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. And some nurses are becoming bitter. The shortage means those still on the job are responsible for more patients and those patients are often sicker, thanks 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. Frustrated, growing numbers of nurses are joining unions that threaten and sometimes call work stoppages as their militancy increases. Working conditions in hospitals were a central issue in at least 36 strikes by nurses in the last two years, including three in 1999 by the New York State Nurses Association. Many nurses are also pressing for state and federal staffing rules. 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.