by Senator John Edwards
“Nurses are the backbone of our health care system. We cannot provide true universal health care without strengthening that backbone. We need to make a serious investment in the nursing profession, starting today.” – John Edwards
Nurses are the backbone of our health care system, yet there are far fewer nurses than our hospitals, health clinics, and nursing homes need. As a result, Americans are paying more and getting less from their health care.
· A Growing Nursing Shortage: By one estimate, New Hampshire needs 672 new registered nurses each year until 2014 to fill vacant positions, but the state's nursing schools graduate less than half that number yearly. By the year 2020, America will be short 1 million registered nurses. Even a state like NewHampshire, which has more RNs per capita than any other state, will have about 27 percent fewer nurses than it needs by the end of the next decade as demand for health care increases. [NHDES, 2007; HRSA, 2006; CHWS, 2006; NHNA, 2006]
· Inadequate Staffing Threatens Patient Health: Patients undergoing routine surgeries in American hospitals are at a 31 percent greater risk of dying if they are treated in a hospital with a severe nursing shortage. The nursing shortage contributes to as many as one-quarter of hospitals' unanticipated deaths and serious injuries. Hiring more nurses could save 6,700 lives in hospitals and 4 million daysof hospital care and dramatically reduce adverse outcomes like hospital-acquired pneumonia and cardiac arrest. [Aiken et al., 2002; JCAHO, 2002; Needleman et al., 2006]
· Unsafe Working Conditions: Many hospitals have responded to the nursing shortage by increasing the number of patients that each nurse is responsible for and forcing nurses to work dangerously-long shifts -- more than 12 hours at a time. [IWPR, 2006]
· Nurses Are Leaving the Profession: Nearly 450,000 RNs are not working as nurses today, deterred by long hours, unsafe workplaces, low compensation and a lack of respect. In New Hampshire, only 62 percent of RNs are working full-time today. [HRSA, 2006; CHWS, 2006]
· Educational Capacity Is Inadequate: Despite the nursing shortage, there are too few seats at nursing schools. Some nursing colleges don't have enough professors, classrooms, or clinical facilities. Nearly 150,000 qualified applicants were turned away from nursing schools in 2005. In New Hampshire, before a recentmuch-needed expansion, 150 nursing students were being turned away every year from New Hampshire Technical Institute. [NLN, 2005; Concord Monitor, 7/5/2007]
John Edwards has offered a bold, detailed plan to take on the big insurance and drug companies to guarantee true universal health care for every American. His plan emphasizes prevention, primary care and pro-active management of chronic diseases. To ensure his plan succeeds and delivers quality health care for everyone, we must address the nursing crisis. As president, Edwards will invest the resources we need to add 100,000 nurses within five years – by bringing back 50,000 RNs who have left the profession, while retaining even more, and graduating 50,000 new nurses.
Retaining Nurses by Respecting the Profession : Edwards will keep skilled nurses from leaving the profession and bring back former nurses. Bringing back just 10 percent of the nurses who have left the profession will increase the number of veteran nurses serving America's patients by about 50,000. Edwards will:
- Ensure Safe Staffing Levels: High patient-to-nurse ratios have been linked to increased medical errors, worse patient outcomes and high staff turnover. Edwards believes that we need requirements that ensure safe staffing levels, determined on a unit-by-unit level, with appropriate exceptions for emergencies. He will support hospitals in finding the nurses that they need to provide high quality care. [Aiken,2002]
- Eliminate Mandatory Overtime: When hospitals force nurses to work more than 12 hours at a time, it becomes difficult for nurses to provide top-quality care and they are more likely to quit their jobs. States like New Hampshire have begun to lead the way in restricting mandatory overtime, but we need a national solution. As president, Edwards will ban mandatory overtime for nurses, with limited, temporary exemptions for truly understaffed areas.
- Improve Workplace Safety: The simple act of doing your job should not cause you harm. Edwards strongly opposed the Bush Administration's abandonment of real ergonomics standards. As president, he will implement a broad, mandatory ergonomics rule, and appoint officials who are committed to enforcing it. He will also help improve nurses' working conditions by offering resources to hospitals that commit to major improvements in nurses' working conditions - such as offering more time off, implementing new safety standards, and giving nurses a greater voice in hospital administration. He will also instruct the Department of Health and Human Services to lead a nationwide initiative on workplace safety and establish a presidential commission to recommend improvements in the nursing workplace, including protections from pandemic flu and safe patient handling.
- Strengthen Nurses’ Voices: Giving nurses a stronger voice will help keep nurses on the job. Edwards will strengthen labor laws to make it easier for nurses to organize and collectively bargain and reverse the court decision that deprived nearly 1 million of nurses and millions of other workers of the opportunity to join a union. He will also offer federal challenge grants to support responsible “magnet hospitals” that offer more training and mentoring, decent pay and benefits and give nurses a voice in hospital administration.
- Add New Nurses to Critical Shortage Areas: Edwards will pay up to full tuition and fees for 50,000 new students to become nurses. In return, these nurses would agree to serve for at least four years where nurses are in critical short supply, such as rural hospitals and urban public hospitals.
- Expand Educational Capacity: In addition, to ensure that schools have the resources to provide the new students with high-quality training, Edwards will invest to increase the capacity of the nation's nursing schools – including training and recruiting nursing faculty -- by 30 percent to meet the challenge of nursing shortage. He will also support distance learning initiatives– like the current partnership between UNH and Granite State College – that can help bring advanced training to rural areas. [Manchester Union-Leader, 8/6/2006]
- Create Partnerships with Hospitals: Classroom training is vital, but there is no substitute for experience. Edwards will support training partnerships of nursing schools and hospitals, like medical schools already have.
- Reach Out to High School Students: To reach a new generation of nurses, Edwards will help high schools implement career education programs in nursing that combine applied skills with rigorous academics.
- Promote Career Ladder Programs. There are hundreds of thousands of low-wage health care workers in hospitals and home care agencies across the country with the dedication and familiarity with the field to become professional nurses – but they don’t have the time or money to go to nursing school. Edwards will support Career Ladder partnerships, where employers and unions help low-wage health care workers and displaced workers from other sectors move up the skills ladder with on-the-job training, time off for training and guaranteed placement. He will build on model programs like thesuccessful workforce development labor-government partnership in Los Angeles County. [Fitzgerald, 2006]