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The facts are startling: Already, there are approximately 116,000 unfilled nursing positions in American hospitals and nearly 100,000 vacant nursing and related care jobs in our nursing homes. Home health agencies report an 11 percent nursing vacancy rate and a 72 percent turnover rate. More than 5,000 community health centers that serve patients without adequate insurance are experiencing a vacancy rate of 10 percent for registered nurses (RNs) and 9 percent for nurse practitioners.
Without aggressive action, the problem will only worsen; a new report estimates a shortage of 500,000 RNs by 2025. The U.S. Department of Health and Human Services' Health Resources and Services Administration (HRSA) presents a less optimistic view in its 2006 analysis, projecting a shortage of more than one million nurses by 2020. Regardless of which estimate turns out to be most accurate, the nation faces an unprecedented nursing shortage as 78 million boomers age and need more health care, and as health care costs continue to rise.
Chief among the many factors that are contributing to the growing nursing shortage, enrollment in nursing schools is not keeping up with the increasing demand for nurses. In 2006, HRSA officials stated that the United States must graduate 90 percent more nurses from its nursing programs to meet the growing need. The problem is a significant lack of faculty to teach future registered nurses. In fact, 88,000 qualified applicants were turned away from U.S. nursing programs in 2006, due largely to a severe shortage of faculty to teach nursing students.
In August 2007, AARP, the AARP Foundation, and the Robert Wood Johnson Foundation launched a joint initiative—Center to Champion Nursing in America (CCNA). As a consumer-driven national force for change, CCNA seeks to ensure that this country has the nurses it needs to care for all of us, now and in the future. CCNA will focus its efforts on two main priorities: the nation's capacity to educate and retain nurses.
In order to help solve the shortage of nursing faculty, AARP is advocating for increased funding and better targeting of a number of existing federal programs.
The current shortage of nurses is already causing harm. In the largest study of its kind, a 2007 review by the Agency for Healthcare Research and Quality documented the situation. Among the study's principal findings: Americans treated in hospitals with a RN shortages were more likely to experience one of five adverse outcomes (pneumonia, shock, upper gastrointestinal bleeding, longer hospital stay, and urinary tract infection). The Joint Commission found that 24 percent of unanticipated adverse events in hospitals that resulted in injury, death, or permanent loss of function were related to inadequate numbers of nurses at work.
These adverse effects and poor quality outcomes will continue to rise, which means that more people will become ill or die, and health care costs will continue to unnecessarily escalate as a result of our inaction. This is even more troubling, because it is happening at precisely the time when we can least afford it—when the nation is about to experience a profound shift upward in the age of its population.
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