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"Nurse shortage hits health, economy"

May 13, 2005 -- Today the Post and Courier of Charleston, SC, published a reasonable, well-written op-ed by Medical College of South Carolina College of Nursing Dean Gail W. Stuart. Dean Stuart argues that her state's severe nursing shortage--and especially the lack of resources for advanced nursing education--threatens not only residents' health, but the state's economic wellbeing. This is an excellent point that is not often made. The op-ed does not really address the underlying causes of the shortage, and it steers clear of discussing more controversial potential solutions--omitting mention of short-staffing and staffing legislation, for instance.

The op-ed calmly makes clear the dire state of affairs for nursing in South Carolina. The state has fewer nurses per capita than the great majority of states, its nursing work force has been rapidly aging over the last decade, it does not train enough nurses to meet its own needs, and its nurses earn far less than the national average, possibly in part because only one-third of them have a baccalaureate degree. Yet South Carolina's nursing schools must turn away qualified students because of a shortage of faculty and lack of resources. The piece also notes that recent research has demonstrated that more nurses means better patient outcomes, and that units staffed with nurses with more formal education had lower patient mortality. It argues that this is not only a health issue but also an economic one, because the nursing shortage affects the state of the local "health-care industry" and business climate. "Industries and investors" look closely at a state's health care environment before making a decision to do business there. In addition, hospitals themselves are economic engines, in large part because they create jobs. And nurses are a key part of hospitals. The piece notes that other states have addressed the shortage through measures such as creating special centers to study it and plan solutions, increasing nursing faculty resources, and initiating demonstration projects. It concludes that South Carolina also needs a "strategic plan" to increase the number of nurses trained at the baccalaureate level and higher, while at the same time "positively impacting" clinical environments, so that there will be a nurse "at every bedside" and "in every school."

The piece does a good job of outlining the dimensions of South Carolina's nursing crisis, and it makes a persuasive general case for greater investment in the state's nursing education. It does not include specifics as to what should be done, nor does it address how the nursing shortage came about, and whether "positively impacting" clinical environments will require legislative intervention, such as through the type of staffing legislation now pending at the federal level and in many states. Some proposed legislation includes mandatory staffing ratios (which are very strongly opposed by the hospital industry and its allies), as well as bans on mandatory overtime and whistleblower protection. Finally, the Courier and Post might have conveyed that Dean Stuart has a doctorate, such as by identifying her as "Gail W. Stuart, RN, Ph.D." Such identifiers improve the nursing image by ensuring that the public understands how highly educated nursing leaders like Dean Stuart are.

Published during Nurses Week, the op-ed presents a timely and compelling argument that the nursing shortage affects South Carolina's "bottom-line" wellbeing, and something must be done. We commend Dean Stuart for her nursing advocacy and the Courier and Post for publishing the piece.

See the op-ed "Nurse shortage hits health, economy" by Gail Stuart in the May 13, 2005 edition of the Charleston Post and Courier.

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