1. Alexander, Mary BS, CRNI

Article Content


Figure. Mary Alexand... - Click to enlarge in new windowFigure.

The nursing shortage impacts the nursing profession as a whole; it is not specific to any one specialty. The demand for healthcare continues, influenced by the varied needs of the population; increasing numbers of elderly; and technology, economic, and policy-driven forces. To maintain the profession, it is vital to have competent and knowledgeable clinicians who will deliver skilled, safe, quality patient care. How can we, as infusion nurse specialists, help to ensure this level of care in the current environment?


There are two major reasons for the shortage: an aging registered nurse (RN) workforce, and a decline in the number of young people entering the nursing profession. In their important recent study, Buerhaus et al 1 state that the average age of RNs has increased at more than twice the rate of other occupations in the US workforce. The percent of working RNs younger than 30 years old has dropped from 30% to 12% of the total workforce. Working RNs younger than 30 years decreased by 41%, whereas the number of working people younger than 30 only dropped by 1%.


With more opportunities outside the nursing profession available to young women-traditionally the bulk of the nursing workforce-there has been a steady decline in enrollment in nursing education programs. Meanwhile, RNs of the baby boom generation will reach retirement age between 2005 and 2015. The small number of younger nurses is insufficient to replace them. It is estimated that by 2010, the average age of the RN workforce will be 45.4 years and approximately 40% will be over age 50. The RN workforce will shrink and continue to age after 2010. 1


As a specialty, we face our own shortages, caused by insufficient education and competency programs and shrinking numbers of experienced infusion nurses available to train novices. We must take action on behalf of the infusion specialty as well as the nursing profession as a whole. Here are some ways to address the issue 1 :


* Prepare for an older workforce by making improvements in ergonomics, increasing retention efforts, and fostering an atmosphere of respect.


* Develop ways to better use the scarce RN pool.


* Design education programs for roles in nonhospital settings.


* Develop ways to keep older RNs in the workforce (eg, as consultants).


* Eliminate stigmas and barriers for men and minorities.


* Improve the image of nursing.


* Continue research on the relationship between nurse staffing conditions and patient outcomes.



Nursing is one of the more trusted professions. It is time to capitalize on the public's favorable opinion and use it to encourage young people to enroll in nursing school. To court the younger generation of potential nurses, we also need to focus on making the profession more attractive-offering competitive pay, flexible hours (which better accommodate the younger generation's lifestyle), and a multitude of opportunities within the nursing profession.


Diversity in practice is reflected by the variety of articles published in the Journal of Intravenous Nursing. The Journal continually solicits and publishes manuscripts that reflect current research addressing nursing's impact on quality patient care. As nurses in a specialty practice, we can demonstrate our passion and commitment by highlighting the benefits we provide to patients. As nurses in general, we can make a difference. The challenge is to develop strategies, form partnerships with our healthcare colleagues, and create an environment that supports initiatives to address the nursing shortage and preserve the delivery of safe patient care.




1. Buerhaus P, Staiger D, Auerbach D. Implications of an aging RN workforce. JAMA. 2000; 283 (22):2948-2954. [Context Link]