Posts Tagged ‘Nursing schools’

Burnout Affects 30 Percent of Nurses

Wednesday, August 29th, 2012

With hospitals slashing costs to cope with growing financial pressures, nurses believe that the resulting insufficient staffing is detrimental to patients.  A team from the University of Pennsylvania has identified a key reason for this: Hospitals where relative fewer caregivers work typically provide inferior care.  If hospitals reduced their proportion of burned-out nurses to 10 percent from the prevailing 30 percent, they would prevent 4,160 cases a year of the two most-common hospital-acquired infections and save $41 million in Pennsylvania alone.  “It is costing hospitals more money not to spend money on nursing,” said Linda H. Aiken, one of the study’s authors and director of the Penn Nursing School’s Center for Health Outcomes and Policy Research.

The researchers determined that the nurses studied averaged 5.7 patients on a typical shift, said Rutgers University professor Jeannie Cimiotti.  “Maybe they are staffed a little bit above what they should, but if they (hospitals) can provide an organizational climate that’s conducive to nursing, I think they’d be fine,” Cimiotti said. “That doesn’t mean you can overburden them because workload is one of those factors that does contribute to burnout.”

“Most burnout is related to high workload,” said Patricia Eakin, an ER nurse who is president of the Pennsylvania Association of Staff Nurses and Allied Professionals.  Patients nowadays need a whole lot of care. There’s a lot of equipment, a whole lot of fancy things. A lot of things that take a lot of time and a lot of attention.”

Historically, the number of nurses per patient was low following World War I.  At what would ultimately become Baylor University Medical Center, the hospital in 1919 accommodated 225 patients who were cared for by a nursing staff of 12 graduates and 100 students.  As recently as the 1980s, nurses often cared for eight or nine patients (Insert Nurse Together link here.)  The night shift could see a single nurse caring for as many as a dozen patients, often without a Certified Nursing Assistant (CNA) to assist.

The shift in the United States from Florence Nightingale’s concept of multi-bed wards (which often contained 30 or more beds and were typically staffed by one or two nurses) to private and semi-private rooms started in the years following World War II and was mostly complete by the 1970s.  Private hospital rooms at this time were primarily reserved for patients whose families could afford to pay extra to keep their relative out of a ward and hire a private duty nurse to provide one-on-one care.  According to Jean C. Whelan, PhD, RN, “Private-duty nursing was the employment of nurses by individual patients for the delivery of care.  Patients hired their own nurse, who cared for them either in their homes or in the hospital.  Patients paid the nurse for her services with cash, based on a predetermined fee.  The nurse, generally employed for the duration of an illness, cared for only one patient at a time.  In essence, the private-duty nurse delivered highly individualized care to paying patients for as long as a patient needed and could pay for the nurse’s services.”

According to a U.S. National Library of Medicine of the National Institutes of Health Study, thousands of nurses — the vast majority of them women — migrate each year in search of better pay and working conditions, career mobility, professional development, a better quality of life, personal safety, or sometimes just novelty and adventure.  The percentage of foreign-educated physicians working in Australia, Canada, the United Kingdom, and the United States is currently reported to be between 21 and 33 percent, while foreign-educated nurses represent five to 10 percent of these countries’ nurse workforce.”

In 1994, nine percent of total registered nurses were foreign-born RNs; by 2008 that percentage had risen to 16.3 percent, or about 400,000 RNs.  Of those, approximately 10 percent had immigrated to the U.S. during the previous five years. About one-third of growth in RNs between 2001 and 2008 was fueled by foreign-born RNs.  The news is not all positive, though.  According to Newsweek, “While pay has risen in some regions to attract more nurses, in recent years it has flattened at the national level.  That’s why up to 500,000 registered nurses are choosing not to practice their profession — fully one-fifth of the current RN workforce of 2.5 million.”

Bringing those badly needed nurses from overseas is not always easy, said William R. Moore of El Centro Regional Medical Center in California, who has been waiting two years for 20 nurses from the Philippines he recruited to obtain visas.  In the meantime, Moore can’t find talent in the area.  “We’re in the poorest and least literate county in California, right in the middle of the desert,” says Moore. “We’re not a destination for (American) nurses.”

As the role of registered nurses has evolved over the years to encompass increased responsibility, so too, have the educational requirements.  A two-year associate degree (AND) or a four years bachelor’s degree — typically a Bachelor of Science in Nursing (BSN) — are the two primary degrees required in the 21st century.  Many nurses opt to pursue their Master of Science in Nursing (MSN) degree, which requires a minimal commitment of two years to complete the course work.  Others go even further in their educations, studying for a Doctor of Philosophy (PhD) or a Doctor of Nursing Practice (DNP).

Studying for a BSN degree — like all college educations – doesn’t come cheaply.  According to the Registered Nurse Education Requirements website, “Tuition and clinical fees together make up the total cost of nursing education while the tuition fee for a two-year nursing course in a community college is just $1,400, the clinical fees can are considerably higher at $4,000 plus per semester.  For a bachelors course the students end up paying almost $7,000 to $8,000 in clinical fees while the tuition is still lower at just $2,000 to $3,000 per semester.  Apart from this, students will also have to incur the cost of books, parking, basic living expenses and housing in case of out-of-town colleges. The cost of training at hospital affiliated nursing schools can be higher at $55,000 for resident student and over $100,000 for non-residents.”

I Just Graduated in Nursing. Where’s My Job?

Monday, May 9th, 2011

This spring’s class of nursing school graduates are running into an unexpected roadblock.  The dream jobs that they thought would be waiting for them are hard to find.  According to Rhys Gibson, “I mean I thought I was the cat’s meow and everything, because I’m an African-American guy coming out of here – I was waiting for the red carpet, I had the grades, had the experience, to an extent but not the practical experience as a nurse working on the floor.  There isn’t a whole lot of money, even on my unit, I was lucky enough to make it in when I did because there hasn’t been another RN1 since and that was December ’09 when I got that job offer.”  Gibson has applied for hundreds of jobs and finally founded a job as a nurse on a geriatric psychiatry ward at Rush University Medical Center.  He is just one of thousands of people who entered nursing schools in Illinois in recent years, many in response to a drumbeat of news about a looming nurse shortage.

According to Cathy Grossi of the Illinois Hospital Association, “There’s been a concerted effort led by the Illinois Center for Nursing to expand the capacity of the educational programming across Illinois to accommodate student interest for nursing education. So we’ve increased capacity around the state about 25 percent.  That’s since 2006. But then the recession hit in 2007.  And while it’s officially been over since 2009, the effects have been deep and long-lasting, even in healthcare – one of the brighter growth areas of the economy.  We are now experiencing an increase in the number of graduates coupled with the time temporarily where there’s probably not as much opportunity as there was in the past.”  According to Grossi, nurse vacancies at Illinois hospitals fell by more than half from 2008 to 2010.

Although the nursing shortage has eased slightly for the time being, it is not going away. The recession brought a temporary reprieve because nurses who were close to retirement have seen their 401(k) portfolios decline.  As a result, they are postponing retirement a few more years until the economy — and their portfolios — recover.  Other nurses have seen their spouses or partners laid off and so have increased their hours to make ends.  Some who left the profession to care for children or for other reasons have started working again to pay the bills.  Additionally, many hospitals are not hiring.  The recession brought hiring freezes to healthcare facilities, and many are still in effect.  Help wanted ads for healthcare professionals dropped by 18,400 listings in July of 2010, even as the overall economy saw a modest increase of 139,200 in online job listings.

Even so, healthcare remains one of the economy’s healthiest industries. On April 1, 2011, the Bureau of Labor Statistics (BLS) reported that the healthcare sector is growing, despite significant job losses in recent months in nearly all major industries.  Hospitals, long-term care facilities, and other ambulatory care settings added 37,000 new jobs in March 2011, the largest monthly increase recorded by any sector.  As the largest segment of the healthcare workforce, registered nurses will be recruited to fill many of these new positions.  The BLS confirms that 283,000 jobs have been added in the healthcare sector in the last 12 months.

The nursing shortage will regain momentum because of the impending baby boom retirement crisis.  When you consider that the majority of registered nurses are over the age of 55, and that they will soon be retiring as well, the terms ‘crisis’ and ‘nursing shortage’ will become even more significant in coming few years.  The nursing shortage is expected to also be influenced by the fact that nursing jobs will grow by 22 percent from 2008 to 2018, according to the BLS.  Add in the fact that the nursing work force is aging and nursing schools aren’t graduating nearly enough nurses to fill the healthcare industry’s requirements, and the growing nursing shortage can be described as a “perfect storm”.

“Moving into the future, we see a very large shortage of nurses, about 300,000,” said Peter Buerhaus, a nurse and health-care economist and a professor at Vanderbilt University.  “That number does not account for the demand created by reform. That’s a knockout number. It knocks the system down.  It stops it.  I think the big story is…the future of nursing is dominated by aging baby-boomer nurses who are going to retire, and we are looking at massive shortages,” Buerhaus said.