Abstract
A serious shortage of nurses has developed since 1984 despite a growing number of employed nurses and a substantial decline in the number of hospital inpatient days. The evidence suggests that the shortage is the result of an increased demand for nurses, not a decline in supply. The increased demand in large part has resulted from the substitution of registered nurses for licensed practical nurses, aides, and other patient services personnel. The substitution was feasible because nurses' wages have been depressed compared with those of other hospital employees. The shortage is likely to abate if nurses' wages increase, making substitution more costly. Even in the absence of continuing wage increases, hospitals could ease the shortage by restructuring patient services and enabling nurses to spend a greater portion of their time in direct patient care.
Full text
PDF
Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- Aiken L. H., Blendon R. J., Rogers D. E. The shortage of hospital nurses: a new perspective. Ann Intern Med. 1981 Sep;95(3):365–371. doi: 10.7326/0003-4819-95-3-365. [DOI] [PubMed] [Google Scholar]
- Aiken L. H., Mullinix C. F. The nurse shortage. Myth or reality? N Engl J Med. 1987 Sep 3;317(10):641–646. doi: 10.1056/nejm198709033171030. [DOI] [PubMed] [Google Scholar]
- Blendon R. J. The public's view of the future of health care. JAMA. 1988 Jun 24;259(24):3587–3593. [PubMed] [Google Scholar]
- Hinshaw A. S., Scofield R., Atwood J. R. Staff, patient, and cost outcomes of all-registered nurse staffing. J Nurs Adm. 1981 Nov-Dec;11(11-12):30–36. [PubMed] [Google Scholar]
- Knaus W. A., Draper E. A., Wagner D. P., Zimmerman J. E. An evaluation of outcome from intensive care in major medical centers. Ann Intern Med. 1986 Mar;104(3):410–418. doi: 10.7326/0003-4819-104-3-410. [DOI] [PubMed] [Google Scholar]
- Kramer M., Schmalenberg C. Magnet hospitals: Part I. Institutions of excellence. J Nurs Adm. 1988 Jan;18(1):13–24. [PubMed] [Google Scholar]
- Mechanic D., Aiken L. H. Sounding Board. A cooperative agenda for medicine and nursing. N Engl J Med. 1982 Sep 16;307(12):747–750. doi: 10.1056/NEJM198209163071211. [DOI] [PubMed] [Google Scholar]
- Misener T. R., Frelin A. J., Twist P. A. Sampling nursing time pinpoints staffing needs. Nurs Health Care. 1987 Apr;8(4):233–237. [PubMed] [Google Scholar]
- Rieder K. A., Lensing S. B. Nursing productivity: evolution of a systems model. Nurs Manage. 1987 Aug;18(8):33-5, 38-40, 44. [PubMed] [Google Scholar]
- Robinson J. C. Hospital competition and hospital nursing. Nurs Econ. 1988 May-Jun;6(3):116-9, 124. [PubMed] [Google Scholar]
- Weisman C. S., Alexander C. S., Chase G. A. Determinants of hospital staff nurse turnover. Med Care. 1981 Apr;19(4):431–443. doi: 10.1097/00005650-198104000-00005. [DOI] [PubMed] [Google Scholar]