This paper examines the growing nursing shortage in the United States and argues that novice nurses represent an underutilized resource that could help alleviate the crisis. Drawing on data from the National League for Nursing and other sources, the paper outlines the multiple factors driving the shortage, including low pay, high stress, aging nursing faculty, and declining enrollment. It then addresses concerns about novice nurses' inexperience — particularly regarding medication errors and missed diagnoses — and argues that proper mentorship and reduced workloads would mitigate these risks. The paper concludes that integrating novice nurses into the workforce, under experienced supervision, offers both a short-term and long-term solution to the ongoing nursing deficit.
One need only read the newspaper classified ads to realize that employers are trying many clever marketing tactics to attract prospective nurses into their organizations. Many are offering sign-on bonuses, extra benefits, and other amenities to attract a limited supply of nurses. As both the general population and the elderly population grow, the number of nurses needed to care for them increases proportionally. The number of people choosing to pursue nursing as a career has been on the decline, mainly due to long working hours, low pay, high job stress, and other factors. These factors will not resolve themselves if the nursing deficit continues to increase.
In addition, graduate nurses find it difficult to enter the workforce due to their lack of experience and a shortage of mentors to guide them. The solution is straightforward: more nurses are needed, and soon. Novice nurses — fresh graduates who usually conduct their work under the close supervision of a more experienced nurse — offer a solid pool of qualified candidates who, under proper supervision, could help address the current nursing crisis.
The National League for Nursing (NLN) states that no single factor can be blamed for the current nursing shortage; rather, it is a complex issue with many contributing elements. Fewer nurses are entering the workforce than ever before, and the NLN has been unable to accurately determine the size of the gap. Numbers from the U.S. Department of Labor report that the number of nurses entering the field is increasing at a steady rate, which might suggest there are enough to fill current needs (NLN, 2002). However, the NLN cautions that these numbers are deceptive because the demand for nurses does not increase in proportion to general labor demand. For the nursing profession specifically, the number of patients is increasing at a disproportionate rate and will continue to do so for quite some time. In places where shortages are most severe, hospitals are closing wings and canceling surgeries due to insufficient nursing staff (NLN, 2002).
The decline in nursing students entering the field is not the only problem. The average age of working nurses has been rising, and there are fewer and fewer PhD-prepared nurses available to teach upcoming classes. Several factors are cited as threats to recruiting potential nurses, including low pay rates, job dissatisfaction, limited supervisory or career prospects, excessive workloads, and long hours caused by staffing shortages. Unless these issues are addressed within the profession, the nursing shortage will continue to grow at an alarming rate (NLN, 2002).
The problem is apparent, but how do we solve it? The first issues that must be resolved are those that create an undesirable work environment for nursing staff. In his book on frontline care, Dr. Karl Pillemer summarizes the situation as follows:
"Many nursing assistants begin with a sense of enthusiasm, sound intrinsic motivation, a desire to help others, and a sense that he or she is making a meaningful contribution, yet workers get burned out, not only by stressful conditions and heavy workloads, but also because of a lack of recognition and respect." (Pillemer, 1996)
According to Brian Vastag (2002), the U.S. Department of Health and Human Services (DHHS) has launched an aggressive program to encourage young people to seek a career in nursing. By the next decade, 600,000 new nurses will be needed to fill vacancies and meet increased demand (Lang, 1996). Novice nurses could be used to fill some of these vacant positions; however, this raises important questions regarding their lack of experience.
Medical mistakes can cost lives and carry serious repercussions for healthcare providers. There is a legitimate concern that, due to their lack of experience, the rate of medical errors would rise if novice nurses were used to cover a large gap in existing staffing. A 2002 Newsday article cited two cases in which novice nurses improperly administered medication in incorrect dosages, nearly causing the death of patients. In both cases, the novice nurses had not been properly supervised (Durkin, 2002).
"Medication errors and supervision risks examined"
"Staffing increases reduce errors and stress"
"Retention challenges and work environment issues"
Durkin, Barbara. (2002). Reliving hospital mistake: Mom recalls overdose case. Newsday, Inc., February 24, 2002.
Lang, Susan. (1996). Lack of nursing assistants is an impending crisis, says Cornell gerontologist. Cornell University News Service. Retrieved June 2002.
National League for Nursing (NLN). (2000). Unpublished data. New York, NY. Retrieved June 2002.
Pepper, G. A. (1985). The nursing process in clinical pharmacology and therapeutics. In M. B. Wiener & G. A. Pepper (Eds.), Clinical pharmacology and therapeutics in nursing (2nd ed., pp. 3–48). McGraw-Hill.
Pillemer, K. (1996). Solving the frontline crisis in long-term care: A practical guide to finding and keeping quality nursing assistants. Cambridge, MA.
Vastag, Brian. (2002). Encouraging young nurses. Health Agencies Update. American Medical Association.
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