Because of short staffing, nurses say they are forced to stay on the job when they are exhausted after a 12-hour shift. Hospital administrators and nurses expect the shortage to worsen. Enrollment in nursing programs is declining even as the population ages. The average age of nurses is rising. The shortage also means those still on the job are responsible for more patients and those patients are often sicker, due to managed care requirements that more care take place outside hospitals.
Patients already find it harder to get a nurse to respond promptly when they call for help.
Eighteen percent of consumers rated their last hospital stay fair or poor in a survey reported in 1999 by Karen Donelan and Robert J. Blendon of the Harvard School of Public Health. Growing numbers of nurses are joining unions that threaten and sometimes call work stoppages as their militancy increases. Hospital executives say they would hire more nurses if they could find them, but nurses say working conditions in hospitals are driving many of them out of the profession. In many hospitals, nurses say they are required to take care of 10 or more medical and postsurgical patients at a time, and those patients are often seriously ill. They complain of injured backs after lifting heavy patients and of risky accidents with contaminated needles.