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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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There are also concerns that cost might not be the only problem in the future. Keeping experienced nurses on hand to train younger nurses in the complex cases seen at UCLA is becoming increasingly difficult as many of these veteran nurses approach retirement with an inadequate number of newcomers following behind, Karpf notes. Certain nursing specialty areas are hurting more than others, including stressful units that require high skill levels, such as neonatal intensive care, pediatric intensive care and the psychiatric wards.

“We think we’re at the beginning of the crisis part of the nursing shortage,” says Mark Speare, UCLA Medical Center’s senior associate director for patient relations and human resources. “Right now we consider ourselves lucky to be able to spend our way out of this, to pay what it takes to get very talented people here. But there are other places that don’t have that opportunity, and some of them will close. It’s going to get worse before it gets better.”

THE TRENDS AREN’T ENCOURAGING. For 20 years, cost-containment efforts and improved treatments have resulted in more outpatient care and shorter hospital stays for inpatients. Construction of new hospitals stopped, and smaller ones were forced by their low census numbers to shut down. But the aging population has begun to figure more heavily than these trends: Hospital admissions, which had declined from the mid-1980s to the mid-1990s, began to increase in the second half of the last decade and are expected to continue that climb into the foreseeable future. And given the higher bar that has been set for admission, today’s hospital patients are much sicker than patients of the past.

Why, then, aren’t there more nurses to take care of them? Several reasons have been proposed, including the expansion of opportunities for women (who continue to make up the vast majority of nurses) in medicine and other higher-paying professional fields. Nursing salaries, adjusting for inflation, rose slightly in the 1980s and then reached a plateau in the ’90s. (In 2000, the average salary for a full-time RN was $46,782.)

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