UB Expert in Nursing Labor Trends Says Profession Faces Aging Workforce, Poor Public Image

BUFFALO, N.Y. -- The nursing profession currently faces two major problems: an aging workforce and a less-than-stellar public image.

This assessment comes from Carol Brewer, Ph.D., associate professor in the University at Buffalo School of Nursing and an expert in nursing labor trends. Brewer has been studying nursing work-force dynamics since the 1980s. She sees two potential solutions to solving these problems and avoiding a major shortage of nursing services: change the behavior of nurses who are already licensed by getting them to work more hours, or educate more nurses to increase the number entering the workforce.

Nurses already are overworked as hospitals have cut numbers, however, and that doesn't bode well for recruitment, Brewer said. It means enticing would-be nurses into a profession that's experiencing a "public-image problem," with its quality of work life on the downturn.

"People coming in...look at all the issues around nursing and they say, 'Why would I want to work as a nurse when I could work as a teacher, or a social worker, or could go into business or medicine?'" Brewer said.

Brewer looked at the differences between hospital-employee nurses versus non-hospital employee nurses in Western New York in 1997, and in 1999 conducted an analysis of state nursing labor statistics with a colleague at New York University. The study appeared in the January/February issue of Nursing Outlook. Her research has shown that:

* The demand for nurses is expanding, while growth in supply has slowed with no sign of an increase.

* Employers have raised wages, but not enough to attract new nurses, and have increased the number of jobs, but in the form of less desirable, part-time positions: "Nurses expect to be in the workforce their whole lifetime," Brewer said. "They expect to be able to work full-time."

* The hospital market drives the need for nursing (hospitals employed 60 percent of nurses in 1996), so fewer dollars for health care to hospitals means less money to pay for nurses and fewer RN positions.

* Nursing has become increasingly decentralized, characterized by an overloading of tasks outside the primary responsibility of patient care, which has led to a devaluing of nurses

Brewer noted that focusing on such issues could skew the public's perception of the profession.

"Nursing remains a stimulating, exciting and fascinating profession, with many career options -- and that is what gets lost when there is so much emphasis about working conditions," she said.

Brewer now will look at nursing labor issues on a national level, concentrating on retention in the profession over time and the effects of turnover on the workforce. She is interested in finding out what makes nurses dissatisfied and if they act on job satisfaction or dissatisfaction.