It is an established and well-known fact that there is a shortage of nurses in this country. A look at some of the statistics sheds a little light on the long-term implications of this shortage and just how important a profession nursing is. Registered nurses constitute the largest health care occupation, with 2.4 million jobs; about 3 out of 5 jobs are in hospitals. Registered nurses are projected to create the second largest number of new jobs among all occupations over the next ten years; job opportunities in most specialties and employment settings are expected to be excellent. Some employers are already reporting difficulty in keeping top RNs.
Those statistics are from the Department of Labor and are somewhat dated; the American Nurses Association cites a figure of 2.58 nurses currently working in this country. What is not in question is the fact that the shortage is going to be a long one and is going to get worse before it gets better. The projection for growth in the business calls for an increase in excess of 27% over the next then years. This figure does not take into account the number of nurses who will be retiring or leaving the profession over that period.
The Changing Industry
Managed health care is creating a substantial change in the delivery of health care, which in turn is creating a shift in the opportunities for nurses. HMOs and large healthcare delivery institutions are replacing the traditional doctor’s office, community hospital and local pharmacy. One of the changes that this model is bringing about is movement toward clinical treatment for minor illnesses and injuries.
A visit to your HMO’s outpatient care facility may or may not connect you with your primary physician, although most HMOs try to maintain some sort of connection between individual doctors and patients. Nurses operating in a clinical environment of this sort will find the role very different than that of being a staff nurse in a doctor’s office with a half-dozen partners practicing in one building.
Medical technology has also resulted in many treatments being provided on an outpatient basis that once required a hospital stay. Mothers giving birth are hospitalized for perhaps 48 hours. The traditional nurseries for healthy infants in maternity wards don’t even exist anymore in some hospitals. An angioplasty can be done without an overnight stay in the hospital.
The aging of the nation’s population is also changing health care requirements. There has been a building boom for assisted care facilities, long term care facilities and hospices. Many senior homes that accept only healthy applicants as permanent residents nonetheless operate on-site medical facilities staffed by LVNs, RNs, and served by visiting physicians.
The Future for Nurse Employment
While hospital jobs for nurses may decline as a percentage of the total jobs available, that will be an indicator of changes in the industry rather than fewer nursing jobs. Opportunities for the future are going to be in home health care, in advanced specialties where nurses are assuming roles once played by physicians, and in clinical nursing and management. Great diversity is on the horizon for this profession.
