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New Partnership Between Nursing And Medicine To Address Nurse, Doctor Shortages

Armen Hareyan's picture

Council on Physician and Nurse Supply concluded calls for a new partnership between nursing and medicine to address the growing shortages of physicians and nurses and the rising complexity of care.

The Council noted that shortages of physicians exist within most specialties and that nursing shortages are widespread. At current levels of training, these shortages can be expected to deepen and there will be too few physicians and nurses to meet future demand. Indeed, the consequences of shortages are being felt already, as patients experience more limited access to care and as the nation suffers under the weight of inadequate reserve capacity for emergency preparedness, insufficient staff for military needs and too few doctors and nurses to properly staff health care facilities that are now being created or expanded in many communities.

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The Council observed that physicians and nurses are interdependent and that shortages in either discipline exacerbate shortages in the other. It concluded that action to alleviate the existing and projected shortages must be a high priority for government and educational organizations. However, simply training more practitioners will not be sufficient. Instead, the Council called for a new partnership between nursing and medicine to train a new generation of professionals who will be capable of working synergistically across the full range of services, from prevention and health promotion to disease management. These practitioners must be skilled in treating patients who have a complex array of needs in an era when chronic illness and survivorship issues will be prevalent.

To achieve the desired goals, medical educators face the dual challenges of building medical school capacity and expanding the number of residency positions, while also restructuring medical education throughout its continuum. Nurse educators face similar challenges in increasing the production of new RNs, particularly those with bachelors of nursing degrees, while also increasing the numbers of nurses who obtain graduate degrees that prepare them for advanced practice and faculty roles.

Meeting these goals will require increased investment in undergraduate medical education and in both baccalaureate (BSN) and graduate education for nurses. It also will require that the current caps on Medicare support for graduate medical education (GME) be lifted and that new and equitable means be developed to support GME. Specific investment will be necessary to increase the numbers of qualified faculty and to expand the number of clinical training sites for both medicine and nursing.

While many important details flow from this basic structure, and a great deal of thought and planning will be necessary, the Council expressed a strong sense of urgency to expand educational capacity because the lead times are long and the failure to act now will jeopardize the ability to achieve the desired goals in the future.