WASHINGTON- Maryland is on the verge of a nursing crisis that could harm patient care in the near future, state and federal officials said this week.
At a U.S. Department of Health and Human Services forum Wednesday, to discuss new nursing statistics, speakers said the number of people interested in nursing is dropping at a time when the population is aging and medical care is becoming more complex.
The report said that 78 million baby boomers are on the verge of retiring nationwide. In Maryland, the over-65 population is expected to grow by 50 percent between now and 2020, it said.
“Our situation is pretty bad,” said Dr. Georges C. Benjamin, the Maryland secretary of health and mental hygiene. “The shortage has hit Maryland hard and suddenly.”
Maryland had 47,860 registered nurses in 1998 and only 45,525 in 1999, Benjamin told the Senate Subcommittee on Aging in testimony Tuesday. With the average age of a Maryland nurse up to 46 and decreasing numbers of people going into the field, the supply is not keeping up with the demand, he said.
The shortage is particularly severe in emergency rooms, critical care, labor and delivery, and long-term care, said Kathryn Hall, executive director of the Maryland Nurses Association.
Hall told the subcommittee that a recent study by her association found that 75 percent of nurses surveyed felt the quality of nursing care where they work has declined.
“The public at large should be alarmed that more than 40 percent of the respondents to the ANA survey stated that they would not feel comfortable having a family member cared for in the facility in which they work,” Hall said.
Nursing staff problems tend to be cyclical, but this one is unique, Hall said. The demographics of patients and nurses are shifting, and the crisis is even more acute due to cost-cutting measures in the 1990s that cut staff to the bare minimum.
The HHS report said there were 856 nurses per 100,000 Maryland residents in March, well above the national average of 782 nurses per 100,000 people. But Maryland fell in the middle when compared to neighboring jurisdictions: Virginia had 711 nurses per 100,000 residents, Delaware had 936, Pennsylvania had 1,010 and Washington, D.C., had 1,675.
Benjamin said the shortage is particularly bad in Maryland because of the proximity of other states and the variety of government and corporate non- nursing options for those with nursing degrees.
Dr. Morton Rapoport, president and chief executive officer of the University of Maryland Medical System, said Wednesday that the state’s nursing problems seem to be worst in Baltimore and suburban Washington. He said nursing vacancies may be as high as 16 to 18 percent in hospitals statewide, up from only 3 percent in 1998 and 11 percent in 1999.
“There are three major issues,” Benjamin told the subcommittee. “Nurses aren’t coming in. They’re not staying in. And those who are there, aren’t happy.”
One proposed solution has been to try to recruit a more diverse applicant pool. The HHS study said that only 5.9 percent of registered nurses nationwide were men and only 12.3 percent were minorities in March.
“In the short-term, we are having to go overseas,” Rapoport said.
He said six staff members are currently recruiting nurses in the Philippines. Nurses from Ireland, Eastern Europe and Ethiopia also are in demand. Rapoport said he hoped to fill about 150 positions with foreign workers.
Working conditions are a major factor in the poor retention rates, Hall said. She pointed to forced overtime, lack of whistle-blower protections and lack of support staff as detrimental to nurses. Coupled with a stagnant wage since 1992, many are choosing to pursue more lucrative fields.
State and local governments are taking steps to address the problem.
Maryland created a 52-member Statewide Commission on the Crisis in Nursing last year that is charged with developing and implementing solutions to the nursing crisis over the next five years.
In Congress, Sens. John Kerry, D-Mass., and Jim Jeffords, R-Vt., plan to introduce the Nurse Reinvestment Act, which would use some of the budget surplus to recruit and educate nurses, and look at ways to make the profession more financially viable for students with large loans to repay.
Rapoport said there is only so much the government can do.
“By the time the feds get to it, it will be too late,” Rapoport said. “I believe the market will address some of these issues. . . .Salaries will increase, and young people will find the field more attractive.”
Benjamin disagreed.
“Medicine doesn’t follow the normal marketplace. There are so many moving parts,” he said, pointing to all the money that has been “suctioned out” and the inadequate number of people coming into the system.