If you really know the U.S. health system, you know one thing: At the core, the show is being run by nurses.
That’s always been a fact of life, but it’s coming into even sharper focus these days as doctors are pressured to treat more and more patients (spending less and less time with each) by cost-obsessed hospitals and insurance plans.
Unfortunately, a “perfect storm” of demographics and limits on training options are about to create a health crisis that will be obvious and potentially dangerous to patients in American health care facilities. We are on the verge of a crippling shortage of nurses. The main reasons are:
- An aging population
- An aging workforce of nurses
- Rising incidences of chronic disease
- A shortage of programs to train new nurses
A Vanderbilt University study has predicted that by 2025, the U.S. will experience a shortage of nurses twice as big as we’ve ever seen since Medicare and Medicaid came in during the 1960’s.
As people live longer, they’re more likely to get chronic disease. In fact, about 80 % of older adults have at least one chronic health issue. That makes them huge consumers of nursing services.
Against that background, the supply of nurses is actually shrinking. Almost three quarters of a million nurses are expected to retire by 2024. Many of them have worked longer than they expected due to financial stresses brought about by the financial crisis of 2008, but are now reaching a point where they have to toss in the scrubs.
Unfortunately, right now we don’t have the capacity to replace them. American nursing schools are now turning away over 75,000 qualified applicants to nursing bachelor and master’s degree programs each year because they don’t have the room or the instructors to train them all. In some areas, this problem is compounded by a shortage in health facilities where nursing school graduates can receive clinical training.
The situation varies around the country, depending on demographics. States like Florida that have huge elderly populations are struggling to fill nursing demand. Meanwhile, hospitals in rural states like South Dakota have actually started closing beds because they face a shortage of RNs.
The situation has caused some hospitals to force longer work shifts on the nurses they have, which has only encouraged more of them to retire or go into health teaching or other allied professions.
Some nursing schools are trying creative solutions, like adding more scholarships or forgiving loans to nurses who agree to teach for a set period of time after graduation.
Additionally, the American Nurses Association is trying to push Congress to expand funding for Title VIII of the Public Health Service Act, which gives federal money to nursing schools to grow educational programs and provide financial incentives for nursing students to complete their degrees. But that would require a change in direction. In recent years, Congress has actually cut the funding for Title VIII. It remains to be seen if the new administration of Donald Trump will see nurse training as part of its effort to increase U.S. infrastructure spending.