A recent study on the appropriateness of minimum nurse staff levels concluded that 98% of nursing homes in New York have nursing levels that fall in the range where quality of care was shown to suffer. This report was conducted by The Center for Medicare and Medicaid Services. Reports linking quality of care and staffing ratios date back to at least 1971. The U.S. Government Accountability Office has issued multiple reports calling for increased staffing ratios. However, the nursing shortage has seen the ratios dip lower and lower as this current wave of reduced nursing staff grips the country's heath care industry and affects us all.

Now is the time for legislation to mandate staffing ratios on both state and federal levels. The over 65 population is increasing both nationally and in New York State. A population projection by the U.S. Census Bureau shows that the population of people in New York age 65 and older will increase by 60% between 2004 and 2030. Not only is the aging population growing but the diabetes epidemic will also increase the number of older people who will need help with activities of daily living and disease management-services provided by nursing homes. We must ensure that nursing homes will have sufficient staff to care for our aging population as they grow in number and dependency.

Nursing home residents, their families and nurses have been waiting while others are debating issues such as cost and nursing shortage. The shortage of nurse educators (RN to MSN) is causing a bottle up in the educational system leading many qualified nursing candidates to seek an alternative career path. It is time for our representatives to acknowledge the link between quality of care and nurse staffing ratios. Residents are suffering from lack of care. Nursing home staff is sustaining injuries due to staff shortages. In order for nursing home residents to receive the care the need and for staff to be able to properly care for residents, they must be given a guarantee that our nursing homes will be staffed appropriately.

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I recently came across a survey published in April that was conducted by the Michigan Center for Nursing, a state-funded agency begun in 2003 to analyze nursing trends. The 23 page report stated some alarming facts many of which point out that not only are current nurses too few, many older nurses are getting ready to retire. Making matters worse Michigan's nursing schools turned away 4,298 qualified applicants last year, even though the state will face a nursing shortage in a few years. The schools had to turn away students because:

* They didn't have enough nurses with advanced degrees to train the applicants;
* They need more links with health care institutions where nurses learn clinical skills;
* They lacked classroom space, laboratory facilities, equipment and supplies.

Still, Michigan schools are graduating more nurses -- 800 more than in 2003, when the last state survey was conducted, the report said. Last year, 4,756 nurses graduated from Michigan nursing programs. And more RNs are utilizing online platforms to earn their BSN, MSN and other online nursing degrees. Unfortunately, even though the schools are graduating more nurses, it's still not enough to stop or even curtail the nursing shortage downward spiral. The survey found that 42% of Michigan's full-time nursing school faculty is 55 or older; 14% expect to retire in three years, and 19% in five years.

The survey, conducted by Lansing-based Public Sector Consultants Inc., was based on responses from 49 Michigan nursing schools and 23,000 registered nurses.

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I'm reading more and more stories about nurses who are being fiercely recruited with $10,000 sign-on bonuses, laptop computers, free trips and in some cases free cars; all this for deciding to work for the recruiting employer. If a nurse wants a change of scenery she/he can relocate to another part of the country for free. Hospitals and other healthcare employers are frequently picking up the tab. When nurses want to return to school and earn an RN to BSN or RN to MSN, their education is subsidized. The current nursing shortage crisis has opened up tremendous financial opportunity for all nurses as RN's everywhere are calling the shots and reaping the rewards.

According to the MSHA, at least 126,000 nursing positions are vacant at hospitals nationwide. The figure is expected to reach 400,000 by 2020. The shortage is caused by the increasing age of baby boomers, along with expanding career choices for women during the past few decades. The nationwide nursing shortage is only part of an overall health care shortage. Doctors, Pharmacy technicians, laboratory technicians and many other health care employees are also in short supply. But the nursing shortage is more noticeable because they make up the largest classification in the health care system.

Publicity about the nursing shortage has led to improvements. Many schools have added or expanded nursing programs. Online nursing degree programs have become more recognized and have helped tremendously, as traditional classrooms are at capacity, but the education system alone can't resolve the problem. More than 147,000 qualified applicants were turned away last year because schools can accommodate only a limited number of students.

The national nursing shortage crisis may not be good for patients and others who fall under the care of this special group, however one thing is clear: it pays to be a nurse.

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