Jobs: Supply and Demand for Registered Nurses 

Submitted by Karina L. Gordin

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Jobs: Supply and Demand for Registered Nurses 

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The post of a registered nurse is particularly important both in the hospital and educational setting given that many responsibilities, which bear great consequences, depend on the nurse to be carried out proficiently. In a hospital environment, which may seem sterile and somber, a nurse’s smile may be very encouraging to the patient who depends not only on such human contact but on consistent monitoring of vital signs, administration of medicine in a timely manner, and a variety of other essential duties reserved to the nursing post. This quality of care may be critically compromised if an emerging crisis in the healthcare industry is not reversed. Specifically, a nursing shortage across America is generating a variety of preventable complications in the medical care system, which includes medication errors, overcrowding in emergency rooms, and even unexpected patient deaths. On the educational front, the shortage of registered nurses means a shortage of hospital health educators and nursing programs, which in turn cannot meet the demand of the number of well-qualified student applicants. It is difficult to pinpoint every contributing factor behind the growing concern, however, these trends, amongst others shortly examined in this paper, contribute to the dramatically increasing nursing shortage every year. 

The president of Human Resources at Cooley Dickinson Hospital, Mary E. Kelleher, asserts that within the last 20 to 25 years, nursing diploma schools have been disestablished in numerous hospitals, therefore shifting the nursing education from hospital nursing schools to academic centers that offer 2 year and 4 year degree programs. As a direct consequence, the number of educational slots required by healthcare employers is lagging as the academic centers receive an inadequate number of nurse educators. “Academic centers require nurses with MSN or higher degrees as educators, and not enough nurses possess those advanced degrees to fill the vacant teaching slots within the college systems. If you check with the area colleges, you will see that there is up to 8-10 times the number of applicants for the number of educational slots available to fill.”[1] James M. Keefe, Vice President of Inpatient Services at Cooley Dickinson adds that the pay-scale for advanced degree nurses with a capacity to teach is considerably lower, when compared with pay-scale of “bedside” nurses, in this way further contributing to a substantial shortage, by means of nurse educators.   

Nursing shortage complications attributed to the lack of funding for educational programs impacts the availability of laboratories, clinical facilities, as well as nurse educators and, as previously stated, potential number of students pursuing a career in the medical field. In addition to this trend, the nursing shortage is compounded by the fact that registered nurses will be reaching the retirement age within the next decade. In other words, the scarcity of students being prepared for nursing posts falls short as the projected retirement pattern of the older workforce is increasing, creating hospital nursing vacancies. In fact, due to the retirement trend, it is estimated that the nursing workforce shall fall by 20% below the demanded level in 2020. 

The nursing shortage does not pose discomfort solely for the patients, but it creates discomfort for nurses themselves as well. The unfilled nursing posts in hospitals create unfavorable working conditions due to factors such as short-staffing, shift-work, an excess of patients per nurse, and therefore nurse retention issues, which contribute to the long-term shortage. As an alternative, registered nurses are looking toward employment opportunities beyond the scope of hospital stations, a trend that has developed significantly in the past several years. Specifically, Mary E Kelleher explains that alternatives to “bedside” positions may be sought after in health clinics, home health care agencies, attorney offices, et cetera, steadily redirecting nurses to new positions. “The expansion of employment sites has increased the number of positions that attract the professional RN, and decreases the applicant pool for the hospitals.”[3]

There is a solution to direct the nurses back to hospital “bedside” positions and ensure improved educational outcomes, it is just a matter of “thinking outside the box,” as Kelleher suggests, “and look at how to train students in the clinical setting, combining the best features of the former “diploma” programs with the current academic programs.” Indeed there is a solution Keefe points out, “increasing the capacity of the educational institutions to accommodate the interested students into their programs is critical. Improving the salaries of clinical educators would be an important step.”[4] In fact, many statewide actions are underway to address the nursing shortage both in the hospital and educational setting. Millions of dollars in funding are raised for scholarship programs that enable registered nurses to earn graduate degrees required for educators. Additionally, hospitals are now slowly putting effort into subsidizing nurse faculty strategies, reimbursing nurses for advancing their educations, as well as seeking private support to strengthen the nursing workforce both on the hospital and educational front. 

  1. Kelleher, Mary E. (2007, Nov. 4th). Telephone interview.
  2. Kelleher, Mary E. (2007, Nov. 4th). Telephone interview.
  3. Kelleher, Mary E. (2007, Nov. 4th). Telephone interview.
  4. Keefe, James M. (2007, Nov. 28th). Vice President of Inpatient Services at Cooley Dickinson Hospital, Massachusetts. Interview.

In terms of the standard pay-scale’s affect on the nursing shortage, Mary E. Kelleher suggests that essentially the salary is adequate enough to have drawn men into the profession, which was unheard of roughly thirty years ago. “The current salary levels for a new nurse who graduates with a two-year associates degree exceeds $60,000 per year when one includes the base salary, plus additional compensation for working on weekends, off shifts, holidays, etc. Experienced nurses earn considerably more.”[2] However, as noted by Kelleher, an appetite for increased wages is permanently unsatisfied, and that the wages are increasing more rapidly than a revenue source’s available funding to pay for the care of patients.