Want a Nurse? Get in Line!

A Legislative Report
Twila Brase, R.N.
President, CCHC


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.
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.