Healthcare Part V – Nursing Shortage Part 1

The biggest threat to American healthcare may be the nursing shortage, specifically Registered Nurses (RN).

The nursing shortage is unique, I cannot find anyone in the US who disagrees about the nature and extent of the problem.

The shortage is also interesting because despite the agreement on the problem, very little was has been done.

The feds passed a nurse reinvestment act a few years ago (Hillary and Dubya had a love fest) but the total funds were like spitting the in the ocean.

There are many small state and local initiatives, but nothing seems to working.

Besides working with hundreds of nurses, I am married to the world’s greatest nurse, who is now retired at age 55. This is a part of the problem, the physical beating has taken a toll and her days of pounding the floor are probably over.


Forty years ago women who wanted to work had limited choices; teachers, nurses, secretaries. This guaranteed a steady supply of young nurses, to take the place of those who quit or retired. How the world has changed.

Now women have all sorts of choices, and men only represent about 4% of nurses (despite numerous outreach programs for a couple of decades).

The average age of nurses is very high, which is a problem. Very few nurses “work the floor” until age 65, which compounds the problem. About 32% of nurses were under the age of 40 in 2004, and only about 60% of licensed RNs at any given time are working full time.


Many Americans need better jobs, so why the shortage?

Nursing requires a skill set many people can not master, and an emotional maturity many people do not have.

The hours are lousy, work includes holidays and weekends, injury rates are high, patients and families can be psycho, physicians can be temperamental and abusive, the pay is ok but not spectacular compared with other professions, and nurses suffer physical and emotional wear-and-tear.

Strategies: Number 1 – create replacements positions

We have LPNs, surgical technicians, casting technicians, imaging technicians, cardio technicians, and etc., We also have Medical Assistants who have completed medical assistant programs like the ones from CALC Institute of Technology: medical assistant program. But we still have a shortage of RNs, because RNs have unique skill sets and everyone else fills other necessary positions.

Strategies: Number 2 – steal nurses from overseas

American hospitals make an organized effort to import nurses. The Philippines actually trains nurses as an export commodity. Sometimes we steal nurses from Europe and South Africa, and then those country steal nurses from poorer countries. We pass around the shortage.

And the US still has a shortage, and it is getting worse.

Your thoughts? More comments in Part Two.