Dealing with the nursing shortage—again

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<ul><li><p>AORN J O U R N A L JULY 1987. VOL. 46. NO I </p><p>Editorial </p><p>Dealing with the nursing shortage-again </p><p>very nurse is well aware of the fact that 20th E century nursing in this country is replete with periods of oversupply of registered nurses alternating with periods of shortage. In my nursing career, Ive lived through the shortage of the 1960s, the surplus of the 197Os, and now the present shortage-projected to become the worst yet. And, for me, reading about the present shortage brings about unpleasant feelings of deji vu. The causes of the prcsent shortage have a familiar ring to them and come as no surprise. </p><p>When I see an article on the present nursing shortage, complete with impressive statistics on the increasing number of job vacancies for registered nurses, I know, without turning the page, what is to follow. More depressing facts on nurses low wages, the lack of a positive professional image, and poor working conditions. Other than the recent push to downsize brought on by the Medicare prospective payment system, the factors contributing to this nursing shortage are not new. Nursing has always been a female-dominated and low-paying profession; the average staff nurse reaches her peak earning power within five to seven years. Enrollments in nursing programs have been down for some time; more women are going into other professions (eg, engineering, law, medicine) where earning power is not as limited. Add to this the fact that most men do not even consider nursing as a career and we have a real problem that is not likely to go away. </p><p>The purpose of this editorial is not to repeat statistics on the shortage or to repeat the usual, temporary solution of offering economic incentives in the form of salaries or tuition subsidies. My </p><p>purpose in addressing the nursing shortage is to ask you, the nurses who are living with the realities of short staffing arrangements, to share what you are doing to cope on a day-today basis. </p><p>For example, at the recent American College of Surgeons symposium on operating room environment (see Nurses, surgeons, anesthesiol- ogists meet to discuss operating room problems in this issue), Linda Groah, RN, BSN, CNOR, director of nursing for the operating room and postanesthesia recovery unit at the University of California San Francisco Medical Center, suggested that managers consider changing the way they orient the OR nurse. She suggested that the staff be subdivided into specialty teams so that every nurse is not required to learn the technical aspects of every specialty. Specialization may not be a solution in a small practice setting, but it may be applicable to many large institutions. </p><p>Another way nurses are coping is by working lots of overtime. Ten- or 12-hour days are not uncommon. This is not necessarily the best solution to the problem, however, because it leads to burnout-another cyclic characteristic of nurses that merely contributes to more practitioners leaving nursing. </p><p>Through its various publications, including Journal articles, AORN strives to portray the optimum perioperative nursing practice. But often circumstances are such that the optimum practice, such as the perioperative nurse performing complete preoperative patient assessments, postoperative evaluations, or completing nursing care plans (all described in this issue) is not possible. When nurses are in short supply, those </p><p>13 </p></li><li><p>AORN J O U R N A L J U L Y 1987. VOL. 46. NO I </p><p>remaining have to settle for safe care, as opposed to optimum care. Sometimes, that in itself is hard to accept because perioperative nurses tend to be perfectionists. </p><p>If enough AORN members are willing to share their solutions to this dilemma, I will devote future Letters to the Editor columns for those letters that contain positive ways OR staff nurses and OR managers can safely adjust perioperative nursing practice to accommodate the present shortage. If you are willing to share your ideas, </p><p>please include your title and place of employment in your letter. </p><p>If your solution to the shortage is to continue to work overtime until something happens to change the nursing supply ratio, you may be setting yourself up for early burnout. But by sharing your other solutions, Journal readers can together explore a different path. </p><p>PAT NIESSNER PALMER, RN, MS EDITOR </p><p>Film Review: Just Look at Me Now The film, Just Look at Me Now: Portrait of a Perioperative Professional, traces the history and image of nursing. Sandra Moorhead, RN, por- trays a realistic picture of how the image of nurs- ing has changed from handmaiden to the physi- cian, to a sexpot, to an educated professional working in a collegial relationship with other health care professionals. </p><p>Many of the images are not flattering; how- ever, they are true and are issues that need to be examined and addressed. In addition to describ- ing the changing image, Moorhead suggests the viewers can tight negative publicity about nurs- ing by writing letters to television stations, greet- ing card manufacturers, and legislators, and by belonging to professional organizations. </p><p>historical pictures of the nurse of the past, and exciting glimpses into nursing of the future. It portrays the nurse of the 1980s in a positive light as a professional with a challenging, exciting future. This would be an excellent film to show nurses, nursing students, and the public. </p><p>In addition, a film study guide and test are included for home study. Registered nurses can earn one contact hour of continuing education by completing the requirements. </p><p>Copies of the Davis + Geck/AORN film can be rented in either %-inch videocassette or 16- mm film for $17.50. The film can be purchased for $125 on videocassette, $75 in either a M-inch </p><p>The 15-minute film contains many interesting </p><p>Beta or VHS format. For more information, con- tact the Davis + Geck Film-Video Library, 1 Casper St, Danbury, CT 068 10-9989. </p><p>VICKI Moss, RN, MS, CNOR AUDIOVISUAL COMMITTEE </p><p>Health Care Building Activity Up 16% in 1986 Building activity in the health care industry- new construction, expansion, and alterations- increased 16% in 1986 when compared to 1985 figures. According to a survey conducted by Modern Healthcare, there was 99.5 million square feet of building activity in I986 compared to 85.8 million square feet in 1985. </p><p>In its survey of architects, construction manag- ers, general contractors, and design/building firms, Modern Healthcare reported that expand- ing and altering existing facilities were the top building activities. New construction was second on the list. </p><p>Respondents said that hospital-based ambula- tory care units will have the greatest opportuni- ties for future construction followed by retire- ment communities and freestanding outpatient care centers. </p><p>issue of Modern Healthcare. The survey results were reported in the Feb 27 </p><p>14 </p></li></ul>