Critical condition: Minnesota’s nursing shortage


Your elderly aunt, usually so kind and patient, complains about the care she received when she was hospitalized after a fall. She said she would call for assistance, but it took unreasonably long for a nurse or a nurse’s aide to come. No one likes to be in the hospital. Maybe your aunt is getting cranky as she gets older. You brush off her complaints, but should you?

Since at least 2003 Minnesota hospitals have been experiencing a shortage of nurses. Carol Diemert, a nursing practice specialist, testified on the impact of inadequate RN staffing in hospitals to the Minnesota’s Health and Human Services House Committee:

For each patient added to a nurses’ average load increases each patient’s risk of dying by 7%. For example, if the nurses’ patient load is four patients, adding one will increase the risk 7% and adding two would increase the risk by 14% and so on.

Clearly, the effects of the shortage are serious.

What caused this shortage? A 2003 study, Findings from the Minnesota Registered Nurse Workforce Survey, attributes the decline to several factors, such as “(a)n aging Registered Nurse (RN) workforce combined with stagnant graduation trends, strong employment and wage growth for nurses, increased staff turnover and heightened employer demand…”

Jane Craig, a high school career counselor in the Twin Cities, is also aware of the shortage, and believes it has been a problem since she began working as a career counselor, about 14 years ago. As Craig sees it, part of the problem is that there are not enough nurse educators, causing long waiting lists for students to gain entrance to nursing school: “…when students are on a long wait list they tend to enter other programs or go directly in to the workforce.”

The belief that a lack of educators is a factor in the nurse shortage is shared by Jennifer Grenell, who is currently employed as a nurse at Mayo Hospital. Grenell writes in an e-mail interview, “There is a real shortage for nurse educators in general in schools which also impacts the shortage as with no teachers, you can’t graduate as many nurses as you need. Many of the teachers were retiring, and there were not enough people going back for masters degrees that would allow them to teach.”

The complexity of systems and clients may also be a factor in the shortage. The Complexity Compression: Nurses Under Fire study indicates the toll too frequent system and procedures changes can make on nurses, when at the same time, the nurses must deal with patients who are more seriously ill, but hospitalized for a shorter time period. The stress of these factors causes many nurses to leave the field.

Will the federal government’s stimulus package affect these trends? As reported by the American Academy of Family Physicians, the package targets $600 million for health care professional training, which includes training for nurses. Additional training funds should help ease the shortage nationally. However, $20 million is targeted for Healthcare Information Technology (HIT), with the aim of making patient records electronic, and so easy to share between facilities. This indicates major computer system overhauls, and will add to the complexity compression, at least in the short term, potentially driving nurses out of the field.

Prior to the stimulus package, various organizations were taking measures to alleviate the shortage. The Mayo Hospital in Rochester is concerned with retention. In e-mail interview, Grenell wrote:

…there is a big push for retention at Mayo for nurses, so they try and keep our salaries competitive so as not to have a huge shortage. They have nurse recruiters that go to colleges across the country to recruit, and they have their big Summer III nursing student internship program that is one of their biggest recruiting tools to combat shortage. I think they have around 150 of the best nursing students from around the country intern here, most of which are offered positions after graduation.

According to Minnesota State Colleges & Universities Fact Sheet: The Nursing Shortage, the colleges and universities have worked to meet the demand: “The Minnesota State Colleges and Universities System, which produces 78 percent of the state’s new nursing graduates, is responding rapidly to the shortage. The system’s 32 institutions are working together to expand training programs, add online degrees and create innovative partnerships to train new nurses and help working nurses upgrade their skills. Some examples:

• An English-as-a-Second-Language class to teach culturally-diverse nursing students to read and write in English to communicate effectively with patients/coworkers.

• A “fast track” LPN program to employ displaced workers.

• A college-business partnership to train, recruit and retain nurses in south central Minnesota.”

Though efforts are being made to address the nursing shortage in Minnesota hospitals, if you have a loved one who is hospitalized, you may want to think about what Scott Parker said in his testimony to Minnesota’s Health and Human Services House Committee, “I am so concerned about the staffing situation in today’s acute care environment, that I have cautioned friends whose family are hospitalized to ‘be there’ to oversee care and ensure safety and comfort.”

Catherine Whitney is a student at Anoka-Ramsey Community College where she is enrolled in a course on journalism for online publications