AlumniBulletin - University of Alabama at Birmingham

Feature Stories
Nancy Dunlap is chief of staff at
The Kirklin Clinic
tasks that might be filled by employees
with other skills sets. But the acuity
of care in the outpatient setting is
going up. Many therapies that used to
be done in the hospital arena now are
being done in the clinical setting, so
we really need highly skilled nurses.”
The percentage of nurses working
in hospitals continues to decline,
Booth says. “Fifty-nine percent of
R.N.’s work in hospitals, and the
rest work in community settings—
offices, clinics, long-term care facilities,
hospices, nursing homes,
schools, industry. We have hospitals
with higher acuity of care and shorter
lengths-of-stay. And patients are
going home much sooner than in
the past, so we must have nurses in
the community. That’s something
that is new about this shortage.”
The Untold Story
Booth traces the roots of the current
shortage to a spate of hospital
closings and mergers in the early
1990s. “The media gave a lot of visibility
to hospitals laying off R.N.’s,
and that led to a decline in applications
to nursing schools,” she says.
“Young people didn’t want to go
into a profession that they didn’t
think would offer them jobs.”
The media, however, did not tell
the whole story. While the number
of R.N.’s working in hospitals
declined by 6 percent, the number
working in community settings
increased by 12 percent. “But the
public only heard about the downsizing
of nurses in hospitals,” Booth
says. “They didn’t hear the other
side of the story.”
A trend quickly became apparent,
driven partly by the aging of
America’s nurses. “Studies show
that younger nurses tend to select
more acute-care units,” Booth says.
“But when you have fewer younger
nurses, then you don’t have the pool
you’ve traditionally had to work in
the acute-care setting. And that’s
where the shortage was first felt—in
the emergency rooms, delivery
rooms, the ICUs. Then it spread to
other units.”
A study in the May 30, 2002,
issue of the New England Journal of
Medicine shows how nursing shortages
affect patient care. Researchers
found that in hospitals with higher
R.N. staffing, stays were 3 to 5 percent
shorter, and complication rates
2 to 9 percent lower than in hospitals
with lower staffing.
Getting Back on Track
Efforts to ease the nursing shortage
are showing some encouraging
results. The University of Alabama
School of Nursing at UAB reports
a 50 percent increase in the number
of new students enrolled in
2002. “We have accelerated our
recruiting since applications started
to go down in the mid 1990s,”
Booth says. “We’ve extended to
younger populations, even visiting
middle schools. We’ve targeted
male prospects and individuals
with degrees in other fields. We
also reinstituted a program in
which student nurses pay back
scholarships by guaranteeing that
they will work in a hospital for a
certain number of years.”
Attracting more males to nursing
is critical, Booth says. “Part of the
problem is a stereotype that starts
13
in the home. We need to educate
parents that males can have wonderful
careers in nursing. Only 5.4
percent of all R.N.’s are male, and I
would love to see us get to a point
where males make up 10 to 12 percent
of our classes.”
“The media gave a lot of visibility to hospitals
laying off R.N.’s, and that led to a decline in
applications to nursing schools. Young people
didn’t want to go into a profession that
they didn’t think would offer them jobs.”
Nursing organizations have
become politically active, pushing
state legislatures to allocate funds
for scholarships, loans, and other
incentives.
On the national level, Johnson &
Johnson is sponsoring a $20-million,
multiyear promotional campaign.
Nurses for a Healthier
Tomorrow (NHT), a coalition of 37
nursing and health care organizations,
is supporting a similar effort.
Physicians also can play a role.
First, they tend to be excellent
recruiters for nursing schools. “We
frequently get students who have
been referred to the school by a
physician, not only in-state students,
but out-of-state students as
well,” Booth says.
But the physician’s role goes
beyond recruiting. “Physicians need
to be very aware of the important
skills set nurses bring to health
care,” Dunlap says. “When you
have mutual respect in the workplace,
it’s usually more satisfying for
everyone involved.
“Physicians really need to make
nurses feel valued and help provide
the kind of satisfaction in the work
environment that will make them
want to stay.”
Rachel Z. Booth is dean of the
School of Nursing.