A research team at UNMC is developing a tool to help Nebraska communities predict and plan for nursing shortages. Mary Cramer, Ph.D., assistant professor, UNMC College of Nursing, received a $5,000, 12-month grant from the American Nurses Foundation to conduct the research.
The grant, titled the Anne Zimmerman, R.N., American Nurses Foundation Scholar grant, recognizes Zimmerman’s contributions to nursing science. Dr. Cramer said the model she and colleagues are working on is unique.
“People haven’t stopped to consider that we haven’t defined what a shortage is and we haven’t developed any targets at all for looking at nursing workforce needs,” Dr. Cramer said. “I think everybody is focusing on the nursing shortage and rightly so — they’re looking at what can we do to deal with the problem.
“Since nursing is such an important component in health care, this model would provide a more grounded and predictable approach for communities who need to know how many nurses they will need, versus the current method which only looks at economic factors like vacancy rates, turnover rates,” Dr. Cramer said.
She said the current definition of nursing shortage also has been based on current staffing patterns, which can vary considerably between hospitals and communities.
“We start hearing employers say they can’t hire registered nurses,” said Dr. Cramer who specializes in community health nursing. “So programs gear up, colleges gear up and federal money gets assigned for educational programs. Nobody knows how many nurses are needed for sure.
“Most efforts to alleviate the nursing shortage have been aimed at ill-defined targets, or targets that have been arbitrarily set by current levels of employers’ staffing needs. We need a more precise, predictive model that combines the demand for health services with what we know should be recommended ratios based on settings and demand for care.”
The study’s objective is to construct a scientific model to determine nursing workforce demand in Nebraska. The premise of the model is the need for registered nurses can be predicted from demands for health services within a population. The model should provide a look at geographic areas and population demographics and learn what the demand for services is and come up with some target number to predict the number of nurses needed, Dr. Cramer said.
The model could be a resource for health departments and policy makers, she said. Researchers will collect a variety of data and create a database of age, race, gender and health demand ratios in Nebraska counties to create a mathematical model. The final product will be a mathematical model to determine demand and identify nursing workforce targets in Nebraska.
“If we know certain characteristics of a population like the age, distribution, race and gender, we know from the literature and also studies that age is linked to certain conditions in society. For example, we know a certain number of people over age 65 will get Alzheimer’s disease or dementia. Race also is linked to health-care conditions, including diabetes in the Hispanic population and hypertension and cardiovascular disease is linked to African-Americans.
“From this, we also know there are certain standards that tell us how many staff are required to be in that type of facility that links registered nurse staff to patient outcomes.”
Dr. Cramer said during past nursing shortages, the market forces geared up and could handle the shortage. Shortages in the 1980s and 1990s were fairly rapidly corrected through the market economy of supply and demand.
“The shortage is more serious now because there are other factors. Nurses are getting older, there are retention problems and young people aren’t going into nursing quite like they were. So it’s less likely we can immediately correct the problem,” Dr. Cramer said.
Another factor in the shortage is a greater demand for nursing faculty. Nursing schools are having trouble attracting nurses to nursing education. “We can only admit as many students as we have faculty. If we can’t hire nursing faculty, we can’t let as many students in,” she said.
The model also could help nursing schools better plan in communities on a long-range basis. It will help nursing schools better predict how many registered nurses they need to educate and what kind of specialties areas, like geriatrics, they need to be educating. She said the model also has implications for other health professions, such as dentistry, pharmacy and the allied health fields.
“The grant is a very competitive and prestigious grant to obtain within nursing circles,” said Bernice Yates, Ph.D., associate dean of research, UNMC College of Nursing.
Once the model is developed, Dr. Cramer said it will provide the framework for larger studies, which could provide funding from the National Institutes of Health and other sources. Dr. Cramer’s research team includes co-investigators, Li-Wu Chen, Ph.D., and Mike Shambaugh-Miller, Ab.D., Donadea Rasmussen, research analyst, Keith Mueller, Ph.D., consultant, and Sangeeta Agrawaal, data analyst.