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UCLA Magazine Winter 2002
It's not your parents dorm anymore
Outside the Ivory Tower
A beautiful Mind
The Long March
The New Scientists
Critical Care

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Winter 2002
Critical Care

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At UCLA and elsewhere, the national nursing shortage is cause for both concern and action, including unprecedented recruitment and retention efforts. Nationally, approximately one in eight hospital nursing positions is unfilled, with key areas such as critical-care and medical-surgical units posting the highest vacancy rates. Meanwhile, declining enrollments at nursing colleges and universities have resulted in an aging workforce. Twenty years ago, one-in-four registered nurses (RNs) was under 30; today that ratio is one-in-10, and many older nurses are expected to retire within the next decade, just as the first wave of baby boomers becomes senior citizens. Current projections are that the nation will be short 400,000 RNs by 2020.

It is a problem that has drawn the attention of leaders nationwide, both within the profession and the government. In one effort to address the issue, President Bush in August signed the Nurse Reinvestment Act to create a Nurse Corps Scholarship and to provide grants and loans to improve nurse education and retention.

Still, the crisis looms large, and the impact has been felt throughout the health-care establishment, most often in the forms of emergency-department overcrowding and the need to close hospital units due to staff shortages. In May, the New England Journal of Medicine published the first large study drawing a connection between inadequate nursing-staff levels and poorer patient outcomes. Harvard researcher Jack Needleman and colleagues found, among other things, that in hospitals with high staff levels (one nurse per 2.5 patients per day), patients experience cardiac arrest and shock 9 percent less often and suffer 9 percent fewer urinary-tract infections, 5 percent fewer episodes of bleeding in their stomachs or intestines and 6 percent less hospital-acquired pneumonia than in hospitals with low staff levels (one nurse per four patients). “When nurses are overworked, or when there are inadequate numbers of registered nurses, they cannot do the same job of monitoring patient condition that they can when nurse staffing is better,” Needleman explains.

“This is a public-health crisis that’s going to be with us for a decade or longer,” says Marie J. Cowan, dean of the UCLA School of Nursing. “And California will be more acutely affected than the rest of the nation.”

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