The Nursing Shortage That Doesn’t Necessarily Come Up Short

You may have seen a few of the high profile newspaper and magazine articles highlighting a growing nursing shortage in the United States.  But, as with so many things in health care, the shortage of nurses is not evenly distributed across the states or even within a state. Seen from this perspective, we may have more of a distribution problem than a shortage. In health care, geography is destiny. 

When I look at Missouri and note that the communities in greatest need of more registered  nurses are disproportionately rural and low income, I am not surprised. Rural and low income communities often experience shortages of many different kinds of licensed health practitioners, which can then produce shortages of local delivery of certain kinds of health care services. For example, lack of adequate nursing staff for an obstetric unit may mean that a hospital closes that unit or some beds in that unit.  

Just how stark is the labor supply differential for nurses in Missouri? One study reports that " Missouri’s nursing shortage reached a record high in 2017, with almost 16 percent – or 5,700 – of positions vacant, up from 8 percent last year. Thirty-four percent of Missouri registered nurses are 55 or older." So, yes, we have a shortage of nurses in Missouri as many baby boomers age out of a career that may have been one of the few professional careers open to women and we also have a shortage of nursing professors, whose formation has a longer lead time.  All of this is happening along with a great push to move all registered nurses to qualifications including a four year degree, no longer sufficing  with a two year degree. 

To complicate things more, it is reported that for every small rural hospital struggling to fill RN ranks, there is a larger more urban facility that increasingly prefers to hire an advanced practice nurse with a masters or a doctorate. Unless a career in the service of a rural area or the historically under-served is the goal, some prospective nursing students may feel concerned about an inability to tell which way all of this is going to break. 

Might you be both today's hot commodity and tomorrow's anticipated leftovers, simultaneously?

X-posted at PrawfsBlawg