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What Nurses Want
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"It costs $50,000 to $100,000 to replace one nurse -- and that's not counting salary," said Pat Rutherford, vice president of the Institute for Healthcare Improvement, a nonprofit organization based in Cambridge, Mass. The money, she said, is spent on overtime payments and temps to cover the position, as well as recruiting and training for a permanent replacement.
The number of open nursing jobs nationwide reached 116,000 in 2007. The vacancy rate has dipped slightly; for now, the dismal economy is providing some respite as nurses take on more work to make up for income lost by others in their households who were laid off.
But hospitals are bracing for 2025 when retirements and other factors are projected to push the number of open jobs to as many as 1 million, just when Baby Boomers will require more nursing care.
"We're in a big, big world of hurt coming up," said Peter I. Buerhaus, director of the Center for Interdisciplinary Health Workforce Studies at Vanderbilt University. Buerhaus said having fewer nurses would seriously compromise hospital care, putting patients at greater risk for pneumonia, falls, bed sores and infections. "This would be lights out for many [hospital] organizations."
More than 150 hospitals have launched pilot projects under the Institute of Healthcare Improvement, which works with such facilities to enhance patient care and nurse retention. And about 300, including Inova and Georgetown, have become certified under the American Nurses Credentialing Center's Magnet Recognition Program. The credentialing center's program is awarded to hospitals deemed to be "magnets for nurses" for introducing more training programs and mechanisms for nurses to have a greater say in patient care.
Experts say the hospitals' investments are paying off.
"We're able to show that nurse satisfaction is significantly higher in magnet hospitals than in matching hospitals" that don't have the status, said Linda H. Aiken, director of the Center for Health Outcomes and Policy Research at the University of Pennsylvania.
With a higher proportion of nurses with bachelor's and master's degrees, Aiken added, "magnets have significantly lower mortality rates than other hospitals." Moreover, she said, patients at magnet hospitals have fewer complications, keeping pharmaceutical and diagnostic costs low.
