Currently, the United States is short an estimated 150,000 nurses, according to an article in the November 8 issue of the journal Health Affairs, and the shortage is expected to increase over the next decade, possibly rising to 800,000 by the year 2020.

Many factors are causing this situation, a conference on the future of nursing was told earlier this year, but it’s important to keep in mind seven “myths” that need to be debunked if things are to get better. Here are misconceptions about nursing put forward at the meeting:

Myth: We can continue to “muddle through” the present and possible future shortages of nurses without serious consequences.
Fact: Lack of nurses has substantial impacts on emergency preparedness, quality of care, patient safety, access to needed health care services particularly for vulnerable populations, and economic growth.

Myth: Not enough Americans want to be nurses.
Fact: Many thousands of qualified nursing school applicants are turned away because U.S. nursing schools lack educational capacity, particularly faculty.

Myth: The U.S. nursing shortage can be solved by opening our borders to nurses from other countries.
Fact: The shortage is too large to be solved by immigration. And the shortage isn’t confined to the U.S.—it’s global. Taking nurses from other countries would simply bankrupt the international supply and would affect health worldwide.

Myth: The U.S. nurse shortage can be solved by substituting unskilled labor.
Fact: Research indicates that substituting licensed practical nurses or aides for registered nurses in hospitals results in higher mortality rates and worse patient outcomes.

Myth: Practicing physicians oppose expanding the roles of nurses or increasing the supply.
Fact: Because of factors such as the changing demography of the physician workforce, regulation of hours, and increasing demand for services, doctors need nurses to be able to “work upstream” in the medical division of labor.

Myth: Care will increasingly shift to out-of-hospital settings, reducing the need for nurses.
Fact: Although inpatient days are falling, people in hospitals are sicker, and there are more chronic illnesses, both requiring intensive services.

Myth: We don’t know how to solve the nursing shortage.
Fact: More federal investment in nurse education is needed, hospitals and other employers need to support the education of new nurses and increase nurse efficiency, partly by seeing to it that nurses actually do nursing. There need to be innovative educational pathways to bachelor and graduate degrees in nursing and incentives for faculty recruitment. And everybody needs to recognize the impact of nursing care on health care quality and safety, and be prepared to pay for it.

The information in this article is drawn from a presentation by Linda Aiken at a September 2006 meeting sponsored by Health Affairs, the Robert Wood Johnson Foundation, and the John A. Hartford Foundation. The entry is posted at http://healthaffairs.org/blog/2006/11/08/nurses-mythbusting-the-nursing-shortage.

See also:
January 2003. News alert: Nursing Enrollments Do Not Meet Demand for New Nurses.