The Hospital Nurse Workforce: Problems and Prospects

News media over the past two years have focused intensively on the implications of hospitals having too few nurses: Reader's Digest, " How hospitals are gambling with your life " (2001); New York Times, " Nursing shortage is raising worries on patients' care " (2001); Wall Street Journal, " How to lessen impact of nursing shortage on your hospital stay " (2001); Chicago Tribune, " Nursing mistakes kill, injure thousands " (2000); Washington Post, " When the hospital staff isn't enough " (2001). Multiple surveys of nurses and physicians document high levels of concern about nurse staffing levels in hospitals. Half of primary care physicians and two-thirds of specialists rate nursing staff levels in U.S. hospitals as fair or poor (Commonwealth Fund, 2000). Two-thirds of hospital nurses report nurse staffing is inadequate in their institutions and forty-five percent report the quality of care has deteriorated in the past year (Aiken et al., 2001). While there is little evidence that hospitals are making dramatic adjustments in nurse staffing because of media coverage and criticism from health professionals, responses from elsewhere are noteworthy. The American Nurses Association, which has for more than one hundred years advocated for increased professional status for nurses, took a historic step this year affiliating with the AFL-CIO (American Nurse, 2001). Governmental responses to the nursing shortage at the state and federal levels have increased. One state, California, passed legislation which is scheduled to go into effect in January 2002 mandating hospital minimum nurse staffing ratios and limiting the scope of work of nurses' aides. The National Conference of