May 25, 2001
Senate Hearing Links Nurse Shortage to Poor Working Conditions
At a May 17 hearing before the Senate Health, Education, Labor, and Pensions Committee, a panel representing policy-advisors and care providers testified that the growing nursing shortage is a symptom - not the cause - of a deteriorating healthcare delivery system. According to the witnesses, industry-wide forces such as declining reimbursement, higher levels of patient acuity, increasingly complex technology, and diminishing resources have created a stressful, unrewarding, and accusatory work environment that drives experienced nurses out of the profession and discourages new nurses from entering the field.
Citing a recent report from the Nurse Division of the American Federation of Teachers, Gerald Shea of the AFL-CIO told the Committee that better working conditions would significantly reduce the number of nurses leaving their jobs. The report found that about 75 percent of nurses planning to leave the profession would consider staying if their working environment improved. Sen. Christopher Dodd (D-Conn.) strongly agreed with this report, referring to a recent bargaining session between a Connecticut hospital and its unionized nurses which focused solely on working conditions, not wages or benefits.
The panel (which also included representatives from a home care provider, a policy research center, and the American Hospital Association) suggested several ways to improve working conditions for nurses. They recommended that the Committee first fund quantitative research that would clearly and specifically identify the primary causes of dissatisfaction - currently, the data is primarily anecdotal. They also advised that nurses play a central role in reconfiguring their workplace and the care delivery system. Julie Sochaski of the Center for Health Services and Policy Research at the University of Pennsylvania reminded Senators that nurses have historically driven important and highly effective changes in care delivery such as the development of specialized intensive care units.
Arguing that mandatory or expected overtime is one of the greatest sources of nurses' dissatisfaction and frustration, Mr. Shea encouraged Congress to consider a ban on mandatory overtime. However, other panel members disagreed and considered a ban simply a short-term solution. Sister Mary Roch Rocklage of the American Hospital Association added that overtime is not used by hospitals as a "quick-fix," but as a method of last-resort. Sens. Edward Kennedy (D-Mass.) and John Kerry (D-Mass.) followed up by announcing their plans to introduce legislation that would offer financial incentives to facilities that avoided mandatory overtime and would provide funding to those unable to fill vacancies.
The panel warned the Committee that the nursing shortage is evolving into more than a staffing issue. It is becoming a patient safety and access issue. Mr. Shea cited a recent JCAHO study that found nearly 25 percent of serious medical errors are linked to inadequate staffing levels. The witnesses urged Congress to put staffing issues at the center of their current debates over patient safety and access to care.
Information: Christiane Mitchell, AAMC Office of Governmental Relations, 202-828-0526.
