NOTING
CONCERNS OVER CUTS IN NURSE STAFFING,
AACN WARNS AGAINST QUICK-FIX SOLUTIONS
WASHINGTON,
D.C., September 15, 2000 -- Following is text of a letter
to the Chicago Tribune by Carolyn A. Williams,
PhD, RN, FAAN, president of the American Association of
Colleges of Nursing (AACN), in response to reporter Michael
J. Berens' recent three-part series (September 10-12) on
nurse errors:
"September
15, 2000
Voice
of the People
CHICAGO TRIBUNE
435 North Michigan Ave.
Chicago, IL 60611
To the
editor:
Readers
of your recent series on nurse errors should be cautioned
against embracing simplistic, quick-fix solutions. Alarmist
headlines that focus on the provider, rather than on the
transformed system of care in which health professionals
practice, misdirect attention from the changed conditions
that make the skills of a well-educated nurse workforce
more vitally essential than ever.
Indeed,
nursing and other health policy leaders remain concerned
that staffing decisions at some hospitals may have been
based less on appropriate, safe, and effective use of personnel
and more on short-term, short-sighted approaches to cut
costs. But alleviating nurse understaffing and the nation's
accelerating nursing shortage requires not simply more registered
nurses, but more RNs of the right educational and skill
mix for a health care environment that has grown progressively
complex.
For
example, advances in technology, faster discharge of hospital
patients, and the rapid expansion of home care, front-line
primary care, and other outpatient services have increased
the population of hospitalized patients who are older, more
acutely ill, and needing more intensified, highly-skilled
nursing care.
As a
result, demand in hospitals and other facilities has accelerated
for registered nurses with the critical-thinking, scientific,
case management, leadership, and communication and patient
education skills acquired in bachelor's- and graduate-degree
curricula. Nurse executives in the nation's hospitals have
reported their preference for the majority of staff RNs
to have at least bachelor's-degree preparation to meet the
needs of today's more sophisticated patient care. Many hospitals
not already requiring the Bachelor's of Science degree in
nursing (BSN) have established "BSN preferred" policies
for new hires.
Contrary
to your report, the majority of new registered nurses in
the last two decades have been graduates of two-year associate
degree programs. Although about 40 percent of all RNs in
the U.S. hold bachelor's or higher degrees in nursing, an
advisory panel to the federal Division of Nursing has urged
increasing this level to at least two-thirds of the basic
RN workforce by 2010. Employers, however, recognize the
distinct contributions that graduates of differing levels
of RN education bring to nursing care and increasingly are
assigning RNs to "differentiated practice" roles.
Research
demonstrates clearly that hospitals with higher numbers
of RNs, and with the best-educated RNs, experience lower
mortality and other improved outcomes in patients, such
as shorter hospital stays, fewer complications, and better
compliance to treatment. These outcomes have been documented
at "magnet" hospitals that have been identified as good
places to practice nursing and recognized for their ability
to attract and retain registered nurses particularly in
times of shortage. Magnet hospitals not only employ higher
numbers of RNs per patient, have a higher proportion of
bachelor's-degreed RNs, and experience lower nurse burnout
than do non-magnet facilities, but also allow nurses flexible
work schedules, greater autonomy over their own practice,
and shared decisionmaking in patient care issues.
The
high-quality nursing care at magnet and other hospitals
illustrates the positive outcomes when staffing decisions
are paired with well-educated nursing personnel, attractive
practice environments, and a careful understanding of the
health system's changing requirements."
The American Association of Colleges
of Nursing is the national voice for university and four-year-college
education programs in nursing. Representing more than 580
member schools of nursing at public and private institutions
nationwide, AACN's educational, research, governmental advocacy,
data collection, publications, and other programs work to
establish quality standards for bachelor's- and graduate-degree
nursing education, assist deans and directors to implement
those standards, influence the nursing profession to improve
health care, and promote public support of baccalaureate
and graduate nursing education, research, and practice.
###
CONTACT: Robert Rosseter
(202) 463-6930, x231
rrosseter@aacn.nche.edu
