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Published: Wednesday, 6/12/2002

Help Wanted.

Your chances of being hired as a nurse, provided you have a degree, are as close to perfect as you can ever expect. Even Nurse Ratchet could get a job these days.

Our national- and local - nursing shortage is predicted to become a crisis in the next decade - which, oddly enough, might make it a good time to think about becoming a health care professional. Why? Job security and huge sign-on bonuses, of course, but there are loftier reasons, too.

Vicki English pursues her masters at MCO to become an Advanced Practice Nurse. She already has two bachelor degrees and a law degree. She'd been a nurse for 15 years when she decided to leave nursing to study law. After four years as a practicing attorney, she returned to nursing.

"It's a much more rewarding and satisfying career for me, maybe not for everybody, but for me," she says. "I didn't find law that rewarding, interesting, but not rewarding."

"Nursing is an art and a science. You don't always to into it just for the money, but the money does preclude a lot of people from going into nursing."

Compared to the many more lucrative options open to women today, it's not all that financially rewarding, English says, adding that women have traditionally filled the nursing role, which is a pity. She notes the $5,000 to $10,000 sign-on bonuses currently offered to nurses as nice, but looks forward to a sustained pay scale increase that would reward nurses for their true worth.

Maria Nowicki, Director of Nursing at Mercy College of Northwest Ohio, encourages people who are good communicators, want to make a difference and care about others to become a nurse. It's also essential to be intelligent, have common sense, and a sense of humor to be a nurse.

There are so many different paths you can take within the profession, she says, which is what makes it so special. From adrenaline-lovers to organizers, superior caregivers to technical wizards, there's a role for most personality types.

Plus, Nowicki enthuses, there's a great opportunity for travel. Traveling nurses can choose short or long-term assignments anywhere in the country.

And, a nursing degree surely acts as your ticket to a job anywhere in the country, should you wish to relocate permanently.

Although nurses now, wherever they are working, feel the crunch of the nursing shortage, Nowicki doesn't feel that hard work should stop anyone from becoming a nurse.

"One of my favorite quotes," she says, "is that 'nursing, if it's done well, is hard work.'"

Mercy College enrollment has 90 students seeking an associate's degree and 30 pursuing a Baccalaureate - up 50% from last year.

She credits the Johnson and Johnson's Campaign for Nursing Future for renewing interest in the nursing profession and showing the positive side.

Most of us are already familiar with the negative side - the one that caused students to run away from a life of mandatory overtime, too many weekends, too many patients and grueling hard work.

It makes sense that that job description wouldn't be someone's top career pick.

While the pay isn't horrible, it doesn't seem to compensate for one nurse doing the job of two or three.

Hospitals are run with such tightly managed care that patients are in the hospital for less time - meaning the time spent in the hospital requres intense care and then they are sent home to recover. This adds up to a continually stress-filled job site.

This, English says, means that it's imperative that the nurses are better educated with more advanced training than ever before. "They are doing more work and should be at a higher level so they know how to cover the span of patient needs."

Nurses used to regularly receive continuing education courses, but managed care companies cut much of this funding, she believes.

According to Dr. Narendra Kini, M.D., in Health Leaders Roundtable on Strategies for Solving WorkForce Shortages, Feb. 2002, an average eight-hour nurse's shift includes approximately four hours spent managing required paperwork as opposed to actually caring for these patients.

A study published in Health Affairs (May/June 2001), shows that a third of nurses younger than 30 planned to change jobs within the last year. And, one out of five nurses think about changing careers within the next five years, says a study commissioned by the Federation of Nurses and Health Professionals, April 2001.

Real wages for RNs dropped from 1993 to 1999, from despite the need to hire more nurses. The median weekly wage had dropped from $792 in 1993 to $750 in 1999, according to the U.S. Department of Labor, Bureau of Labor Statistics.

The 2000 Statistics estimates that Toledo's registered nurses earn a median hourly of $19.58 and $41,920 annually - up $2,490 from 1998. The Ohio average income is $43,280 and the national average is $46,410.

Your average local hospital is stocked with nurses who are getting closer to retirement. The average age of a full-time nurse is 49, which puts them merely a decade away from leaving the work force.

Training requires one instructor for every 8 students, which poses problems for schools scrambling to find enough doctorates and classrooms. So, in times of shortage, potential nurses are actually being rejected in some states. Nevada has the worst nursing shortage in the nation, and most schools do not have room for almost half of those who apply.

"I've always thought that each nurse has a responsibility to educate the next generation, whether on the job or as an instructor," Nowicki says.

Average faculty age is 50, which means America need's people to hit the books quickly. It takes about 5-7 years to fulfill post master's studies and obtain a doctorate.

Nationally, just barely more than 50 percent of nursing school instructors have doctorates, and students with master's dropped 27.5 percent from 1997 to 1998, according to the American Association of Critical Care Nurses (AANC), whose guidelines recommend clinical nursing educators to have a doctoral degree.

According to the fall 2001 survey by the American Association of Colleges of Nursing, enrollment in baccalaureate programs in nursing increased by 3.7% nationwide since last year, ending a six-year period of decline. Despite this slight increase, enrollments in all programs are still down 17% or 21,126 students from 1995.

"This shortage takes place at a time when women, who have traditionally filled the nursing role, have many more educational and professional opportunities than they did in the past. Nursing has simply become less attractive to women," says Edward O'Neil, Ph.D., M.P.A., of Health Workforce Solutions in Alameda, CA who co-authored a new report "Health Care's Human Crisis: The American Nursing Shortage."

So why again is it that anyone should want to be a nurse?

Job security aside, things just might be improving in the work environment.

Many states, including Ohio, has taken legislative action that includes a ban on Mandatory overtime practices, a review of Staffing Systems that do not indicate appropriate level of nurses per patient ratios and Whistleblower Protection laws for nurses who report unsafe hospital practices and conditions.

Nowicki hopes to see the Nurse Reinvestment Act in Washington pass and provide significant scholarships as well as lowered qualifying income levels for financial aid so that more students will choose nursing and educating.

Each new nurse that enters the field reduces the patient load and makes it a better career choice for everybody - as long as pressure continues on care providers to maintain enough nurses.

A study by the Harvard School of Public Health, Vanderbilt University School of Nursing and Abt Associates found that the more care a patient receives from a nurse correlates with getting well faster, fewer urinary tract infections and incidences of upper gastrointestinal bleeding; and lower rates of pneumonia, shock and cardiac arrest.

Naturally, the reverse proved also true. Longer hours of care resulted in fewer "failure-to-rescue" deaths.

Surprising? Of course not. But it might be the evidence the public needs to demand better care for their money.

"The relationship between nursing staff and patient outcomes is critical, especially given the nation's growing nursing shortage," said American Nursing Association (ANA) President Mary Foley. "That is why ANA will continue to press for more research and for more solutions from Congress, including passage of the Nurse Reinvestment Act, which will provide much-needed scholarships and other funding necessary for bolstering the image of nursing and recruiting more nurses into the profession.

"In addition, ANA will continue to push for legislation that improves nurses' working conditions - so that we can retain practicing nurses at the bedside."



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