In Wisconsin and across thecountry, one of the greatest challenges facing our health care system is the shortage of registered nurses. Whilemany people assume that this problem may not be a weighty subject, this issue could soon causedetrimental effects on our state and the nation. Whilecolleges and the government are trying to find the root of the problem, we must analyze the numerous factors thathave pushed us into the current situation we are in.
Althoughcharacteristics such as the aging generation of baby boomers, health care legislation,college acceptance rates, and even retirements have driven us to the state weare in, there is a larger problem that has impacted the shortage. Within this paper, I will be furtherdiscussing this bigger issue as well as the small factors that have affectedthe shortage and the larger problem of the shortage that our state isfacing. With this information, I hope toincrease the knowledge that common people know about the nursing issue andaddress the best solution to this problem. Tobegin addressing this problem, we must go to where one of the leading factorsfirst began. As a response to WWII ending, eager young adults who yearned tostart families made the birth rate swell. The total number of babies born in1946 was around 20 percent more than the amount in 1945. The increased birthrate ceased around 20 years later in 1964.
This boom of babies was the beginning of the “baby boomer” generation. Asof today, this generation makes up almost 40 percent of our nation’spopulation. In addition to making up almost half of our population, the “babyboomers” are already in their 60s and needing additional health care. According to the United States CensusBureau, the number of baby boomers turning 65 each day is around 10,000, whichwill continue until around 2030. Inaddition to this, the American Hospital Association (AHA) has predicted that by2030 more than 60 percent of baby boomers will be suffering from chronicconditions, 25 percent will be living with diabetes, 33 percent will be obese,and nearly 50 percent will be suffering from arthritis. With this anticipated large increase of individuals needing hospital orclinic treatment, the need for the number of health care workers, includingnurses, will rise. Another factor that is increasingthe need for health care workers is the Affordable Care Act, or ACA, which waspassed in 2010.
According to USA Today, the boomer generationwas said to gain the most from this health care act which drastically changedour health care system. Before the Affordable Care Act, the boomer generationoften times would pay higher health costs, around five to seven times higherthan younger Americans. This became a big problem if their former employees didnot offer retiree health benefits.
There would also be the occurrence of healthinsurance companies denying coverage to people who had pre-existingconditions. With the ACA being passed,it gave older Americans the access to health care without the limitationsstated before. The Affordable Care Act prevented insurers from denying coverageto individuals who already had pre-existing conditions and it limits the agerating so that a Boomer could only pay three times as much as youngergenerations. Although with the Affordable Care Act, it now authorizesstates to develop a system of coordinated care through a health home.
Thehealth home facilitates access and coordinate health services through homehealth care.These different health cares include primary care,behavioral care, and community-based care for recipients with a chroniccondition. Withthis better health care system, not only has the life expectancy rateincreased, but the number of health care workers has increased simultaneously. While the life expectancy rate maybe increasing, the state will soon be seeing a large number of individualsretiring throughout numerous occupations. Beginning in the early 1970s, alarger number of female baby boomers declared nursing as their profession. By the 1990s, baby boomer registered nurses(RN) made up around two-thirds of the nation’s RN workforce, totaling aroundone million nurses. The number of RNs peaked at 1.26 million in 2008, but sincethen, the baby boomer nursing generation began retiring in large numbers.
According to Health Affairs, since 2012,around 60,000 nurses were exiting the work force each year. In abouta decade, more than 70,000 RNs will be retiring annually. The heavy retirementof one million RNs from the workforce between now and 2030 will leave thehealth care field in a massive deficit. Withthe increasing number of baby-boomer nurses retiring, the quality of patient carecould in turn decrease as new and less experienced nurses enter the nursingprofession. With most of our oldergeneration nurses retiring, not only are they leaving jobs open, but they arealso taking decades of experience with them. I am not suggesting the new nursesare not capable of providing care, but the older nurses have more experienceand knowledge when it comes to managing difficult situations with patients.
With the patients care at risk, we must address this situation happening in ourstate more than ever and begin to find solutions. To begin addressing the problem ofthe nursing shortage, we must look at what colleges around the state aredoing. Around our local four-yearcolleges, the nursing departments are beginning to feel the stress from thestate to help aidin the number of nurses going into the field. Linda Young, the Dean of theCollege of Nursing and Health Science at the University of Wisconsin-Eau Clairecomments on the problem the state is facing. She says: The numbers are not looking good,as we look to the future, we’re going to face an even more dramatic nursingshortage than we are now, so we need to prepare for that.
Although collegeslike the University of Eau Claire are feeling the pressure, they continue to turn away half oftheir qualified applicants due to the limited number of faculty the programhas. Even our state’s biggest university, the University of Wisconsin-Madison,has a very limited number of applicants accepted each semester. Through an interview with Dr.
Lisa Bratzke,the Honors Program Coordinator and an Assistant Nursing Professor at theUniversity of Wisconsin-Madison, she states, “The shortage will become worsewith time.” Wecontinue to see a trend throughout the universities in Wisconsin in which theiracceptance rates are failing to keep up with the number of studentsapplying. In 2012-2013, 50% to 80% ofqualified undergraduate students who applied to nursing programs at eitherUW-Madison, UW-Eau Claire, UW-Milwaukee, or UW-Oshkosh were denied admission. While these applicants were all wellqualified to be admitted to these programs, the were ultimately denied because of the lack of faculty members to teachthem. It is evident that the nursing shortage is not a direct cause of thelack of students going for nursing, but rather the amount of faculty who can teachthem. While these four nursingprograms are struggling with faculty members, the state itself is trying toencourage current nurses to return to school and earn a higher degree. In2013, a $3.
2 million fund called the Nurses for Wisconsin initiative, was givento four UW system schools to increase the number of nursing instructors. Thismoney will offer fellowships and loan forgiveness to help nurses return toschool, earn advanced degrees, and become nursing instructors. These fourschools, which include Madison, Eau-Claire, Milwaukee, and Oshkosh, are stillstruggling with the challenge of increasing enrollment with a decreasing numberof instructors. The Nurses for Wisconsininitiative, which lasted until 2015, was meant to accomplish numerous goals. Firstly, it would provide fellowships, whichis financial support, to nurses enrolling in doctoral programs at the fourpreviously listed schools.
Thepre-doctoral fellowship will also support students pursuing either a PhD or Doctor of Nursing Practice (DNP) degree.With this fellowship, individualswill receive paid tuition and fees, as well as a salary in exchange for athree-year commitment to any of the four listed UW nursing schools. Lastly, thefour schools are offering loan forgiveness as a way to encourage faculty with aPhD or Doctor of Nursing Practice degreeto educate. This program will repay up to $50,000 of student loan debt fornew employees. Up until its end in 2015, this money was a huge step to help thestate rebuild and enhance the nursing programs these colleges offer. Inaddition to the Nurses for Wisconsin initiative fund, numerous hospitals aroundthe state give tuition funds to nurses going back to school to earn a higherdegree. While this helps give currentnurses the push to go back to school, the new Republican tax legislation would makethis more difficult. One of the biggest lossesis that grad students who get tuition waivers will now have to pay income taxon the waiver.
This includes graduate nursing students who are receivingtuition waivers while working with the staff. After an interview with Dr.Catherine Kennedy, Graduate Admissions Coordinator at the University ofWisconsin- Eau Claire, she says:Althoughwe do not do the tuition waiver, we do offer work with the graduatefaculty. In addition to this, I do knowmany individuals use the HRSA Loan Repayment which allows licensed registerednurses to receive loans to help pay for graduate programs.While all theseprograms were a jump in the right direction, the process of reinventing similarprograms may take some time.
To further address this problem, we need creativestrategies to help repair these programs and the state. While the nursing shortage problemis Wisconsin continues, we are faced with the question: How do we get morenurses? After numerous years ofvolunteering and working in the Marshfield Clinic Hospital, I have seen theeffects of the shortage directly on the community and patients. Through my experience as a Certified NursingAssistant (CNA), I have had a first-hand encounter with the deficit of nursesin hospitals.
With this nursing shortage becoming more prominent, the RNs arepressured to not only take numerous extra shifts, but also take shifts that canlast over sixteen hours. These long shifts not only endanger the patients, butalso the nurses working. These incidentscaused by the lack of staff give me the motivation to reconsider a solution forthe nursing programs and the state. While the Nurses for Wisconsin initiative gave Wisconsin the jump startit needed, it should have not ended in2015. Since this fund has ended, there has not been another initiative toaddress this problem.
Nevertheless,other states and universities have begun working with AACN, the AmericanAssociation of Colleges of Nursing, to help improve access to graduate programsthat lead to positions as professors in colleges. To begin addressing this problem again, the universitiesneed additional funding to help influence current registered nurses to returnto school. In addition to this, manyassociations like the American Nurses Association and the AACN, have urged Congressto improve Nursing Workforce Development programs. The Public Health ServiceAct, which is the primary source of federal aid for nursing education programs,needs to increase the amount of aid available. According to the University of Notre Dame:The ANAand AACN believe that it can help alleviate the financial burden of trainingnew nurses, including nurse educators.One of thetop solutions to this problem is increasing the funding the state is receivingfor nursing programs.
While this may not happen, there are numerous othersmaller and more manageable solutions that are possible for not only the state,but also for universities like Eau Claire. While focusing on current registered nurseswill greatly aid to the deficit of nurses, focusing on current high schoolerscould also help the number of individuals considering the field of nursing.While we would still need more individuals to teach these students, it mightcreate a higher supply and demand influence on the state. Inmost public high schools, surrounding colleges will give presentations toattend their school. We need nursing programs,to also start these presentations to influence high schoolers to considernursing as a profession.
In additionto this, colleges should also begin pushing current nursing students into theeducation side of nursing. Thiscould be done by either providing beginning level programs to give experience toundergraduate nursing students, or by giving additional information about furthereducation for nursing. Another solution local colleges could pursueis forming strategic partnerships to help increase their programs capacity forstudents.
The University of Wisconsin-EauClaire began forming a partnership with the Marshfield Clinic to increase thenumber of applicants accepted. Thisadditional program at the Marshfield site has allowed around twelve moreapplicants to be accepted into a nursing program. This partnership between the clinic and theuniversity is what other collegesshould begin.
This would not onlyincrease the number of applicants being accepted into nursing programs, butalso would increase the number of locations in which you could earn a four yearnursing degree. Additional colleges likethe University of Minnesota have begun private partnerships with the VA HealthCare system in hopes to expand enrollment in the school’s BSN program. These examples of small expansion couldultimately save the nursing programs in the state. Although they accept fewer amounts ofapplicants, they also require a smaller number of faculty to sustain theprogram. While these smaller solutions may help thenursing shortage in our state, we ultimately need to focus solely on thefaculty in these programs. The main issue, while still affected by baby boomerage, is the shortage of faculty in these schools. Each year, massivenumbers of qualified applicants are turned away because of the lack ofprofessors.
While influencing teenagersin high school and undergraduate nursing majors may begin to solve the lack ofnurses, the first step to repairing the nursing system is acquiring moreprofessors who are able to teach these students. To begin fixing the shortage, we need to begininfluencing and encouraging current nurses in the health care field to returnto school and earn the licenses they need to educate. Programs such as the Nurses for Wisconsin initiative is what the stateand universities need to be contributing towards the solution. These types of programs provide financial aidto nurses who are seeking the opportunity to go back to school and earn ahigher degree. Without these nurses who even have a small interest inreturning to school, we will fail to rebuild the program and the problem in ourstate will persist. Robin Beeman, Assistant Dean for the Eau Claire nursingprogram in Marshfield even says, “The shortage of faculty qualified to teach isbecoming more of the issue.
” Without these nurses andprofessors, the nursing shortage in Wisconsin will become even worse. The number of nurses Wisconsin universities areoutputting is not nearly enough to sustain the amount of elderly people we willsoon be caring for in the near future. Whilethe grants, new facilities, and even higher acceptance rates could fix thecurrent shortage, our state needs to start looking at what we currently have. Althoughthe previously stated smaller solutions would be very useful, the issue of thisdetrimental nurse shortage will fail to be solved without the current nurses wehave.
The solution to the nursingshortage Wisconsin is now experiencing, is the nurses themselves.