Several Factors at Play

In nursing,  pay isn't the only issue. Difficult working conditions and 
understaffing also  deter qualified people from pursuing the profession (see 
BusinessWeek.com,  8/21/07, '_Labor Shortages: Myth and  Reality_ 
(http://businessweek.com/bwdaily/dnflash/content/aug2007/db20070821_451283.htm) '). But average 
annual wages for registered nurses (one of the  most highly trained 
categories) is now just under $58,000 a year, compared with  a $36,300 average for U.S. 
workers overall. And it's clear that qualified  American nurses see that as 
not enough: There are 500,000 registered nurses who  are not practicing their 
profession -- fully one-fifth of the current RN  workforce of 2.5 million and 
enough to fill current vacancies twice  over.

Hospitals insist the U.S. shortage is too severe to address simply  with 
money. Carl Shusterman, an immigration lawyer in Los Angeles, says he has  100 
hospital clients that have 100 vacancies apiece. With two- to three-year  waiting 
lists to get into nurse-training programs in the U.S., pressure to  import 
nurses won't abate, he says. "Even if we could train more nurses and pay  them 
more, we'd still need to import them," says Shusterman. "It's ridiculous to  
claim that any foreign nurse is taking a job away from an  American."

Undeniable Results

Raising pay has successfully  attracted _nurses_ 
(http://aol.careerbuilder.com/PLI/QuickSrchV2.asp?QSKWD=nurse&siteid=cbaol92nrs)  in the past, however. To 
 remedy a shortage that developed in the late 1990s, hospitals started hiking 
 wages in 2001 -- and added 186,500 nurses from 2001 to 2003. Some advocates 
draw  a direct link between wages and recruiting. A 2006 study by the 
Institute for  Women's Policy Research, 'Solving the Nursing Shortage Through Higher 
Wages,'  concluded that "increasing pay for nurses is the most direct way to 
draw both  currently qualified and aspiring nurses to hospital employment."

While  nurses' advocates say better pay is critical, they also argue that 
working  conditions must improve if the U.S. is to cultivate an enduring nursing  
workforce. Future projections of staffing troubles are ominous. The current 
8.5  percent shortage is expected to surge to 29 percent -- or more than 
810,000  nurses -- by 2020, according to the U.S. Health & Human Services Dept. "You 
 will draw in some people with a good pay raise, but you won't necessarily 
get  them to stay," says Cheryl Johnson, a _registered nurse_ 
(http://aol.careerbuilder.com/PLI/QuickSrchV2.asp?QSKWD=registered-nurse&siteid=cbaol92nrs)  and 
president of the United  Association of Nurses, the largest nurses' union in 
the U.S. "Almost every nurse  will tell you that staffing is a critical 
problem. The workload is so great that  there's not time to see how [patients are] 
breathing, give them water, or turn  them to prevent bedsores. The guilt can be 
unbearable."

Whatever mix of  better wages, better working conditions, and foreign workers 
hospitals employ,  solving the nursing shortage in the long run will require 
solutions on a number  of fronts. "_Nurses_ 
(http://aol.careerbuilder.com/PLI/QuickSrchV2.asp?QSKWD=nurse&siteid=cbaol92nrs)  are getting more organized, 
but major change  isn't going to happen overnight," says Suzanne Martin, a 
spokeswoman for the  United Association of Nurses, which represents 115,000 RNs. 
"There are other  interests and lobbies that would prefer to keep things as they 
 are."

Herbst is a reporter for BusinessWeek.com in New  York.

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