Summer 2001

Providing Intensive Care For the Crisis in Nursing



nyone doubtful that a crisis in the nursing profession exists now and promises to worsen should listen to Edward Salsberg, director of the Center for Health Workforce Studies on SUNY's Albany campus. Everywhere he has looked, he finds disturbing data. Here are some examples:

o Since 1996 there has been a steady decline in RN graduations in New York State. In 1995, at CUNY, there were 1,232 RN graduates; in 2001, 780-a 37% decline.

o With in-patient days declining and hospitals increasingly becoming large intensive care units, the demand for full-time RN's (who make up 26% of all hospital employees) has jumped 23% since 1992.

o Minorities are seriously under-represented in the profession. Five percent of RN's in 2000 were African American (but 12% of the population); 2% of RN's were Hispanic (11.4% of the population).

Dr. Edward Salsberg delivering some daunting data at the "Crising in Nursing" conferenc.

Salsberg was not the only messenger delivering bad news at a major day-long conference on "The Crisis in Nursing" co-sponsored by CUNY and 1199 Service Employees International Union and moderated by Executive Vice Chancellor for Academic Affairs Louise Mirrer at The Graduate Center last March 29. The subtitle of the keynote address, a demographic analysis by Dr. Peter Buerhaus, a leading scholar on the profession and Professor of Nursing at Vanderbilt University, said it all: "Trouble Now, Big Trouble Ahead."

In a recent article on the aging RN workforce, Buerhaus noted further disturbing data, notably that between 1983 and 1998 the average age of RN's has risen 4-1/2 years to age 42, and the number of working RN's under 30 has fallen from 419,000 to 246,000 (a 41% decline). Down the road, as early as 2005, Buerhaus sees serious problems as the large cohort of RN's from the 77-million-strong "baby boom" (1946-1964) begin to retire, and they are succeeded by the much smaller 44-million "baby bust" generation (a.k.a. Gen-X).

If there was a silver lining to all these dark clouds at the conference-which was sponsored jointly by CUNY's John F. Kennedy Jr. Institute for Worker Education and the 1199 Service Employees International Union/League Employment, Training and Job Security Fund-it was a galvanizing sense of "the need for collaboration between institutions of higher education, organized labor, the health care industry, and government" (the official subtitle of the conference).

In this proactive spirit, Governor George Pataki not only kicked off the conference with special remarks, but also took the occasion to announce a $3 million grant to create a CUNY/1199 worker education center in the Bronx to train healthcare workers, including nurses. Citing Bureau of Labor statistics, he noted that between 1993 and 2004 there will be 473,000 RN job openings, and between 1998 and 2008 the figure jumps to 794,000.

Following the opening ceremonies were two plenary sessions addressing "The Nursing Pipeline" and "Nursing and Re-organization of the Workplace." In these and other smaller sessions many large questions were addressed, among them: How can career ladders by enhanced within the profession? What strategies can be developed to diversify the nursing profession? How can collaborative efforts increase retention and improve the quality of care?

In response to the dismaying data, Chancellor Matthew Goldstein convened a special Nursing Task Force, chaired by BMCC President Antonio Perez, with the support of CUNY's new University Dean for Health Sciences, Dr. Rosa Gil. Gil emphasizes the professional diversity of the more than two dozen Task Force members. Among them are representatives of five hospital systems, two managed care companies, a pharmaceutical company, a home health care agency, and chairs of six of CUNY's eleven nursing programs. Gil, formerly Chairperson of the NYC Health and Hospitals Corporation, adds that two principal goals of the Nursing Task Force, which met for the first time on June 6, will be to study comprehensively how nursing educators and programs can better meet the needs of the health care field and to develop more effective recruitment strategies.

In his letter to prospective Task Force participants, Chancellor Goldstein set mid-November as a goal for a final report, with implementation of a CUNY-wide nursing education plan by Spring 2002.