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The nursing shortages in America are rapidly becoming the cause of a major crisis in healthcare.11 The need for qualified caregivers, of which nursing is the most prominent, is the most serious issue facing healthcare providers today. It is promising to get worse. The deepening shortage of nurses is expected to worsen over the next ten years. 3, 12 Hospitals, doctors, and professional health associations have attributed the following to the nursing shortage:
- Hospital bed closures
- Cancellations of elective surgeries
- Diversions of ambulance from emergency room
- Less than optimal environment for the practice of medicine
- Increase in medical errors
- Active nurses are becoming stressed, overworked and nearing burnout 3,13,10
The causes for the shortages are multiple and complex. The general population of the U.S. is growing older with increasing chronic diseases which create a need for more nursing services. There has been a growing awareness of the seriousness of the shortages over the last five years. State and Federal Governments, hospitals and professional associations are starting to propose solutions. Health and Human Services Secretary, Tommy Thompson, said that his department will begin searching for a way to heal with this “critical shortage” 10
In his speech at Georgetown University, he urged hospitals, corporations and universities to look for “creative solutions”. He announced $27 million in grants directed to students who enter nursing schools. Congress is proposing legislation to meet the growing nurse shortage. Senators John Kerry and Jim Gifford have introduced a bill, The Nurse Reinvestment Act. This bill would create a “National Nursing Service Corp” which would provide nursing school scholarships in exchange for a commitment to serve in a health facility with a critical nurse shortage.
Two bills have been introduced in the House of Representatives focusing on the nursing shortage - The Nursing Employment and Education Development Act and the Nurse of Tomorrow Act. 10 The American Hospital Association has organized a National Commission on the Workforce Shortage to work on long-term solutions to the nurse shortage. 15
Hospitals are trying many short-term solutions to their acute shortage. One of the most frequently used strategies is to offer sign-up bonuses for RN’s of $5,000 - $10,000 for one-two years’ commitment to work. They are also offering other incentives to RN’s such as 9, 15 paying off school loans or paying for the education of nursing school students who commit to work for them after graduation.
These incentives can be expensive and ultimately a short-term solution to a long-term problem as they compete for a finite number of nurses. A survey done by the American Society for Health Care Human Resources Administration and AON Consulting revealed that 51% of health care workers planned to remain with their current employee only for several years. Therefore, it is logical to assume that the nurses receiving the sign-on bonus for a 1 - 2 year employment commitment would leave after their time is up. If it costs $145,000 to recruit, re-train and retain a new RN each time a nurse leaves, these $5,000 - $10,000 incentive bonuses become expensive and very temporary. 2
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