Highlighting Critical Care

Trends and perspectives in critical care nursing

Wanda L. Johanson, CEO

Wanda L. Johanson, CEO of American Association of Critical-Care Nurses interviewed by Richard Eng, Program Manager, GE Healthcare American Association of Critical-Care Nurses (AACN) http://www.aacn.org

The article also available in PDF: 101KB

Opening remarks

Some time ago, GE Healthcare hosted a visit by the American Association of Critical-Care Nurses (AACN). The aim of the visit was to identify mutual synergies and develop a stronger collaborative relationship. Issues and events such as individual missions, e-learning, patient safety, and the nursing crisis dominated the discussions. During the event, the CEO of AACN Wanda Johanson, RN, MN was interview by Rich Eng of GE Healthcare. This article has been previously published in GE's Window Magazine in 2004, Permission for republication in CWWJ has been approved by AACN.

Nursing crisis - is it getting better or worse?

That all depends on how you're measuring it. In the short term, there has been a noticeable improvement in regard to national awareness of the situation. There is evidence of increasing enrolments at nursing schools – some even have wait lists. Federal funding for nursing recruitment programs has increased, as well as the number of national privately funded recruitment campaigns.

For the long term, we need to do more. The entire nursing community has been united around this issue. In ten years we're looking at a huge shortage of nurses as the baby boom generation ages. Even with current programs, we won't have enough new nurses to fill the gap. There could be a national healthcare crisis if we let down our guard. If you look at the demographics of the nursing population, you'll notice that it is aging, too. As registered nurses reach retirement age, we may experience a huge loss from our workforce. We must keep today's nurses active by creating ongoing retention activities.

Our research has shown that the number one priority for working nurses is to maintain a healthy work environment. That translates into reducing stress on the job. The healthcare community must remember that nurses put their patients' safety first so one of their biggest job dissatisfactions is that in today's environment they cannot spend as much time with their patients as they need to ensure excellent care. Inadequate systems and staffing result in less time spent with patients and an increase in job stress for nurses.

What kind of impact does this shortage have for hospital and hospital suppliers?

This is a key point. In terms of the hospital, nursing services are their most essential resource. It is imperative to have nurses to provide good healthcare. Hospitals must focus on recruiting and retaining their nursing staff.

A diminished nursing staff will actually result in increased costs. Hiring nurses from staffing agencies for the short term will actually cost hospitals twice as much money as having the nurse as part of their staff. Again, our research has shown that patient complications increase without vigilant nursing care. This can result in increased cost as well as decreased quality for the healthcare enterprise.

For hospital suppliers, the nursing shortage offers both a threat and an opportunity. Expenditures within the hospital are always being watched. If more of the operating budget goes toward personnel, i.e. short-term nurses from staffing agencies, there will be fewer purchases of material goods. However, high technology that increases nursing efficiency is valued because it can contribute to the bottom line.

What is AACN doing to help with the nursing shortage?

AACN has been active on several fronts. We have been developing programs and implementing plans with, and for, the nursing community for the past two years. For example AACN has worked as an advocate for government funding with regard to recruitment and retention programs. We have been active members of the industry's key coalitions to reduce the impact of the looming shortage. On a local basis, we have been working through our 250 chapters to target children and youth to familiarize them with nursing as a career. Our chapters are getting young people involved, using ‘home town' people to recruit future nurses.

One of AACN's major efforts is the development of a healthy work environment. We're working on what this environment should 'look' like, in terms of the nursing staff, support for education, etc. In late 2003, we introduced the AACN Beacon Award for Critical Care Excellence. We will look for an ideal ICU environment and use that as a model to determine workplace excellence and share that with our membership and the medical community. In the context of the nursing shortage, if we can create a healthy work environment, we can help to promote the recruitment and retention of nurses.

What is the value of certification for a critical care nurse?

Certification is a mark of excellence. Certification is good for patients, and there is evidence that it results in better outcomes. Certification is good for employers because it improves the quality of their healthcare delivery by adding a level of patient trust.

Certification is also a key recruitment and retention strategy. Our research has shown that certification is one of the highest job satisfiers for nurses. It has value in that it proves that they have the knowledge and the skills to do their job. The increased confidence that a nurse acquires through certification translates to increased patient safety.

During this shortage, a healthcare enterprise cannot afford not to certify their nurses. It is a critical show of support for nurses striving to advance their professionalism. From a marketing standpoint, certification offers patients proof that their nurses have the skills and experience to be able to do the best for their patients.

What can hospital administrators or industries do?

There is one imperative for administrators. Invest in creating and sustaining a healthy work environment for their nursing staff. At the same time, they must leverage the skills that nurses have to design and model the healthcare system of the future. Administrators need to use this asset, not marginalize it. Nurses are not just employees, they are a huge asset. Again, our data shows that adequate nurse staffing prevents patient complications and increases the quality of outcomes.

GE has made a name for itself by constantly innovating and by listening to the customer. My advice to GE and other companies is to do more. Engage nurse customers in dialog and use this resource for problem solving. Use your technology to support the re-design of care processes that are no longer effective. We're calling on you to move to an even higher level of technology and help find new solutions for healthcare.

When will we feel the impact of proposed changes?

We're beginning to see some success now. At this point, it's all about sustainability. We're beginning to open some young people's eyes to nursing, but if it's not sustained we will hit a crisis point in a big way. Everyone is a stakeholder in effecting change. There is no substitute for a nurse, especially when nursing vigilance is a 24/7, life or death situation. In healthcare, a nurse has a presence that no other clinician has. It is essential. Think about it. Who will be there for us as we age?

The nursing community cannot do this alone. We need committed industry partners to help us make these changes. After all, creating solutions is something that is within all of us and it is essential that we work together. By thinking along the same lines we will create solutions for change.

Is there anything else you would like to share?

Yes! Nursing is a fabulous career. It's flexible, it's exciting, it's rewarding. Tell your friends, tell your family, tell your children. At AACN we talk about this all the time and we're excited about the opportunities that the future will bring to nursing. We have 65,000 members that can make a difference - and we are!

Last updated: 21 March 2005Created
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