From remarks by Sen. Lawton Chiles (D-Fla.) in the Senate Feb. 16:

Our nation is facing a shortage of nurses that seriously threatens the delivery of safe and quality health care to patients. According to the 1986 nursing supply survey conducted by the American Hospital Association, the vacancy rate for registered nurses in U.S. hospitals more than doubled between 1985 and 1986 -- from 6.3 percent to 13.6 percent. . . .

Even though the number of nurses educated has doubled over the past 30 years, demand for registered nurses is increasing. The Bureau of Labor Statistics has forecast a 33 percent increase in the number of positions between 1985 and 1995 . . . . At the same time, fewer people are choosing to be nurses, as evidenced by declining enrollments in nursing education programs. . . .

{R}easons that nurses give for leaving the profession are: increased severity and intensity of care in hospitals, poor staffing ratios, undesirable working hours and a lack of administrative support. More significant, however, is professional dissatisfaction which results because the specialized abilities of registered nurses are . . . not fully utilized. Under current management practices, . . . nurses are often inhibited in their ability to provide high-quality, cost-effective care because they are required to perform nonclinical, non-nursing-related tasks. . . .

What can be done to solve our nursing shortage problem? . . . S. 1833 {the Medicare Nursing Practice and Patient Care Improvement Act} authorizes the funding of projects to demonstrate and evaluate innovative nursing practice and management models which are designed to link case management with patient care, increase the nurse's role in administration, improve working conditions . . . and improve the cost-effectiveness and quality of patient care.