Not Enough Caring

What should Hawaii do to combat its shortage of nurses? Susan Scheider has a few solutions.

October, 2002

Immediately after she arrived in Honolulu last February, Susan Scheider hit the ground running as the new chairwoman of the Hawaii Nurses Association’s (HNA) collective-bargaining unit. It’s a role with which she is all-too familiar: she is a graduate of Northeastern University’s School of Law in Boston; she served as a labor counsel for the District of Columbia Nurses Association for the past 20 years; and she brings more than 20 years of legal and healthcare-industry experience to the HNA.

In Hawaii, an average of 400 nurses retire annually, but only 280 graduate each year. Scheider’s goal is to combat the statewide problem before it reaches epic proportions. Today, there are roughly 23,000 licensed nurses in Hawaii, of which 8,000 are practicing.

Why is there a nursing shortage in Hawaii?
While the nursing shortage has begun to arrive in Hawaii, it hasn’t yet hit at the levels that the Mainland has experienced. According to the Joint Commission On Accreditation of Healthcare Organizations [JACO], there are currently 126,000 nursing vacancies unfilled in hospitals nationwide. From talking to people, they say Hawaii is about five years behind trends that happen on the Mainland. I would expect the same patterns that we see elsewhere in the nation to be hitting Hawaii in the next couple of years. JACO says by the year 2020 there will be 400,000 nursing vacancies nationwide; that is more than triple the current rate.

Some of the reasons nurses are leaving, have to do with working conditions. Nurses go into nursing because they want to help people. If they are faced with terrible understaffing, they can’t provide the quality patient care that they are committed to ethically and from all of their training.

One of the biggest compensation issues is building in more recognition of the value of experienced nurses. In Hawaii, there is very little distinction between what an inexperienced nurse and an experienced nurse are paid. The value of training is not recognized. New nurses rely all the time on the assessment skills and experience of the more senior nurses.

What has the shortage done to existing nurses?
Because hospitals are 24/7, nurses have to put up with all sorts of demands on their schedules that get them away from their families. Mandatory overtime is a symptom and a side effect of a nursing shortage. The Joint Commission on Accreditation of Healthcare Organizations says 24 percent of patient errors resulting in critical injuries and death were related to inadequate staffing.

What are you and your collective-bargaining team doing as we speak, and what do you hope to accomplish?
One of the major planning needs has been to help prepare for the big five negotiations. Five of our biggest units were previously multi-employer bargaining units. Now they are separate, but it involves close to 2,500 nurses and their contracts. They all expire on Nov. 30 of this year. This is going to be key in terms of keeping enough nurses at the bedside.

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