Commentary: What has Caused the Nurse Shortage Crisis?

On shortages of nurses and nursing cutbacks

There are no simple answers to the question, hat has caused the nurse shortage crisis?, as the topic of nursing shortages is complex and open to debate. There are obviously many causes, some of which include demographics, education and funding. Examine these particular causes with an eye to the future, taking a pro-active, positive and a constructive stand, with regard to possible resolution of the nursing shortage crisis. While this crisis situation may not be resolved immediately, it may be possible to implement changes for the future.

This is not the kind of scenario, where there is only one problem that can be isolated and rectified immediately. There may not be a quick fix for the current nurse shortage crisis. This is not suggesting that something cannot be done, as there are possible long term solutions.Nurse shortages are a global concern and this is not something new or different. There have always been nurse shortages. This is likely to continue into the future, unless effective changes are instituted, during this era.

Consider this example. There appears to be a growing problem of nurse shortages because of the advanced technological advances in global communication. The population of the world is expanding rapidly. More nurses must be trained and increased funding is needed for the education of registered nurses, everywhere. Any nurse shortage has the potential to turn into a crisis situation, when large numbers of people,  in an area do not receive appropriate nursing care because there are not enough nurses. This can happen at any time and in any place.

From a registered nurse's perspective, registered nurses are trained to meet the nursing care needs of people. They try to meet those needs, even when it is not always possible to do so. Registered nurses work long hours, often putting their own personal lives at risk. Registered nurses provide professional nursing care, but when there are not enough nurses, the quality of care can diminish.

Registered nurses strive for excellence in their profession, which should be reflected in the pay and benefits that they receive. In comparison to other medical professions, their financial remuneration and benefits are not unreasonable, but their pay should be increased because of the growing demands placed upon them and their increasing workloads. The financial remuneration that nurses currently receive for their work or have received in the past, is not the cause of the nurse shortage crisis.

One of the major causes of the nursing shortage crisis has to do with substantial cutbacks in healthcare, due to the lack of funding, which means that the numbers of registered nurses are reduced, because of monetary restraints instituted on many different levels. In order to understand this more fully, consider nursing shortages from a broader perspective. 

Use this model. A pebble tossed into the water, creates a series of concentric rings. Call this the pebble effect. The individual is represented by the center of all the circles that form. The next ring would represent the family and so on: individual, family, community, city, province or state, country, world and universe.

It immediately becomes evident that there is a delicate balance between all of the different levels of society, where nurses, nursing care and nursing education are concerned. How complex the question of the nursing shortage crisis actually is! Patients that need nursing care are found, on every level. So are nurses, nursing care and nursing education, but cost has to be calculated in the equation on every level, as well.

Look at these four factors: nurses, nursing care, nursing education and the cost.

Operating on a minimalist principle, with regard to the law of supply and demand for registered nurses, comes down to the question of who gets what share of the pie. When there is money available for health care, where does it go? Is it absorbed by communities or cities or is it relegated to certain provinces or states instead? Who ultimately benefits from it? Where does this leave the individual? What happens on one level has repercussions, on every other level.

This is true, even when it entails providing the minimum possible number of registered nurses per capita. Remember that reduction to the minimum possible number of registered nurses per capita, potentially leads to a shortage of nurses and a potential crisis situation. This is less than an ideal scenario.

There are other factors that must be considered.

The law of supply and demand for registered nurses incorporates aging population trends, population growth spurts and the various levels of health care development of first, second and third world countries into the picture. Nurse shortages are never restricted to the western world.

Another factor is the increasing global recession which places an added burden on the supply and demand for registered nurses, because there is a lack of money for health care, which includes funding for nurses, nursing care and nursing education.

Demographics play a major role in nursing shortages. For instance, post World War II demographics indicate that there are an extremely high number of baby boomers in comparison to the numbers of other population groups. At the same time, there are a low number of post baby boomers. This becomes part of the future supply and demand picture for registered nurses. It appears that there may not be sufficient numbers of post baby boomers that can be trained as registered nurses, for the future.

There is the rising cost of nursing education. Colleges and universities are currently providing the majority of the training for registered nurses, but the cost of this level of education is extremely high. Obviously, when there is a nursing shortage, more nurses need to be trained and more nursing schools could and should be established. But one has to ask, who is going to pay the cost? Will it be governments who delegate money to provinces or states? Or does the cost ultimately come out of the pockets of the city or community being served by the registered nurses? Should families or potential registered nurses as service providers, have to cover the cost of their nursing education?

What role does global technology play in all of this? High emphasis on more advanced, global technological development in other areas of interest and concern, may result in health care being placed on a lower level, in terms of priority. This also includes nurses, nursing care and nursing education.

What is taking precedence to health care and more specifically, nursing? What is more important? Does developing the infrastructure of a country take priority over the health care of people, in that same country? Even if that does provide jobs, are people who are not taken care of properly health wise, going to be able to work at those jobs?

What takes precedence with regard to government funding? Is it nurses, nursing care, nursing education or the development of a space station? Should the majority of government funding go towards military protection of a country? What about company bailouts, during a time of recession?

It appears that the voice that cries the loudest is likely the one that receives the dollars that are available.

Allocating more dollars for health care, does not necessarily mean that it increases the numbers of nurses. Health care is broad in scope and is not restricted to nurses, nursing care or nursing education. Every dollar that goes to heath care does not go directly to nurses or towards provisions for nursing care; neither does it necessarily go towards education for more nurses.

There are those who will argue that nurses are overpaid. Some will suggest that nursing care can be done by paraprofessionals. Others question why anyone should have to pay the cost of educating registered nurses at colleges or universities. There are also those who argue that each individual (or his or her family) should be ultimately responsible for his or her nursing care. This kind of a mind set heads directly towards a nightmarish scenario and a potential crisis situation.

The decision making process involves those who do not know or recognize the value of professional nursing care, as opposed to non-professional nursing care.

The bottom line comes down to the reality that registered nurses must take a strong stand as advocates for other nurses, nursing care, the nursing profession, as a whole and nursing education. Health care education and nursing care are vital for the survival of the human race. Registered nurses stand as professional advocates for people, all around the world. .

Speaking out as nursing professionals and voicing concern about nursing cutbacks, will not necessarily resolve the current crisis situation, but it may help to elicit some kind of a response, from those who are not fully aware of the serious implications of nursing shortages everywhere.

For those who argue against increases in health care funding, in order to resolve the nursing shortage crisis, ask yourself these questions. Do you need nursing care now? Will you need nursing care in the future? What level of nursing care will you need? What level of nursing care do you want? Are you willing to settle for minimal care? What will you do, if you do not receive any nursing care? Will you be satisfied with nursing care, administered by paraprofessionals? Do you know the difference?

More nurses, nursing care and increased nursing education, are needed all around the world. Registered nurses provide both quality nursing care and professional health care education.

Yes, there are critical nurse shortages right now, but there are also nursing cutbacks. Over the long run, who will suffer? Everyone will suffer, particularly patients who need nursing care.

Who can speak out? Almost everyone has a voice. Everyone may also need care, compassion and concern 

from registered nurses, at one time or another, especially when it involves a crisis situation, like a pandemic. Should the current nurse shortage crisis be taken seriously? Yes.