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A collision between a shrinking nursing workforce and an aging baby-boomer population is looming. This scenario has sparked widespread concern about higher costs, jeopardized access, and compromised quality of care.

According to Dr. Peter Buerhaus, associate dean for research at Vanderbilt University's School of Nursing in Nashville, TN, and leading expert on the aging of the RN workforce in the United States, there are options for staving off a nursing shortage crisis. Dr. Buerhaus describes these options in the last installment of a four-part series in Nursing Economic$, The Journal for Health Care Leaders.

The number of women interested in nursing is dropping dramatically: women graduating from high school in the 1990s were 35% less likely to become RNs compared to women who graduated in the 1970s, according to Dr. Buerhaus' findings. In addition, the current nursing workforce is aging: 40% of working RNs will be over 50 by 2010. As fewer enter the field and the older nurses retire, who will care for the 78 million baby boomers reaching age 65 in the next 3 decades?

Dr. Buerhaus and his co-authors recommend the following:

• Accept that the RN supply will drop and adapt working conditions for older nurses.
  
• Use technology to save precious RN labor and boost training and education for unlicensed assistive personnel.
  
• Monitor hospitals that cut staffing excessively and make that information available to the public.
  
• Prepare RNs for changing roles and adjust curricula accordingly (more emphasis on gerontology, mental health, and chronic conditions).

The authors also advise improving the image of nursing, reducing the costs of nursing education, eliminating barriers and stigmas facing men and minorities, developing ways to keep older RNs in the workforce, and allowing more foreign-educated RNs into the United States.

The shortage is "a social problem whose implications are so broad and deep that the time has come to put it squarely on the nation's social policy agenda," the authors state. They add that only then "will it be possible to capture the public's attention, generate and shape political will." Dr. Buerhaus and his co-authors strongly recommend that Congress requests an objective study by an independent body such as the Institute of Medicine.

Part IV of the Nursing Economic$ series is featured in the November/December 2000 issue. The first three articles, which were published in the May/June, July/August, and September/October 2000 issues, concentrated on the effects of the shortage, the increasing age of RNs graduating from associate degree programs, and how wider career options have enticed women into other fields.

Along with Dr. Buerhaus, co-authors of the articles are Douglas O. Staiger, associate professor of economics, Dartmouth College, Hanover, NH; and David I. Auerbach, doctoral student in health policy, Harvard University, Cambridge, MA.

Nursing Economic$, The Journal for Health Care Leaders, is published bi-monthly by Jannetti Publications, Inc., East Holly Avenue Box 56, Pitman NJ, 08071-0056; 856-256-2300; Fax: 856-589-7463; e-mail: janetd@ajj.com; www.ajj.com/jpi

SOURCE: Jannetti Publications