Well, well, finally it's being noted that there may be more to the nursing shortage than reduced student enrollment.

Why this should surprise anyone beats me. Surely I was not the only one told by new grads that their career plans were for a master's degree and teaching rather than shift work in a CCU. It's been obvious for years -- take a quick glance around any chart desk -- that nurses are getting younger all the time.

So why are older nurses leaving? I can only speak for myself, and my reasons are legion.

The nursing image is all tied up with motherhood and apple pie. Sacred. We are supposed to be some sort of 20th-century medical nun "called" to heal and comfort ailing mankind . . . forever. Opting out is a sacrilege; it is a sin to like something better.

I wasn't "called" in any sense of the word. The art school I preferred was inconceivable to someone of my working-class background. Nursing was a cheap education (a diploma granted after 3 years OJT, a method now considered obsolete) and better than office work. Other nurses give equally mundane reasons, such as a wish "to work with people" or "not to be cooped up in an office all day," reasons which apply just as easily to forestry or catering. Waitresses and nurses are often confused anyway, the same cute little uniform.

With such motivation and inspiration getting nurses into the profession, it follows that their reasons for quitting would be equally profound: practical things like wanting a Monday-to-Friday, 9-5 job like the rest of the world, or a wage commensurate with the responsibility, never mind the cost of living.

In how many jobs are you penalized for doing your work well? Show capability of handling chaos and stress and a heavy patient load, and sure as God made little green apples, you'll be stuck with the whole show again and again. And no rewards like a Christmas bonus or stock in the company. My biggest mistake -- made when new to the staff of one Washington-area hospital -- was to show that I could cope with a ward of 20 some cardiac patients on the night shift.

To this day I bless the man whose laboured breathing -- heard all over the ward -- told me he was still alive so I could get my work done. Now if I had blown that one: given the wrong medication, forgotten the diet-order sheet, and/or messed up the census report, or worse still, if that patient had died, my chances of being left again in such a position would have been minimal.

But what really gave me the push out the hospital door was my own ability to worry. "What if . . . " was always at the back of my mind. Up until now, Someone Up There had been telling me to look over and see that baby turning blue, to take that B/P one more time, to check that fungus. I'm no walking PDR with drug dosages at my fingertips and the responsibility of the medicine cart, not to mention half a dozen IV's, makes me very, very nervous. My luck, I decided, couldn't last forever, and I have enough gray hairs.

I have also given up the joys of playing politics with the time sheet, weekends off for good behavior, vacation requests in by 15 Jan. I see no need to be insulted by orientation personnel telling me "if the patients weren't here, you wouldn't have a job."

But the greatest of all reasons is that ugly one: money. I have yet to meet that nurse who denies salary as an issue in job dissatisfaction. All the ones I know have to eat. It's stating the obvious to point out that nursing on Sunday ($12.75/hr. for an agency-provided nurse) should be worth as much as cashiering in a supermarket ($13.50/hr.). One pay raise I received--after strike threats in California and New York concentrated a few minds--included instructions to work harder.

Employers, it seems to me, still see nurses in terms of the menial tasks they do rather than the skilled ones: the cleaning of vomitus off the floor vs interpreting an EKG. All those flowers put in vases; all those babies delivered before H.R.H. arrived.

No one looks for the 5-cent cigar anymore. Cheap nursing has gone the same way. If a hospital around here offered what a Texan one did, I admit I'd be tempted. They resolved a chronic serious shortage of weekend staff by paying a week's wages for 2, 12-hour Saturday and Sunday shifts.

But in the meantime, I own up to a faint nostalgia when I pass a nurses' station (the few times I can bring myself to enter a hospital). The satisfaction of seeing a patient who had every right to be dead walk out the front door is not to be found anywhere else.

But until my part in helping make that exit a vertical one is properly rewarded, I'll do something else.