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Complex Issue: Many Factors contribute to nursing shortage
Letters to the Editor

Editor, Times-Dispatch: It is with great interest that I read the editorial, "Nursing Supplies." Indeed, the shortage is an important and troublesome issue for nurses and the patients they care for. However, the proposed solution let hospitals train more nurses -- is both simplistic and inappropriate.

The Virginia Hospital and Healthcare Association has tracked the financial support provided by its member hospitals to the existing education system. This support is in the form of tuition reimbursement for nurses to continue their education, stipends to support clinical faculty positions, financial support for facilities, and various other infrastructure needs.

In 2002 this support amounted to $27.3 million, and in 2004 it rose to $37.6 million. Asking hospitals to increase support and take on hospital-based training programs is unfair and short-sighted.

The shortage is a problem for the entire commonwealth, not just the health-care sector. The educational preparation of a registered nurse is far more than a training program. Complex coursework in the sciences and liberal arts combined with an intense laboratory and clinical training component are the minimum education requirements for a nursing program. This level of education is best provided in colleges and universities whose mission is to provide education and where other professions acquire their requisite knowledge.

Today's health-care environment is complex. Patients are sicker and discharged earlier than ever before. The answer to these challenges does not lie in educating nurses faster, or compromising the education standards that exist today.

An adequate supply of registered nurses will help this commonwealth attract and retain business and add to economic growth. The solutions include providing support to increase the number of nursing school faculty, and to ensure that we recruit and retain nurses and nursing students to Virginia's hospitals and schools of nursing.

Teresa M. Haller, President, Virginia Nurses Association, Richmond.

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Editor, Times-Dispatch: We were pleased to know the impending nursing shortage is well known and understood.

By the year 2020, without aggressive intervention, the commonwealth of Virginia is predicted to have a shortage of 20,000 nurses.

However, the information about support provided by hospitals and health systems to the public colleges and universities is extremely inaccurate. Due to the tremendous needs, these health-care organizations have been supporting the educational systems with human and fiscal resources for many years.

Hospitals have provided clinical faculty and have reported $500,000 to $1 million annually to support expansion of nursing programs. The Virginia Hospital and Healthcare Association tracks the financial support provided by their members.

In 2002 the amount was $27.3 million, and in 2004 the amount was up to $37.6 million. Hospital-based training programs would duplicate infrastructure and waste resources unnecessarily.

Supporting public colleges and universities already established would be more economical. Having adequate nursing resources is an economic factor for attracting new business to our communities.

Hospitals and health-care systems are doing their part!

Shirley Gibson, President, Virginia Organization of Nurse Executives, Richmond.

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Editor, Times-Dispatch: The editorial, "Nursing Supplies," seemed to lack any basis in fact. How about some real facts:

The nursing shortage is actually caused by educational issues surrounding our society in the 1970s and 1980s. This was a time in our country's history when high school graduates were told to go after the "money jobs," instead of service jobs such as nursing. And there were also many new opportunities for women. That led to an influx of lawyers, accountants, engineers, and other well-paying jobs by people who in the past might have gone into the service professions. The result is that there is almost a whole generation of nurses missing. So while clinical nurses and many of today's faculty are getting ready to retire, there is no one to replace them.

You also comment about not seeing hospital administrators who look undernourished. The reality is that VCU has a nursing program; HCA supports the John Tyler School of Nursing; Bon Secours and Southside Regional Medical Center in Petersburg both have nursing programs. So if you did your research, you would know the reason 1,300 qualified students were turned away is not because of greedy and well-nourished hospital administrators. It is because there are just not enough nursing faculty to teach all of these potential students.

You also mention how nursing education could prove a "profitable enterprise." Nursing programs are generally not a profitable enterprise. Nursing education requires not only classroom time, but hands-on laboratory and clinical education as well. In the clinical setting, an instructor may not have responsibility for more than 10 students at a time. In what other profession do you see those kinds of demands on faculty and staff? The fact of the matter is that all of the well-nourished hospital administrators in this community have major investments in local nursing schools.

Michael Mueller, Midlothian