NURSING: Burnout Takes Its Toll, Fuels Shortage
A feature in this month's California Journal outlines problems fueling dissatisfaction among nurses and investigates the factors behind the state's nursing shortage. California has 566 registered nurses per 100,000 residents, the lowest proportion of the 50 states, according to the California Strategic Planning Committee for Nursing. As the population grows, the shortage will become "even more severe, particularly in critical-care, public health, home care and advance-practice specialties," said Catherine Dodd, executive director of the American Nurses Association-California. Dodd testified at a state Senate hearing in March that many California nurses retired because of "overwork and burnout." The Journal reports that as nurses' "dissatisfaction grows, their militancy increases." The California Nurses Association, another nurses' union that lists 30,000 members, has "moved successfully on several fronts" to force hospitals and HMOs, such as Kaiser Permanente, to provide higher salaries and better working conditions. But those "successes have not come ... without great personal and professional cost."
In Search Of Authority
While advanced-practice nurses across the country are "slowly broadening the scope of their practice," California "lags far behind other states in independence and status accorded nurse-practitioners." The state ranked "near the bottom" in areas such as prescribing authority, legal status and reimbursement rates, according to a New England Journal of Medicine report. Across the country, nurse-practitioners can earn as much as $95,000 a year, although salaries in most urban areas of California range from $55,000 to $75,000. California RNs earn "considerably less, perhaps $40,000 to $50,000," said CNA.
'Fragmented' Training Also Blamed
"At the heart of the controversy over California's looming nursing shortage is the state's fragmented system of nursing education," which is divided between community colleges, state universities and the University of California. While the majority of the state's nurses hold degrees from community colleges, advanced degrees are increasingly desirable. But for many nurses, obtaining additional education -- while often working and raising a family -- is a "formidable" challenge, leaving many without the advanced training needed to be competitive. State lawmakers have introduced several bills to promote nursing training, the Journal reports (Bathen, 8/98 issue).