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Background
The nursing shortage began with the introduction of managed care in the early 1990’s when hospitals began cost cutting by decreasing patients’ length of stay. Practice was shifted toward community-based care expanding the demand for registered nurses in primary care, home care, and outpatient surgical centers. Acute care was left facing a growing elderly population with increased acuity of patients with increased technological needs. The implementation of capitation to drive down costs resulted in a greater demand for registered nurses throughout the health care environment. This problem is compounded by the growing phenomenon of RNs whose average age is 43.3 years resulting in a high number of retirements within the next 10-15 years. Although the demand for registered nurses is growing daily, the nursing supply is having the greatest impact on the current shortage. According to a recent survey by the American Academy of Colleges of Nursing, baccalaureate program enrollment dropped 2.1 percent in fall 2000 for the sixth consecutive year. Multiple factors contribute to the decline in enrollment.
Factors Contributing to Declining Enrollment
• Decreasing number of high school graduates
• Expanding structure of opportunity for women into other professions
• Negative image of nursing
• Workload
• Pay
• Lack of appreciation/respect
• Lack of power/autonomy
• Lack of knowledge regarding roles/responsibilities of nursing
• Stereotype of “female profession”
Factors Positively Influencing Nursing as a Career Choice
• Observation/Interaction with a nurse
• Caring for family member/friend
• Job security/flexibility
• Career advancement opportunities
• Interaction with diverse population
• Opportunity to care for others
• Desire for “important work”
• Financial support
Strategies to Encourage Nursing as a Career Choice
• Target students during their prime decision-making years of career choice
• Assess students’ perceptions of nursing roles/responsibilities
• Assess attributes that students associate with an ideal career
• Provide education, information, and make presentations to students regarding:
- Roles/responsibilities of nurses
- Career advancement opportunities involving:
- Graduate education
- Leadership/Governmental opportunities
- Job security/flexibility |
• Correlate portrayal of nursing with students’ perceptions of ideal career
• Role modeling of students with registered nurses including:
-Shadowing
-Nursing camps/clubs for interested students
- Attendance at educational career days |
• Focus recruitment efforts on minority (culture/gender) students by:
- Mentoring programs
- Involvement in advertising/lecturing campaigns |
• Careful portrayal of nursing by media and within social settings
• Promotional campaigns emphasizing nurses’ critically thinking, working with technology, and rewarding aspects of nursing career
• Education for individuals influencing career selection of middle/high school students
Prepared by:
Robin Hawkins, MSN, RN
starhawk70@hotmail.com
University of Tennessee
March 2001
Ms. Hawkins completed the above work in partial fulfillment of course requirements for N582, Scholarly Inquiry for Advanced Practice Nursing. Ms. Hawkins has prepared a review of the literature on the topic of nursing student career selection that is available upon request. She also participated in a statewide survey of nursing students about career selection that was sponsored by the Tennessee Center for Nursing, Inc. and published in the Tennessee Nurse, 64 (3), pages 14-18, entitled Nursing Student Career Choice: A Pilot Study. The manuscript was written by Mona Shattell, Nancy B. Moody, Robin Hawkins, and Joan Creasia. Requests for information should be directed to Nancy B. Moody at Nmoody@lmunet.edu.
References
Al-Kandari, F.H., & Ajao, E. (1998). Recruitment and retention of nursing students in Kuwait. International Journal of Nursing Studies, 35, 245-251.
American Association of Colleges of Nursing. (2000, February). Nursing school enrollments decline as demand for RNs continues to climb. Washington, DC: Author.
American Association of Colleges of Nursing (2001, February). Nursing school enrollments continue to post decline, though at slower rate. Washington, DC: Author.
American Association of Colleges of Nursing. (2000, June). Amid nursing shortages, schools employ strategies to boost enrollment. Washington, DC: Author.
Boughn, S. (2001). Why women and men choose nursing. Nursing and Health Care Perspectives, 22(1), 14-19.
Boughn, S., & Lentini, A. (1999). Why do women choose nursing? Journal of Nursing Education, 38(4), 156-161.
Grossman, D., Arnold, L., Sullivan, J., Cameron, M.E., & Munro, B. (1989). High school students’ perceptions of nursing as a career: A pilot study. Journal of Nursing Education, 28(1), 18-21.
Hemsley-Brown, J., & Foskett, N.H. (1999). Career desirability: Young people’s perceptions of nursing as a career. Journal of Advanced Nursing, 29(6), 1342-1350.
Kersten, J., Bakewell, K., & Meyer, D. (1991). Motivating factors in a student’s choice of nursing as a career. Journal of Nursing Education, 30(1), 30-33.
Magnussen, L. (1998). Women’s choices: An historical perspective of nursing as a career choice. Journal of Professional Nursing, 14(3), 175-183.
May, F.E., Champion, V., & Austin, J.K. (1991). Public values and beliefs toward nursing as a career. Journal of Nursing Education, 30(7), 303-310.
Mendez, D., & Louis, M. (1991). College students’ image of nursing as a career choice. Journal of Nursing Education, 30(7), 311-319.
Nevidjon, B., & Erickson, J. (January 31, 2001). The Nursing Shortage: Solutions for the Short and Long Term {On-line}.
Available: http://www.nursingworld.org/ojin/topic14/tpc14_4.htm
Stevens, K.A., & Walker, E.A. (1993). Choosing a career: Why not nursing for more high school seniors? Journal of Nursing Education, 32(1), 13-17.
Tomey, A.M., Schwier, B., Marticke, N., & May, F. (1996). Students’ perceptions of ideal and nursing career choices. Nursing Outlook, 44(1), 27-30.
While, A., & Blackman, C. (1998). Reflections on nursing as a career choice. Journal of Nursing Management, 6, 231-237.
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