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VIRGINIA NURSING WORKFORCE AND EDUCATIONAL PIPELINE SHORTAGE
Why Registered Nurses Make a Difference in Patient Care:
The importance of nursing personnel to patient health and safety cannot be overemphasized.
Nurses are frequently the link between positive and negative patient outcomes. Helping patients recover, preventing illnesses, and promoting health are three primary functions of nurses and their assistants. Nurses accomplish these functions through interventions such as educating patients about their treatments and conditions, activities designed to prevent complications such as coughing and deep breathing exercises, helping patients compensate for loss of functioning, providing emotional support, educating patients and families; and performing a wide array of measures designed to determine patients’ health status, such as vital signs, pain assessment, and pulse oximetry. Nurses also implement the medical treatment plan such as administering medications, monitoring the effects of medications, and assessing and treating wounds.
The health care system has continually increased technology and the complexity of patient care over the past two to three decades. Hospitalized patients are now sicker and need someone guiding their care that can think critically and make sound assessment decisions. Registered Nurses are trained to do just that. If you were admitted to the hospital with an acute Heart Attack, (Myocardial Infarction), would you rather have a Registered Nurse, trained in physical assessment and critical thinking, in charge of your beside care; or would you feel comfortable having an unlicensed assistant, (that might have three months of training), attempting to care, make assessments and report changes in your health status to your physician? The fact is that without sufficient numbers of well-trained and experienced nurses, patient outcomes will suffer.
Other examples of how an RN makes the difference in health care are included in the attached ‘RNs Make THE DIFFERENCE toolbox.
“Today, we’re taking care of Virginians who need nursing care. But, who will take care of us when we retire and need a nurse…….An R.N. in Winchester”
In the year 2020, Virginia will have nearly 23,000 fewer nurses than we need. One in three Virginians will lack access to the nursing care they need.
But we don’t need to look into the future to see the effects of the nursing shortage. Right now, Virginia ranks 40th in per capita supply of nurses – an embarrassing statistic for a state that ranks eleventh in per capita income.
We watch as our employers are forced to hire temporary nurses – at a much higher cost – as a stopgap solution.
We know our hospitals divert emergency patients and defer elective admissions when they don’t have enough nurses.
We don’t need to read the studies that show that when spread too thinly or lacking the appropriate skill set, the nurse is at risk of missing early signs of a problem, or missing the problem altogether, and adverse outcomes increase.
And this situation will get worse as nurses retire and an insufficient number of new nurses are educated and licensed to take their places, as more of our residents become senior citizens and have increasing health care needs, and as the state grows.
Quality health care, access to health care, and affordable health care are dependent on an adequate supply of nurses – now and in the future.
“I am a senior at Collegiate School in Henrico County. I have wanted to become a nurse since as long as I can remember. In November, I was deferred from the University of Virginia School of Nursing [because there was no room]. I really would like to go to the University School of Nursing and continue to live and work as a nurse in Virginia.”
A high school honors student testifying before the Senate Finance and House Appropriations Committees, January 2004
Recruitment campaigns funded by the private sector and implemented during the past decade have been successful. More and more people want to choose nursing as a career.
Nursing programs are located all across the Commonwealth. But, they have many more qualified applicants than they can accept because of constraints on faculty, space, technology, and clinical placements.
Last Year the Virginia Initiative for Nursing Education (VINE) proposed these initiatives to address the nursing shortage:
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Support a $9.1 million budget amendment to fund a 15% expansion in nursing enrollment in Virginia state-supported schools of nursing |
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Support increased funding for nursing faculty salaries that would recruit and retain faculty. |
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Provide state-funded technology grants to nursing schools |
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Provide state-funded grants for nursing school retention efforts. |
Unfortunately the state provided no extra funding for nursing education during the 2005 General Assembly session.
What Virginian’s can do to help with this problem:
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Don't assume your legislator knows how an RN is educated and trained or what unique skills an RN brings to health care. Refer to the first paragraph and to the attached ‘RN Makes The Difference’ Toolbox for ideas about how RNs make a difference, and give an example. |
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Contact your legislators and educate them on this issue and the need to increase funding for nursing and nursing education in the state of Virginia. |
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Tell your legislators why Registered Nurses are important to you and your family’s health and wellbeing. Better yet, tell your legislator why Registered Nurses are important to his or her family’s health and wellbeing. |
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Ask your legislators to support future initiatives to increase funding for nursing and nursing education. |
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Tell your legislators that they are welcome to contact LCVN: Melody Eaton (Chair) at eatonmk@jmu.edu, or the LCVN website at www.virginianurses.com. |
Facts About Virginia’s Nursing Shortage
The shortage of nurses in Virginia is a condition that continues to threaten the stability of the Commonwealth’s healthcare system. If current trends continue, the demand for fulltime-equivalent registered nurses (FTE RNs) in Virginia is projected to be 69,600 by the year 2020, while supply is anticipated to reach only 47,000. Without action, Virginia will be short 22,600 FTE RNs in 16 years (a 32% shortfall).
The majority of nurses are employed in hospitals where they represent one in four employees. Yet, the need for nurses is projected to increase most rapidly in nursing facilities, with a projected increase of 66% by 2020.
The current nurse shortage, and the projected worsening of the problem, is caused by increased demand and inadequate supply. The changes in supply and demand are attributable to:
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increased population, expected to grow by 12% (900,000) by 2010; |
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aging of the population, with a 30% increase in the number of senior citizens expected by 2010; and |
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health services utilization trends that show that senior citizens consume 35% of hospital resources even though they represent only 11% of the population. |
While the demand for RNs is projected to increase, the supply of RN FTEs is projected to remain constant with an increase of only 4% by 2020. Beginning in 2015, the number of RNs leaving the workforce will exceed the number of new RN graduates. This trend is caused by three major factors: aging of the RN workforce (current average age is over 45); a similar shortage in other states; and an inadequate supply of new nurses.
Statewide, schools report a total enrollment of slightly more than 6,000 RN students. In 2003, 1300 qualified applicants were turned away from Virginia’s schools because of inadequate capacity.
Nursing faculty are nearing retirement (the average age is 50-55). Recruitment of educationally prepared academic faculty is reported to be the most significant barrier to increasing enrollment. Clinical faculty salaries are reported to be $10,000 - $15,000 lower than those offered by healthcare providers.
Any expansion of nursing education programs is dependent on an adequate numbers of well prepared nursing faculty. Virginia nursing programs report considerable difficulty in filling clinical faculty vacancies, as well as an increasing difficulty in hiring senior- level faculty. Faculty are aging. The average age is over 50 and in some schools, over 50 percent of the faculty will be retiring within the next five years.
Another concern is the cost of operating nursing programs relative to current tuition and fee revenue. Consistent with other health professions, nursing programs are expensive to operate. Due to high faculty-to-student ratios (required in staffing hands-on clinical courses) and the cost of acquiring, maintaining, and upgrading healthcare technologies and laboratories, the operating expenses of nursing programs are high. To be accredited by the Board of Nursing, nursing programs must maintain at least a 1:10 faculty-to-student ratio to assure patient safety during clinical courses. In Virginia, many hospitals require that this ratio not exceed 1:8 in order to ensure safe patient care. This faculty-to-student ratio is much higher than for other collegiate majors, and faculty salary costs relative to tuition and fee revenue are high.
Each year, the Board of Nursing licenses slightly less than 2,000 new RNs with the vast majority of these being graduates of Virginia nursing schools.
Schools of nursing need increased funding to increase their capacity. This funding should be directed toward achieving parity with the private sector for nursing faculty and to encourage potential faculty to attain the educational credentials for teaching in schools.
Schools need increased funding so they can update the technology needed to assist students to attain competencies needed for entering the workforce. This could include funding for simulation hardware and software and/or funding to establish or expand distance-learning modalities.
Where attrition rates are high, schools should have access to small grants aimed at assessing attrition and determining how to increase retention of students.
The current nursing shortage endangers the public’s health and unnecessarily drives up the cost of health care. Without significant intervention, in 2020 Virginia will have 30% fewer nurses than needed, and these problems will worsen.
Inadequate health care services impair quality of life for Virginia’s citizens and impede business development.
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