ANNAPOLIS – Donna Dorsey sometimes jokes with colleagues at the Maryland Board of Nursing that one day they can provide nursing care for each other — but she knows the shortage of quality care is not humorous.
The board director spoke at Senate and House health committee hearings last week, presenting a thorough report on the main causes of the shortage and ideas for how to counter them. The report, she said, could help mitigate the problem.
Mirroring a worldwide trend, Maryland’s nursing shortage continues to surge and figures to get much worse. If trends continue, the state will experience such a massive shortage of nurses that thousands will be without sufficient care, she said.
The Maryland Commission on the Crisis in Nursing was created in 2000 to address this problem. The 55-member commission, including Dorsey, a vice chairwoman, has devised plans it thinks will reduce the shortage. With the commission set to expire in December, though, it still has not created a long-term solution.
If trends in retirement and enrollment continue, Maryland’s nursing shortage would balloon to more than 17,000 by 2012, exacerbated by nursing needs of the aging Baby Boomer generation.
Nurses are in short supply, the commission found, because of:
— Insufficient educational opportunities. Maryland nursing schools turned away more than 1,800 students in 2004 because they lacked faculty and classroom space. Numerous other students didn’t try to enroll because there wasn’t enough scholarship money available.
— Poor workplace conditions. Employers often work nurses ragged with uncompensated overtime, high patient-to-nurse ratios and poor treatment by supervisors and co-workers.
— A bad image of nursing. Young students avoid nursing careers because, as registered nurse Mary Emma Middleton put it, “people visualize nursing as (only) bedpan duty still.” Hollywood’s depiction of nurses — from the soft, bumbling Greg Focker of “Meet the Parents” to the dissatisfied nurses on “ER” — has exacerbated this image problem.
Through its research and subcommittee work, the commission pushed for successful legislation making forced overtime for nurses illegal (the 2002 Senate Bill 537) and barring employers from disciplining health care workers who blew the whistle on unlawful practices (the 2002 House Bill 329). It also educated middle and high school students about nursing, encouraged nursing schools to attract more faculty with higher salaries and fostered partnerships between hospitals and educational institutions.
Overall, Dorsey said she believes the commission has met its goals, especially in identifying short-term solutions.
“We probably headed off the real crisis for a few years,” said Dorsey, a 30-year nursing veteran. “We’re pleased with what the commission has done but clearly the commission has not finished.”
It’s still missing a long-term strategy. The commission’s biggest worry is how to stave off the coming conflict of a stagnant nursing population and Baby Boomer patient surplus.
That collision is “going to be great,” said Sen. Paula Hollinger, D-Baltimore County, a registered nurse and chairwoman of the Senate Education Health and Environmental Affairs Committee. “So we’ve got to solve the problem . . . This state needs to make a commitment.”
Extending the commission would be part of that commitment, Hollinger said.
Delegate Adrienne Mandel, D-Montgomery, also a commission member, favors making the commission permanent. She may sponsor a bill calling for that.
“This is going to be a big challenge,” Mandel said. “I saw the commitment of the (commissioners) involved . . . They truly care about the work they’re doing and they want to see it done well.”
Dorsey said if the commission is extended, members will further examine workplace issues like nurse fatigue, physical strains and technological advances.
It would also ask the state for more scholarship and educational funds because, as Mandel noted, “nursing has a very high price tag on its education.”
Faculty and student shortages, though, are the most critical issues.
“If we don’t get faculty,” Dorsey said, “we aren’t going to be able to get more nurses.”
No matter what happens to the commission, the third of its kind in Maryland, its key players and legislators know that they cannot fix the nursing crisis any time soon. As members of the Baby Boom generation, many of them have personal stakes in this issue. That’s why they’re so worried.
“I still think there’s going to be a wide shortage,” said Middleton, a Maryland Nursing Association district president. “There will never be a lack of jobs in this field. If you want job security, be a nurse.”