PRINCETON, NJ – According to the 2004 Health Resources and Services Administration’s National Sample Survey on the registered nurse population, the nursing shortage is expected to hit 1 million by 2020.

The next four-year survey will be released in the first quarter of 2010, but the industry is not waiting to see if the number has risen. Various organizations have been working hard to reverse the trend through innovative programs.

The Robert Wood Johnson Foundation’s (RWJF) New Careers in Nursing provides scholarships to under-represented minorities to attend nursing schools. To date, the program has awarded 700-plus scholarships, according to Sue Hassmiller, RN, senior adviser for RWJF.

“We need more nurses, younger nurses and a more diverse cadre into the field,” she said.
States and hospitals are providing money to send their licensed practical nurses to become registered nurses. Payers, local foundations and companies whose missions are aligned with healthcare access are also making investments.

In 2008, approximately 41,000 students were turned away from nursing schools because of a nationwide shortage of nursing faculty. With the average age of nursing faculty at 57 years, the industry is looking to create interest among nurses to become faculty members.
“We need more money for scholarships” to enable nurses to earn their masters and doctoral degrees Hassmiller said.

With clinical space also an issue, simulation training has been deployed to help students learn how to take care of patients at the most basic level. Some nursing schools are also collaborating to use a single electronic point of entry for available clinical areas, which allows for swapping and negotiation among schools, Hassmiller said.

Parallel to these efforts, stakeholders are actively designing new curricula that align with the needs of the 21st century and a growing population that is living longer, including chronic disease management, long-term care and end-of-life care.

Aside from growing the numbers of new nurses, organizations are looking at ways to retain nurses. “Retention is just as important as recruitment,” Hassmiller said.

RWJF sponsored a time and motion study to determine the time nurses spend with their patients.

The national average is only 30 percent of a nurse’s shift, according to Hassmiller. Through its national initiative, Transforming Care at the Bedside (TCAB), RWJF’s goal is to increase that percentage at 300 hospitals, specifically in the medical-surgical units, she said.

TCAB’s tools help hospitals improve their work environment by eliminating inefficiencies and putting quality of patient care back into the hands of nurses, said Hassmiller. Through TCAB, Cedar Sinai Medical Center reported an average of 86 percent of a nurse’s shift being spent with patients.

Program progress is most visible with scholarships, Hassmiller noted. To date, RWJF has funded 76 faculty positions in New Jersey nursing schools.

While funding is necessary, public education is also critical. Nursing associations may be big in numbers, but not in influence.

“At Robert Wood Johnson Foundation, we’re trying to present nursing as a societal issue,” Hassmiller said. “Nursing is an economic issue for communities.”

To that end, RWJF is collaborating with local corporations, banks and chambers of commerce to take action and implement funding and other innovative programs to decrease the nursing shortage. The 90 member organizations of RWJF’s National Nurse Funders Collaborative’s are helping to find new funding sponsors.

“We all have to work together,” she said. “It takes more than just nurses to move the needle. I am hopeful with healthcare reform that more federal money will go to basic nursing, education and faculty.”