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By Louis Pilla
lpilla@nurses.com

WASHINGTON, DC—In conjunction with the announcement of preliminary findings from the government's latest statistical portrait of nursing, Congressional legislators Wednesday announced that they would soon introduce measures designed to address nursing shortage issues.

In what may amount to a Valentine's Day present for the profession, legislators from both house of Congress took aim at a nursing shortage that appears to differ in its causes from previous nursing shortages and promises to get worse before it gets better.

The announcement of preliminary findings from the National Sample Survey of Registered Nurses, regarded as the nation's most extensive numerical portrait of the profession, seemed to take backstage to announcements of the legislative moves.

At an event held in a Senate office building here, U.S. Senators Jim Jeffords (R-VT) and John Kerry (D-MA), and U.S. Representative Lois Capps (D-CA) indicated they would introduce wide-ranging legislation that would help bring nurses into the profession, retain those that are already there, enable nurses in practice to advance in their career, and devote more resources to providing better statistics about the profession.

"We must take action to encourage more dedicated Americans to enter the field and to support them once they are there," said Jeffords. "Our society is not doing a good job at demonstrating how much we truly depend on the nursing profession.

"Increased wages are only a part of the solution. We have a responsibility to foster a cultural respect and gratitude to those who make incredible sacrifices to care for us in our weakest moments."

The nation is facing an "incredible shortfall of well-trained, experienced nurses in all fields and all levels of expertise," said Capps, a nurse now serving in Congress.

Not the same type of shortage
The legislators suggested that this shortage differs from previous shortfalls in the nursing profession.

Previous nursing shortages, Kerry suggested, were tied to business consolidation or an economic cycle tied to a downturn in the economy. But the present shortage, he noted, issues from a combination of factors "that makes this much more volatile and dangerous."Kerry traced the shortage to such factors as cuts in Medicare funding, the impact of managed care, and inadequate Medicaid payment rates set by the states, specifically in long-term care.

Capps, meanwhile, said that rises in compensation haven't attracted enough individuals to the field. What's more, she said, an aging nurse workforce presents a dynamic that hasn't been seen before.

Legislative efforts
Lawmakers should soon introduce legislation in both the Senate and House. On the Senate side, the Kerry-Jeffords Nurse Reinvestment Act would, according to Kerry, authorize for the first time in history a national nurse service corps, which would administer scholarships and loan repayment programs.

Other provisions would include:

• Recruitment of new students through funding of national and local public service efforts to enhance the profile of nursing and get students to commit to a career in nursing, as well as expanded school-to-career partnerships to show youth the value of nursing
  
• Support of remedial education for older nursing students and those from disadvantaged backgrounds
  
• Help for colleges and universities to develop curriculums in gerontology so that they can be ready to care for a growing senior population
  
• Help for institutions to provide advanced education and training to nurses across the career ladder.

The measure would also, he said, reauthorize a Federal Medicaid matching program so that states would be able to receive an enhanced federal match of 90% of the cost of nurse education and training in nursing homes.

Finally, the measure may involved a tax break to provide incentives for nursing staff.

"The act will reinvest in nurses in the field and provide them with education and training at every step of the career ladder at every healthcare facility at which they work," Kerry said.

Second initiative
Similar legislation seems to be in the works in the House. Capps outlined that would include proposals to improve access to nursing education, create partnerships between healthcare providers and educational institutions to support nurses as they seek training, and improve the collection and analysis of data about nursing workforce.

She also said that she is looking into the idea of creating a national nursing service corps to help fund the education of nurses who commit to working in high-need fields and areas.

It would also provide grants for developing public-private partnerships between hospitals, nursing schools, and high schools.

Doing the numbers
As for the release of the preliminary findings of the 7th National Sample Survey of Registered Nurses, various statistics affirm the familiar litany of a nursing workforce with too few new members and too many older nurses. These include:

• 2,696,540 individuals were licensed RNs in the U.S. as of March 2000. That represents an increase of 137,666 over the 1996 level, but only a 5.4 percent increase in the total RN population, the lowest increase reported in any of the previous national surveys
  
• the average age of the RN population was 45.2 years, almost one year older than the 44.5 reported in 1996.
  
• 58.5 percent of RNs reported working full-time, 23.2 percent part-time, and 18.3 percent said they weren't employed in nursing.

"An inadequate supply of RNs can impact both cost, access, and in addition, quality of healthcare provided to the American public," said Mary Wakefield, PhD, RN, director of George Mason University's Center for Health Policy, Research & Ethics, which sponsored the event. "The impact of declining numbers is already palpable in some areas."

Look for continuing coverage of the National Sample Survey in future articles on Nurses.com.

See related articles:
ANA addresses nursing shortage at Senate subcommittee hearing
Nursing shortage looms
Nursing scholarship program proposed