There's a memorable scene in the movie "The Electric Horseman" in which the director of a spectacularly inane Las Vegas variety show asks a down-and-out celebrity cowboy to recite a promo for a breakfast cereal. When the cowboy finally manages to mumble the words correctly, the director's face lights up. "That's good! But much, much bigger!" he shouts, gesturing theatrically to show the cowboy how to deliver the line to a full house.
That scene comes to mind when thinking about the looming health-worker problem. The industry, government and educators have begun to react to what is now a shortage and will soon be a crisis in U.S. hospitals, as an aging population simultaneously robs us of older health workers and adds to the burden on the care system. As we detail in our second annual Workforce Report, providers are partnering with nursing schools; governments have helped with scholarships and recruiting efforts; and a number of high schools have started vocational programs for future health workers. Some health systems have addressed nurse retention through programs to empower nurses with new technology and more prominent clinical roles.
These are positive steps to be emulated across the nation. But the effort has to be much, much bigger. From 2002 to 2012, some 1.1 million new nurses will be needed to replace those leaving the industry. In contrast, last year 76,618 nursing students took the national license exam, down 20.5% from 96,438 in 1995. In the coming years, the U.S. Labor Department also projects that we will need hundreds of thousands of medical technicians, home health aides and physical therapists. Healthcare has become the nation's No. 1 worker need.
At the same time, the industry is competing with other technology fields for a smaller pool of skilled young people. Studies show that more than half of high school graduates lack the background needed to succeed in college or the workplace. There just aren't enough young people with the requisite science and literacy skills to meet the requirements of a more sophisticated service economy. Every sector, especially government, must do its share to improve our educational system.
Healthcare is an attractive field. It is growing as a share of gross domestic product. Healthcare jobs are relatively stable. The higher-skilled posts pay reasonably well, some very well. The work, though sometimes messy, involves caring for people. There is new evidence that having enough qualified staff contributes directly to fewer deaths and better patient outcomes, which ought to make idealistic young people want to enter the field.
In order to make it even more attractive, however, the field must become more professional. The hospitals that retain workers are those that are creating environments where nonphysician staff are respected and given room to grow. This means delegating authority to RNs, who in turn delegate tasks to licensed practical nurses and nurse assistants, freeing the RNs to do the more complex work. RNs and technologists should have more of a voice in hospital affairs and some hope of further advancement in the organization. In contrast, hospitals where nurses are misused by doctors or blamed for the rate of medical errors are going to have serious problems competing for a dwindling supply of workers.
One thing the industry ought to do is more and better quality advertising of healthcare as a career path. For industry associations this would be money well-spent. Healthcare should be able to use television to get young people thinking of health careers early enough so they have time to develop the skills needed to care for all those aging baby boomers.
What do you think?