WASHINGTON (ASRN.ORG)- Health Affairs unveiled a series of six studies examining the nursing workforce in the context of health reform. The papers were released at a forum presented by Health Affairs and the Center to Champion Nursing in America (CCNA) that featured a lively discussion among policy-makers, nursing leaders and researchers, and health reform experts.

According to one of the studies, the continuing recession will contribute to an easing or temporary end to the current registered nurse (RN) shortage, as older nurses delay retirement or return to work, and part-time nurses seek full-time jobs. However, as the baby boom generation's health needs increase and the economy rebounds, the nursing shortage will intensify again in the next decade, according to the study, which provides detailed workforce and compensation projections. Other studies released at the meeting addressed nursing education, workforce development, increased quality and efficiency and patient satisfaction.

"These important findings demonstrate that nurses have developed and implemented innovative models of care that promote the goals of health reform: expanding access, improving quality and safety and reducing costs," said Susan Reinhard, Senior Vice President and Director of the AARP Public Policy Institute and CCNA Chief Strategist.

"The crises facing nursing -- and the nation's health and health care systems -- are inextricably connected," said Susan B. Hassmiller, Senior Adviser for Nursing. "Today we explored various approaches to ensuring we have enough well-prepared nurses in the future and that insights and innovations from the nursing profession are applied as we work to make our health care system better for all. Americans will not receive the health care they need unless we make an investment in a well-prepared nursing workforce."

We have an historic opportunity to prevent the nursing shortage by acting now to expand nursing school enrollments at a time when applications are at an all-time high, but we must first address the nurse faculty shortage and financially-strapped colleges and universities. Increased public subsidies are needed to provide greater access to nursing education, with an emphasis on baccalaureate and graduate nursing education, where job growth is expected to be greatest.

The continuing recession will ease the current nursing shortage in many areas of the country, but the results will be temporary: the United States will face a significant shortage of nurses by 2025. Hospitals and policy-makers should use this respite to strengthen the nursing workforce by addressing issues associated with an increasingly older workforce. Policy-makers should also implement policies to increase the capacity of nursing education programs to avoid future imbalances in the nurse labor market.

The U.S. must ensure a sufficient nursing workforce to care for a more diverse and aging population. To do this, we must change the way nursing education is delivered so that vacant faculty positions are filled and other educational resources bolstered.

For health reform to be effective and the U.S. economy to recover, must build, empower, and deploy a 21st century health care nursing workforce. Nurses will deliver, coordinate and direct care in hospitals and community-based and home settings, but these nurses will be in short supply unless we address the nursing and nurse faculty shortages.

Patients' reports of satisfaction are higher in hospitals where nurses practice in better work environments or with more favorable patient-to-nurse ratios. Improving nurses' work environments, including nurse staffing, may improve patients' experiences and their quality of care.

Because the staffing and organization of hospital nursing affects quality and cost, nurses must be actively involved in process improvement directed at quality and efficiency. Magnet accreditation and the Transforming Care at the Bedside (TCAB) program show how nurses and staff, supported by leadership, can lead the improvement of health care quality and efficiency.

The Center to Champion Nursing goals are to increase funding to expand nursing education to prepare right-sized and richly skilled nursing workforce; to increase the involvement of nurses in decision making about care delivery and management; to increase the number of nurses remaining in the workforce past traditional retirement age; and to decrease turnover amount new nursing graduates.

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