We Will Always Need Nurses

Tracy Dick talks with a UAB nurse about the long-term outlook for the profession.

Healthcare facilities exist to deliver care, but without an adequate supply of healthcare professionals, the system cannot function. Currently, the United States is in the midst of a nursing shortage, and Alabama has been affected.

Tracy K. Dick, PhD, RN, CNE, COI, Assistant Professor at the UAB School of Nursing, has been following these statistics. "I have been amazed at how the words nursing shortage in Alabama have elicited only a low-level response, especially among those outside of the nursing profession," she says. "Historically, nursing shortages have shown a somewhat cyclical pattern, so a cyclical reactive response may have prevented a true crisis in our state. However, the COVID pandemic and other realities have challenged any presumption of normalcy. The time to engage in a paradigm shift from reactive to proactive workforce planning strategies is now so that we don't experience a nursing shortage crisis in Alabama."

Last year, Dick conducted a survey of Chief Nursing Officers (CNOs) with acute care facilities that focused on supply and demand for acute care registered nurses in our state. The results raised red flags even before the pandemic hit. The survey findings revealed that 68 percent of participants had a high degree of difficulty in filling registered nurse (RN) positions. Another 24 percent reported moderate difficulty. When the CNOs were asked specifically about hiring experienced RNs, the high difficulty percentage increased to 80 percent.

"I wasn't able to identify anyone in Alabama who has been studying supply and demand of the nursing workforce," Dick says. "Before my study, there was anecdotal evidence of a shortage but no research-supported evidence. That is the point I am trying to make. Alabama needs ongoing research about the nursing workforce, because it impacts health care. Nurses comprise the largest percentage of health care professionals, so there can be far reaching effects."

Additional workforce demand is expected to increase as the current workforce ages. Alabama's growing percentage of individuals 65 years or older, combined with the state's sustained chronic disease burden, promises that the demand for health care services will continue to increase. "Coupled with that, the U.S. Census Bureau recently reported an anticipated decline in the number of people considered part of the working-age population across the United States," Dick says. "A critical shortage of nurses could occur if the anticipated decline in the working-age population numbers proves to be correct in Alabama.

"The nursing profession is a great career opportunity and is expanding exponentially. When I was in nursing school, there was talk about the expanding role of an advanced practice nurse. I thought then that it was just around the corner. We are finally seeing that reality. We now have many opportunities for advanced practice nurses. That is fantastic and much needed, but we need an increasing number of expert frontline nurses too. When you have an experienced nurse leave the frontline for advanced practice, it creates a position to fill.

"There will always be a need for nurses to serve at the bedside in acute care facilities. The front line is exciting but can also be challenging. It is physical and emotional work. Most acute care facilities use a 12-hour shift model. Although younger nurses typically like the 12-hour shift, experienced older nurses often seek positions with more flexibility in work hours. I believe that to realize higher quality health care and prioritize patient safety, we must increase the focus on the work of nurses and their value to healthcare.

"I have been a nurse for 32 years, and I want to do everything I can to draw attention to this current nursing shortage and the long-term outlook. I am passionate about this. We need an adequate workforce to provide health care for the people in Alabama. We have an opportunity at this critical juncture to discuss, collaborate and to act to avoid a future critical nursing shortage in our state."


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