Volume 87, Number 6, Bulletin of the American College of Surgeons

The health care worker shortage VOLUME 87, NUMBER 6, BULLETIN OF THE AMERICAN COLLEGE OF SURGEONS 8 T he American Hospital Association reports that the greatest threat to America's health care system is the growing shortage of qualified personnel and that the greatest majority of open positions are for nurses. 1 The Joint Commission on Accreditation of Healthcare Organizations (JCAHO) states that the current nursing shortage is " unprecedented in its complexity and future implications. " 2 Three major factors have been identified as contributing to the current shortage: (1) declining enrollments, (2) an aging workforce, and (3) competition for skilled personnel. Many experts believe that the nurse workforce shortage will worsen in the next two decades when the largest cohorts of registered nurses (RNs) enter their 50s and 60s and eventually retire. Concurrently, as large numbers of nurses retire, the Baby Boomer generation will require more health care. These two factors alone lead to a prediction that the nurse workforce will fall to nearly 20 percent (400,000 RNs) below projected needs by the year 2020. 1 This overall situation has significantly contributed to shortages in all specialties and specifically in the operating room (OR), where there are numerous reports of significant and noticeable shortages. 9 profession, increasing care demands by an aging population, the changing nature of the health care environment, and the resulting stress on the individuals providing care. 7 Factors attributed to the current and worsening shortage in the OR include: (1) an aging workforce with many current and imminent retirements; (2) the lack of surgical education content and clinical experiences for nursing students; (3) demands for professional nurses in ambulatory care surgical settings; and (4) the difficulty of attracting and keeping OR nurses. 8 Although these factors exist in numerous clinical areas, their effects seem more dramatic in the OR. Nursing shortages are worsening at a time when job satisfaction in the field appears to be at a record low, with more nurses in hospitals reporting less satisfaction with their employment. 9 Aiken also reports that more than 40 percent of nurses working in hospitals report dissatisfaction with their jobs and that one in three hospital nurses under the age of 30 plan to leave their current job in the next year. 10 The greatest concerns among staff nurses include: (1) the malaise that has beset health care and nursing; (2) financial concerns, including salary ; …