What’s the outlook for nursing in 2013? Will nurses increasingly need advanced degrees? What's causing the high turnover rate among nurses? What will drive the nursing shortage, if it occurs?
A recent Q & A with Carol Brewer, published in The Buffalo News, provided some answers. Brewer, a professor of nursing at the University at Buffalo School of Nursing and the associate dean for academic affairs is a member of the New York State Regional Action Committee for the Future of Nursing. She is also co-leader of the RN Work Project, which studies career changes and work attitudes, and the director of nursing for the New York State Area Health Education Center System Statewide Office, which develops nursing policy and workforce development programs.
On the subject of higher education for nurses, Brewer referred to a 2010 Institute of Medicine Report, which cited the benefits of a BSN on patient outcomes, and that graduates are not only younger but remain in the workforce longer and continue on to pursue advanced degrees.
In regard to turnover rates and how to reduce them, Brewer noted that just over a quarter of hospital-trained nurses leave their first jobs within three years, and over half do so within six years. Most simply move on to another hospital. Reasons vary from changing clinical interests, a healthier work environment, or better work-life balance (shifts, stable hours, etc.).
To retain nurses, Brewer points to the success rate enjoyed by Magnet hospitals, which concentrate on improved nurse satisfaction, practice autonomy, and offer better career opportunities. If nurses feel their contributions are valued, they tend to stay. Also helping to retain nurses are “dedicated education units.”
Will healthcare reform expand the role of RNs? Brewer suggests that nurses don’t need to expand their roles as new healthcare systems kick in. Nurses know how to move patients through the health care system to produce better outcomes. For example, nurse practitioners can provide safe and effective primary care in a variety of settings. Independent practice nurses have the same patient outcomes as those who practice in collaboration with doctors. It all comes down to money for physicians who want to bill for collaborative services with nurse practitioners.
As for the current job shortage for new RNs, Brewer was optimistic. Having lived through three acute shortages of varying lengths (one that lasted nearly 10 years), she notes that the growing numbers of aging nurses leaving the workforce may produce a shortage and trigger more hiring. She indicated that while new nurse graduates may not be getting their first choice jobs, they are landing nursing jobs.
While nursing schools are being flooded with applicants, they’re turning away many. The reason, says Brewer is a shortage of nurses with teaching credentials. It takes up to seven years to produce a doctoral-prepared nurse. That, plus faculty to student clinical ratios have been mandated at 1 to 8.
There’s no doubt that big changes are coming to nursing—both in the numbers and types of jobs. Education and job satisfaction will become the drivers in improving the lives of nurses and ultimately the healthcare they provide.
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