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The Nursing Shortage as a Sociological Issue

This is an excellent Paper 1 example by Christina Jones.

In April of 2006, officials with Health Resources and Services Administration (HRSA) released projections that the nation’s nursing shortage would grow to more than one million nurses by 2020 (HRSA, 2006). A report by the American Association of Colleges of Nursing (AACN) states that nursing schools in the U.S. turned away 42,866 qualified applicants from nursing programs in 2006 (AACN, 2007). The current nursing shortage and the difficulty of qualified applicants getting into nursing programs is therefore an issue that interests me so I am choosing it as the topic of this paper.

I will begin by a description of some of the personal troubles this issue has created. Our text points out that troubles are personal problems that an individual feels or experiences in their own life (Anderson and Taylor, 2008:5). In 2001 my mother began her second battle with breast cancer. She went into Swedish Hospital in Seattle with severe back pain and this is when my personal experience with the nursing shortage began. I should point out as background information that both my mother and I had a history with both the nursing profession and with this particular hospital. My mother was an LPN (Licensed Practical Nurse) who worked at this hospital for many years when it was Providence Hospital and had two of her three children there. I was treated there twice for an appendectomy and a D&C procedure as a teenager. After high school I went into a RN nursing program and did some of my training there. I did not complete the nursing program because I decided to become a counselor instead. Within a couple days it became apparent that the care my mother was receiving was not adequate. She could not get assistance in a timely manner for a great number of things and missed one of her radiation treatments because no one showed up to take her. Once someone tried to give her the wrong medication. The only reason she didn’t take it was because she had just taken her meds and didn’t understand why they were trying to give her more. As a result my stepfather and I started to take shifts at the hospital to help care for her. My mother was at Swedish Hospital for about three and a half weeks before she died there. I spent about eight to ten hours a day at the hospital during that time. This gave me a lot of time to observe what was behind this inadequate patient care, which I will address later in this paper.
In fall of 2005 I went back to college to become a registered nurse. I had all my prerequisites for the R.N. program last year at PCC and applied--I did not get in. This year I have the prerequisites to apply to five schools and am doing so at significant personal expense in time, money and effort--my chances of getting in are still not good. Though I have worked hard and am a Phi Beta Kappa student with a 3.72 GPA it may not be good enough to get me into a nursing program in this area. This also is classified as personal trouble. However both of these personal experiences are examples that illustrate a sociological issue--meaning something that affects large numbers of people because of a particular social structure or arrangement (Anderson and Taylor, 2008:5).
This concept of understanding the difference between troubles and issues is used for organizing concepts within the sociological imagination and is from the work of C. Wright Mills, an eminent sociologist. In order to do this, one has to imagine the point that biography and history crosses and how the structures within our society affects individuals (5). One way to do this is through observation.
Anderson and Taylor point out that observation is an important tool in sociology and is used to reveal certain trends or patterns that may lead to certain conclusions or eliminate others (6-7). In this case my observations resulted in my starting with one opinion and arriving at a different one. My mother, who had been out of nursing for over 20 years, kept saying that this care she was receiving, “… is not anywhere near the standards of care provided in my day”. At first my parents and I assumed Swedish Hospital had become a second rate hospital and that it was staffed with incompetent and uncaring people. This idea gradually changed as I spent considerable time at the hospital and debunked that theory. Debunking is looking behind an accepted assumption and seeing it from a different perspective (7). Since my mother’s experience, I have spoken with many people who have had negative experiences with their own hospital care or someone they knew. I have also read numerous articles about such experiences. The general consensus is that the nurses today are not as caring or professional as they used to be. My observations and conversations led me to a different conclusion. When my mother needed something I could not do for her she pressed her call light, we would wait for a reasonable amount of time, depending on the need, and then I would go to search out a nurse. Rarely did I find idle, uncaring nurses at the nursing station, ignoring call lights. Instead they were all busy helping other patients. That is when I came face to face with the reality of our nursing shortage and the result it has on patient care. The nurses on duty simply had more patients than they could adequately take care of. Because there are numerous stories like my mother’s and mine, it illustrates not just a personal hardship, but the social issue of a nursing shortage, which is something a sociologist would seek to understand and resolve.
A sociologist would want to discover the sociological origins of this issue. Nursing has a long history, of which I know a little. When my mother became a nurse, most of her training was in the hospital under the guidance of other nurses. My mother was not a good student but she was a very loving and caring person and she became a very competent nurse, but I know she would not have managed the academics required today. When I originally went into a two year R.N. degree program, I did so right out of high school in 1970. I had no difficulties getting in with my 3.0 GPA. Going to school full time would have taken me two years (six terms) to complete. The same degree today takes at least one year of prerequisites to even apply to a program and then your chances of getting in, if you do not have a 4.0 GPA, are slim--at PCC your chances are slim with or without a high GPA. Even with the added difficulty, there are more people who want to become nurses and have done their prerequisites than there are programs to train them.
From a sociological perspective there are a number of possible reasons for this. One is that colleges need money to run and a major source of that money comes from tuitions the students pay. At colleges the cost per credit is the same regardless of the class. However, nurses require classes that can be quite expensive to deliver because they consist of so many science classes with labs and nursing classes that require clinical experience and highly trained instructors. By necessity, these classes need to be small. Because of the social/economic structure of education there is more of a need to have this kind of education subsidized because the tuitions are not going to cover the cost. In lieu of such subsidies it may be more viable for a college to turn out more students with Associate of General Studies or Associate of Arts Degrees than Associate of Applied Science Degrees in Nursing. This would involve focusing on the economic structures of society as a possible source of this particular sociological issue. I am sure Karl Marx’s ideas of sociology would have a lot to say about this but that is beyond the scope of this paper.
Sociological imagination is defined as “…the ability to see the societal patterns that influence individual and group life”, a term first described by C. Wright Mills (5). I have attempted, in this paper, to differentiate troubles from issues while also illustrating how they interact. Mill’s argued that personal biographies are determined within the social and historical context in which they occur. I have tried to illustrate how this works by using a personal biography and examining its specific social and historical context and possible sociological origins. In this case the personal and sociological perspective are both troubling to me but that seems to be the nature of the beast.

Bibliography

Anderson, Margaret L. And Taylor, Howard F. 2008.” Sociology in Everyday Life” Thompson/ Wadsworth,: Portland Community College, US.

HRSA, 2006, “What is Behind HRSA’s Projected Supply, Demand and Shortage of Registered Nurses. http://bhpr.hrsa.gov/healthworkforce/reports/behindrnprojections/index.htm
AACN, 2007, “ 2006-2007 Enrollment and Graduation in Baccalaureate and Graduate Programs in Nursing” ? http://www.aacn.nche.edu/Media/FactSheets/NursingShortage.htm