Nurses, Pharmacists Take On New Roles | WSJ | 1.31.05
Nurses possess a high degree of training and skill, and an increasingly strained U.S. health-care system is gradually making better use of their talents. According to U.S. News & World Report, the nation’s 2 million-plus nurses are handling tasks once thought to be the exclusive domain of doctors, such as “administering chemotherapy and running their own primary-care practices.” …
…that hospitals could face a 29% vacancy rate by 2020, a figure which translates into 810,000 nurses. The current vacancy rate is put at 7%.
Nurses Step to the Front | USNews | 1.31.05
…In 1980, 60 percent of nurses received their basic education through on-the-job training courses in hospitals. That number was cut in half by 2000. During that same time, the share of nurses earning associate’s degrees more than doubled, to 40 percent. The number of nurses pursuing master’s degrees and doctorates has tripled over the past two decades–by 2000, one in 10 registered nurses had made the leap. And the number of doctoral programs nationwide has grown from 52 in 1990 to 93 today. By 2015, the American Association of Colleges of Nursing wants all nurses doing advanced practice work that now requires at least a master’s degree–this includes nurse practitioners, clinical nurse specialists, nurse midwives, and nurse anesthetists–to hold a doctorate of nursing practice. …
More Nurses Needed | USNews | 1.31.05
…The trouble is that most nurses are now headed toward retirement. In the 1980s and 1990s, enrollment in nursing schools sank as young women took advantage of increased career opportunities in other fields. By 2000, the average age of RN s was about 43. In the past few years, high wages have drawn former nurses back to hospitals–but two thirds of the new hires are older than 50, making things more lopsided than ever.
Nursing schools would have to increase enrollment by 40 percent annually just to compensate for retiring RNs. …
Doctors Vanish From View | USNews | 1.31.05
…Many doctors around the country are similarly frustrated. A 2001 California survey of physicians found that 75 percent of respondents grew less satisfied with practicing medicine over the previous five years. A nationwide survey by the Henry J. Kaiser Family Foundation found that 87 percent of doctors say the overall morale of the profession has gone down in the past few years, and nearly 60 percent said their own morale had declined. …
In 2003, the median debt for graduates of public med schools was $100,000 and, for those graduating from private schools, a whopping $135,000, according to the Association of American Medical Colleges. (In 20 years, the median debt level has increased more than 4.5 times.) Meantime, malpractice insurance rates are still climbing. …
Shortages will (and do) vary by geographical area, depending on reimbursement levels, malpractice insurance rates, and the cost of living. …
In certain specialties like geriatrics, cardiology, neurosurgery, and oncology, the shortages are projected to be nationwide, even in areas with a high concentration of doctors. Demand for their services will rise as the baby boomers age and develop chronic conditions, but there isn’t a corresponding surge of interested students. …
The demand for the “mid-level” providers and the allied health providers may be increasing in terms of cognitive and technical skill sets—but is it solely due to the expansion of the horizon (lateral or horizontal growth) or is there also a downward drift (vertical growth) of the skill sets traditionally offered by physicians and driven by increasing unmet demand and a worsening economic milieu. Similarly, there is the upward drift (another form of vertical growth), best seen in the BSN → MSN → PhD-Nursing movement that runs counter to the demand needs placed on the professional and aging nursing population. Are we not seeing both physicians and nurses being squeezed into the marginal areas of their mainstream disciplines where economics and impact on life-style are most favorable? Will “traditional nursing” expand into the “general medicine” and “less-than-desirable” medicine venues as physicians adapt to their new practice realities? Who and what class of health service providers will fill the void left by nursing as it seeks to adapt to their unique pressures and expectations? In any given ecological niché, all species experience adaptive changes—no one gets to mutate alone…
4 Comments
The US News and World Report issue should be required reading for all physicians.
Many of us have an exaggerated sense of our contributions and undervalue the work of nurses and other healthcare professionals. In a lot of cases they do work that is every bit as good as ours for far less cost and without a fraction of the hoopla and ego.
I've written about such in a number of places on my weblog. I offer my post of 12/2/04 “Bailed out by Nurses” as one example.
Agree! For those that work (or have worked) with paramedics there is a similar migration of technical and cognitive skills—see a dated piece here.
The US News and World Report issue should be required reading for all physicians.
Many of us have an exaggerated sense of our contributions and undervalue the work of nurses and other healthcare professionals. In a lot of cases they do work that is every bit as good as ours for far less cost and without a fraction of the hoopla and ego.
I’ve written about such in a number of places on my weblog. I offer my post of 12/2/04 “Bailed out by Nurses” as one example.
Agree! For those that work (or have worked) with paramedics there is a similar migration of technical and cognitive skills—see a dated piece here.