1. Leonick, Leonard MPA, RN

Article Content

The 21st century nursing shortage is unlike any other labor shortage in the United States. Studies of the problem have yielded calls for increased compensation and improved working conditions. This, however, has not brought people to the profession in droves, or even trickles. We must find solutions before the crisis is beyond our ability to fix.


What is it that draws workers to take jobs in public safety and not nursing? It doesn't appear to be better working conditions or schedules. It doesn't appear to be better pay-in some areas, RNs with seniority may surpass salary levels of police officers and firefighters. There appears to be only one area of compensation that separates these similar, but disparate, positions. For the public safety officers there is a finish line, an end point. They are promised, upon appointment, that they will receive half-pay pensions after 20 to 25 years of service. This is to reward them for physically demanding, highly stressful, and often life-threatening jobs. Police officers and firefighters take advantage of this promise in their recruitment drives, and it seems to work.


It's clear that we need a new way of looking at the shortage of RNs. The current fragmented health care system cannot solve its own problems-it's up to the federal government to step in with a bold, new solution to this ever-increasing problem. My proposal would require an untried incentive to bring new blood to the profession. I propose that the government (the largest purchaser of health care, with Medicare, Medicaid, the Veterans Administration, the Bureau of Indian Affairs, and so on) establish half-pay pensions for RNs who work 25 years full time in the profession; part-time employees would be credited on a prorated basis. The promise of an adequate retirement while being young enough to enjoy it is not uncommon in jobs that require heavy physical labor under extreme conditions and on poor time schedules. I contend that if people were given the promise of an obtainable goal-early retirement and its benefits-more of them would become RNs.


Today, RNs are promised the opportunity to work until age 65 (or beyond) in order to earn Social Security, Medicare, and whatever small pensions hospitals or health care facilities may give them. With service-credited pension plans, RNs would be offered the opportunity to retire with half pay after 25 years of full service. They could choose to stay longer and be credited with an additional one-twenty-fifth of their salaries for every year of full service thereafter. RNs who work full time for 50 years (God bless them) would be entitled to pensions equaling full salary.


RNs could retire with half pay after 25 years.

FIGURE. No caption a... - Click to enlarge in new windowFIGURE. No caption available.

The mechanisms that such a program would require already exist. The Social Security Administration (SSA) now tracks and credits every quarter of a year a worker contributes to the system. Breaking out the RNs from the overall workforce is feasible. Since nurses rarely stay in one facility or geographic area, the SSA's records could be used to track and credit years worked.


Service-credited retirement would be too costly and difficult for any one facility, health care network, or even state to track and fund. The federal government is a vital stakeholder in alleviating the RN shortage and has intervened in times of need-it created (in 1934) and still administrates the Railroad Retirement System, a retirement program separate from Social Security for railroad employees. For this proposal to become a reality, Congress would have to legislate it-all states are affected, and all of their constituents will be touched by the shortage.


Most of all, RNs must have a say in this proposed change. With their professional organizations, such as the ANA and its state and local chapters, nurses must educate the public on and lobby for this proposed retirement system. RNs may not benefit from the program immediately, but they must recognize its potential for recruitment and retention. Future generations will thank them for it.