An Interview with ANA President Barbara Blakeney

Alabama Nurse,  Jun-Aug 2004  by Yox, Susan B

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In recognition of National Nurses Week 2004, I spoke with Barbara Blakeney, MS, APRN, BC, ANP, President of the American Nurses Association (ANA), asking her some of the questions I hear most often from Medscape's nurse readers.

There are 2.7 million registered nurses (RNs) in the United States, and 2.2 million of them are actively employed. With the theme of Nurses Week 2004, "Nurses: Your Voice, Your Health, Your Life," I asked first about the nursing shortage and nurse staffing, likely the issues at the top of everyone's list of concerns.

Medscape: The number one issue is obviously the nursing shortage. How bad is it, and is this shortage any different from shortages we've seen in the past?

"To put it simply, there are certainly not enough of us to get the work done that needs to be done," Blakeney said. She pointed out that although we have weathered nursing shortages in the past, this one is quite different. Why? Because in addition to not having enough nurses, the nurses working now are older. As a result, many aging nurses, feeling tired, overworked, and underpaid, are retiring early. In fact, estimates are that the number of RNs will fall to 12% below the demand by 2010, with a 20% shortage by 2015.

Medscape: What about the related concern of too few nursing faculty? Is it true that many qualified applicants to nursing programs are being turned away because there are not enough faculty members to teach them?

"That is absolutely true. We don't have the academic infrastructure to accommodate the young people who would like to go into nursing as well as the older career changers, who see nursing as a viable option." Blakeney went on to explain that at the BS level, 11,000 well-qualified applicants were turned away in 2003.

"These are people with grade point averages of 3.7, 3.8, and 3.9, and we don't have enough room in our programs to accept them"

The aging of nursing faculty members is even more acute than the aging of the nursing population as a whole. The average age of nursing faculty is now 55 years. These experienced teachers are not paid as well as they could be; consequently, as they get older, many are moving quickly toward retirement, without enough replacements in the ranks, "some states have as many as 30% of their nursing faculty eligible to retire," Blakeney pointed out. In addition, in times of financial belt-tightening, programs in the public sector often suffer cuts first. The reality is that a full two thirds of the BS education in nursing takes place in public universities, so these programs are even less able to expand and recruit faculty in the current environment.

Medscape: Where is ANA focusing the most effort this year in dealing with the escalating nursing shortage?

Blakeney described numerous legislative efforts to improve funding for nurses. ANA continues to lobby Congress to increase funding of the Nurse Reinvestment Act, legislation that targets nursing workforce development via programs designed to attract more students into nursing programs; improve the workplace for nursing; support schools of nursing to provide faculty an updated curricula; recruit a more diverse student population; provide assistance to students to enable them to complete nursing studies; and ensure the collection and analysis of current nursing workforce data to. guide the appropriate implementation of these programs. Blakeney explained that $205 million is being requested this year, the fourth annual increase for this important legislation.

Because inappropriate nurse staffing is the number one concern of nurses today" Blakeney continued, the ANA is strongly supporting the RN Safe Staffing Act (S. 991), legislation introduced by Senator Daniel Inouye (D-HI) on the eve of National Nurses Week in 2003. Companion legislation in the U.S. House of Representatives, the Quality Nursing Care Act (H.R. 3656), was introduced by Representative Lois Capps (D-CA), an RN, in December 2003.

Blakeney believes that this particular piece of legislation is "the smartest bill to date on staffing." Rather than ratios, the RN Safe Staffing Act builds in some flexibility to allow for variations in various settings, nurses' experience and skills, and patient populations. In addition, the nurses practicing on a particular unit will have a big part in determining the ratios in their own setting. Hospitals will need to publicize their process for both determining the needed ratios in their facility and their success in meeting them.

A safe nursing environment is essential to keep nurses working as well. A survey done in 2001 indicated that the majority of nurses report that health and safely concerns play a major role in their decision about remaining in the profession. For example, more than 80% of needlestick injuries can be prevented through the use of safer devices. The ANA's Safe Needles Save Lives campaign has been successful in passing legislation requiring hospitals to use safe needles or needleless technology where appropriate.

Handle With Care is a more recent ANA ergonomie initiative aimed at preventing work-related musculoskeletal disorders through greater use of assistive equipment and patient-handling devices. "Studies of back-related workers' compensation claims reveal that nursing personnel have the highest claim rates of any occupation or industry,k even higher than construction workers," noted Blakeney. In an ANA survey, more than 59% of the nurses surveyed listed a "disabling back injury" as one of their top health and safety concerns, and nearly 84% of the nurses surveyed said they continued to work despite experiencing back pain.