Panel holds hearing on nursing shortage

The continuing shortage of nurses was the focus of recent public hearings held by the National Commission on Nursing. The com- mission is an independent group of represen- tatives from nursing, medicine, hospital man- agement, and government, whose purpose is to study and find solutions to the problems facing the nursing profession.

One of the commission’s first efforts was a series of regional hearings held in late Feb- ruary and early March. The hearings in Chicago, Boston, Atlanta, Denver, Houston, and San Francisco were set up to gather “grassroots” information on nursing issues as they relate to the shortage.

The commission, which is funded by the American Hospital Association, the Hospital Research and Educational Trust, and the American Hospital Supply Corporation, hopes to issue recommendations based on the in- formation next September.

Testimony at the hearings came from a wide range of individuals, including nurses, physi- cians, hospital administrators, nursing educators, and legislators. Almost everyone agreed on the critical nature of the shortage, but views on the causes and possible solutions varied greatly.

Several speakers pointed to nurses’ poor power base and limited voice in hospital policy matters as important factors in the shortage. Poor nurse-physician relationships and lack of support from hospital administrators were also mentioned along with the well-publicized prob- lems of low pay, unusual hours, and stressful working conditions.

Much of the blame for nurses leaving hospi- tals was leveled at hospital administrators. Testifying in Denver, Joanne Dodd, director of nursing at Billings (Mont) Deaconess Hospital,

said that administrators seldom take nurses into consideration when planning hospital pol- icy. “It’s amazing to me that goals and objec- tives can be developed for an institution with- out talking to the nurse, who is closest to the consumers of our product-patient care,” Dodd said. “This lack of recognition by top management is one of the reasons nurses leave nursing.”

Lack of support from management is another factor. William Leary, president of the Montana Hospital Association, said his or- ganization had reviewed exit interviews from major hospitals in the state and found cases where nurses had been harassed or “put in their place” by physicians. “When this occurs, administration has failed to stand up and sup- port the position of the nurses,” he said.

Nurses are suffering in part because nursing management is weak. One of the greatest shortage problems is the scarcity of leaders in nursing, according to Carol Peterson, dean and professor of nursing at South Dakota State University, Brookings. “Until the nursing pro- fession has a bigger pool of leaders, it will suffer serious problems.” She said power struggles between management and nursing and struggles within nursing continue to de- moralize the profession.

Peterson supported baccalaureate training of nurses as a key to professionalism in nurs- ing. Many other speakers agreed that associ- ate degree and diploma programs taught the technical and clinical skills, but left nurses un- prepared for greater responsibilities. “Nurses are placed in positions in which the job de- mands are unrealistic when compared with their educational preparation,” Joanne Dodd said. “The nursing education system has not responded quickly enough to changes in the

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system of health care delivery.” Dodd blamed nursing service personnel as

well as educators for the educational in- adequacies. “The two groups spend far too much time saying ‘you are not preparing a product I can use’ or ‘you don’t know how to use the product I am preparing.”’ She stressed that advanced education is the only answer.

During the same Denver hearing, however, supporters of diploma programs continued to criticize the clinical skills of baccalaureate- prepared nurses. Marilyn White, director of nursing at Missoula (Mont) Community Hospi- tal, said many new graduates are unprepared for the realities of practice in the acute care setting. She said she often hires “new gradu- ates supposedly ready for practice” who have never attempted a venipuncture or a cathe- terization. Many of these same students have never worked nights or weekends, she said, and seemed surprised to learn they will have to work these hours.

White also deplored the lack of operating room experience in current training programs. “Perhaps my school went to extremes when it scheduled me to spend three months in the operating room and required that I obtain the experience of scrubbing on a specific number of major and minor surgeries,” she said. ”However, haven’t we gone too far to the other extreme to have today’s student nurse not ex- perience, but only observe?”

Testimony in the other five cities was similar to that in Denver. Testifying in Chicago, Ameri- can Nurses’ Association President Barbara Nichols said nurses in acute care settings need better salaries, flexible scheduling, and ways to influence the environment in which they practice. She also said hospitals need to provide recognition for clinical performance and length of service to retain valuable em- ployees and reduce turnover.

Also speaking in Chicago was Karl D Bays, chairman of the American Hospital Supply Corporation. Bays said the nursing shortage won’t be solved until the right questions are asked. He asked if nurses have been given adequate authority corresponding to their re- sponsibilities, warning that an imbalance could only lead to frustration. He questioned whether hospitals have placed “sufficient priority on the investments we make in nurses’ compensa- tion, compared to other investments.”

In Boston, Virginia Layfield, chairman of the Task Force in Nursing from Maryland, told the commission hospitals must take action to keep their nurses. She said hospitals have a re- sponsibility to market nursing as a career choice. She called for clinical ladders with in- creased compensation for nurses who desire to stay in patient care. Hospitals should supply or support management courses for nurses who wish careers in this direction.

Layfield also recommended that hospitals provide career courses in the high schools to interest young people in nursing.

Speaking in Denver, Beverly Jones, director of nursing services at Longmont (Colo) United Hospital, agreed. She said nurses and hospi- tals have failed to market nursing as a palata- ble profession to potential nursing students. “We must appear to be what we are,” she said, “stimulating, rewarding, creative, with a poten- tial for a variety of experiences offered by no other profession.”

Rebecca D Morris Assistant Editor

Company sponsors 20 nurse scholarships American Medical International, Inc/Eastern Region, has become the largest scholarship sponsor in the 1981 National Student Nurses’ Association (NSNA) Scholarship Program. The company presented a $20,000 contribution for 20 $1,000 scholarships for NSNA members.

in the 1981 scholarship program. Announcement of NSNA scholarship winners was made during the opening ceremonies of the NSNA Convention, April 29 to May 3 in Cleveland.

NSNA will award $70,200 to 64 students

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