Shari Beardslee

Professor Jean Waltman

English Composition II

1 May 1990

The Need for Nurses

At one time it was the dream of many little girls to become a nurse. Today, however, America is facing its worst nurse shortage since World War I (Gorman 77). Carolyn Davis, head of the Health and Human Services Secretary's Commission on Nursing, estimates that currently about 200,000 nurses are needed to fill the vacancies (Kleinman 69). The nursing shortage is found everywhere. The Hay Group, a business consulting firm, reports that 60 percent of all hospitals in the United States have shortages substantial enough to threaten the quality of care provided. The Southeast seems to have the most severe shortage, an astonishingly high 68 percent (Miller et al. 32). Even our area is experiencing a shortage of nurses. Seventy-seven ads for nurses were printed in the April 15, 1990, issue of the Detroit News and Free Press. The ads were nearly begging for nurses, offering signing bonuses, instant pay, and new rates. The demand for nurses seems widely spread throughout the nursing field. Medical, surgical, critical care obstetrics, and nursery nurses are all becoming rare commodities.

What has become of all these women in white? The answer lies in not one but several causes. One possibility is the fact that women have greater career options. In the past, women who chose to work outside the home had two basic choices: nursing or teaching. Today more women than ever are in the work force, but their options have greatly increased. There are women doctors, lawyers, firefighters, and police officers. In fact, women today are found in nearly every field of work. Nursing has been left behind, as women move on to jobs with higher pay and greater status. Nowadays a career in nursing is socially degrading. A woman (or man) in this field is often looked down upon as "merely a nurse." Career counselors and teachers may also be at fault. Carolyne Davis spent a year trying to find an explanation for the nursing shortage and was appalled to learn that many high school students are actually being steered away from nursing, told by teachers and counselors that they are "too bright to be a nurse" (Hubbell 73).

Another reason for the nursing shortage is increased demand. Americans are living longer than ever and requiring more medical attention. In fact, the number of elderly patients has almost doubled in the past two decades (Gorman 78). Obviously a larger population requires more nurses. AIDS and other diseases have caused more and more people to need nursing care. Usually, fatal diseases mean long drawn-out hospital stays—which mean more nurses are needed to care for these patients. It is estimated that by the end of the century, the demand for nurses will be double the supply (Will  80).

Although new career options and increased demand are partially to blame, the two greatest factors are low salaries and poor working conditions. The average starting pay for nurses is around $22,500. This is a comparable starting pay for most college graduates. However, the average maximum salary is $32,000—and is usually reached in six or seven years (Hubbell 73). Nurses can expect less than a 40 percent wage increase during their entire career (Will 80). As if low wages were not bad enough, there isn't much to look forward to afterward either. A survey of the American Nurses Association in 1988 revealed that only one quarter of nurses have retirement benefits (Seixas 105). With so little financial reward, the nursing field is hardly appealing.

The intense working conditions of nurses are also rather undesirable. The medical community has come to rely on nurses as cheap, versatile labor. for the amount they're paid, it would seem that a nurse's job would be fairly simple and relatively stress-free. Nothing could be further from the truth. A nurse must have an abundance of stamina, superior technical know-how, and the ability to withstand a tremendous amount of pressure. Stress may explain the especially high burnout rate. And nurses' responsibilities are constantly increasing due to advances in medical technology.

A new program installed by Medicare is contributing to the difficult working conditions. The Prospective Payment System (PPS) is a program in which hospitals are paid a pre-determined fee for each patient—determined by the condition or illness of the patient. If the hospital can provide the care for less, it keeps the difference. If it costs more, the hospital must cover the excess. As a result, hospitals began laying off LPNs, aides, secretaries, clerks, messengers, and housekeepers, which means nurses must often do their own paperwork, take blood samples and specimens to the lab, make beds, and even mop floors. What ever happened to the nurses we used to know—whose job was to care for the sick? The nursing shortage is really a vicious circle. There is a shortage, which causes the existing nurses to work twice as hard to compensate for the lack. This causes them to burn out quicker, causing a greater shortage. And the process repeats—getting worse each time. The turnover rate for nurses is an amazing 45 percent (Miller et al. 33).

Gail Douglas, an operating-room nurse at Atlanta's Northside Hospital, has been a nurse for three decades. She has worked in almost every nursing speciality. Gail is trying to support herself and her three daughters. Last year her earnings totaled $37,116. She has two goals: to keep herself from getting deeper into debt and to change careers. She says she'll do anything but nursing: "It's a dead-end job." Gail is fifty years old and has been trained only for nursing. At her age, it is unlikely that she will be able to pursue a new career. Why is the burnout rate so high? Why are people like Gail so dissatisfied with their jobs? As already mentioned, a nurse's job is extremely difficult. The hours are also undesirable. Nurses often work 50–60 hours per week (Gorman 77). Because of the lack of nurses, those we have must work overtime and extra shifts. With all of the responsibilities of a nurse, these extra hours can be very trying and extremely stressful. It is no wonder the burnout rate is so high.

The nursing profession is unattractive and unpopular. The opening of new fields for women and an increase in the demand for nurses has created the tremendous shortage. The fact that nurses are overworked and underpaid has also made it an undesirable profession. Given these facts, it is not surprising that there is such a great shortage of nurses today.

Works Cited

Gorman, Christine. "Fed Up, Fearful, and Frazzled." Time, 14 Mar. 1988, pp. 77-78.

Hubbell, John G. "Where Have All the Nurses Gone?" Reader's Digest, June 1989, pp. 71-76.

Kleinman, L. "Code Blue." Health, Feb. 1989, pp. 68-71.

Miller, Annetta, et al. "Seeking a ℞ for Nurses." Newsweek, 10 July 1989, pp. 32-33.

Seixas, Suzanne. "A Nurse's Battle with Burnout." Money, Sept. 1989, pp. 104-06.

Will, George F. "The Dignity of Nursing." Newsweek, 23 May 1988, p. 80.

This piece originally appeared in:

Beardslee, Shari. "The Need for Nurses." 1990. The Great American Bologna Festival and Other Student Essays, edited by Elizabeth Rankin, St. Martin's, 1991, pp. 135-38.

The author was a student at Eastern Michigan University, Ypsilanti, Michigan.