Chapter 5

Question 1

Current Nursing Shortage

Answer 1

Began in late 1990s
Unlike earlier nursing shortages
Longer lasting; more severe
Widespread (worldwide; developed countries exacerbating shortages due to nurse migration)
All practice settings (greatest in acute-care hospitals; rural > urban)
Short-, long-term future demand continue to increase

Question 2

Causes of increased RN demand:

Answer 2

Growing population
Medical advances -> need for adequately educated nurses
Increased acuity of hospitalized patients

Technological advances in patient care
Increased emphasis on prevention
Growing elderly population with increased longevity
Aging baby-boom generation

Geographic maldistribution
Workforce poorly distributed geographically
Greatest concentration in New England
Lowest concentration in Pacific region
All states affected; some states in dire situations

Question 3

RN Supply

Answer 3

Short-, long-term future demand continue to increase
Nursing projected to be nation’s top profession in terms of projected job growth
6% RN shortage at beginning of 21st century will swell to 20% if not addressed

Question 4

Factors affecting RN Supply

Answer 4

Enrollment in nursing schools
Increased, but not adequate to replace nurses lost to retirement
Need for increased funding
Title VIII of Public Health Service Act
2002 Nurse Reinvestment Act
Private foundation funding: Partners Investing in Nursing’s Future

Enrollment in nursing schools
Inadequate number of nursing faculty to teach
Part-time, unemployed nurses
Pool already tapped
Possible re-entry if more flexible, shorter shifts
Older RNs returning offers only brief reprieve

Use of foreign-born nurses
Possible negative implications on domestic job market, health care quality
Complex international implications

Question 5

Roots of the Shortage

Answer 5

Aging workforce
Increased employment of nurses in outpatient or ambulatory-care settings
High turnover due to worker dissatisfaction
Inadequate long-term pay incentives
Increasing recognition of greater earnings, autonomy as free agents (per diem, traveling nurses) rather than as full-time employees

Question 6

Consequences of the Shortage

Answer 6

Patient outcomes sensitive to nursing interventions
Nurse staffing affecting patient outcomes
Statistically significant relationships between staffing, patient outcomes; more research needed
Call for regulatory oversight of nurse staffing issues

Question 7

Strategies for Solving the Shortage

Answer 7

Redesign of workplace for older workforce
Increase number of nursing students in pipeline
Import foreign nurses
Improve nursing’s image
Increase faculty pool
Move toward self-service approach to patient care

Question 8

Which of the following would be most effective in helping to solve the current nursing shortage?

Answer 8

Redesign the workplace for younger nurses
Use nurses as the primary bedside caregivers
Minimize the use of foreign nurses
Promote a more positive image of nursing

Question 9

Promote a more positive image of nursing

Answer 9

Strategies to help solve the nursing shortage include
Improving nursing’s image
Redesigning the workplace for an older workforce
Importing foreign nurses
Moving toward a self-service approach to patient care (use of family members as caregivers to supplement RNs by providing most bedside care)