Consultant predicts shift in nurses' value
A new study from business consulting giant PricewaterhouseCooper's Health Research Institute predicts that the spread of pay-for-performance initiatives focusing on the quality of clinical care and patient satisfaction measures will elevate the professional stature of hospital nurses vis-à-vis that of physicians. While doctors traditionally have been considered hospitals' revenue "rainmakers," the ongoing focus on quality and patient care measures will give nurses far more influence over revenue growth, the study concludes.
The study asserts that the roles of nurses and physicians are beginning to blur in the delivery of primary care to U.S. patients, with hospitals increasingly relying on "physician extenders," such as nurse practitioners and physician assistants. Competition for such clinicians already is escalating as more retail health clinics employ physician extenders, and by 2009, about 1,500 retail clinics staffed by RNs are scheduled to open in the U.S., it says.
The study calls for major changes in the education of nurses and physicians in order to head off a predicted shortage of 1 million nurses and 24,000 doctors by 2020. It notes that hospitals receive significant federal funding to subsidize education of doctors but that no such subsidies help underwrite nurse education and training. In addition to the high cost of providing nursing education, colleges and universities have to cope with a scarcity of clinical training sites. Together, those factors result in findings that only 23% of persons who want to become nurses actually working as nurses, and only 45% of those who apply actually being accepted to nursing education programs.
U.S. nurse vacancy rates are running between 7% and 10%, causing hospitals regularly to turn to temporary workers and international recruitment to fill the workforce gap, the study says. In 2005, about 13% of all new licensed nurses in the U.S. were international recruits, it says. The resulting turnover costs hospitals big-time. Hospitals with poor retention programs spend an average of $3.6 million more annually than hospitals with high retention rates, the study says.