Illinois faces impending nurse shortage
ILEPI-UIUC study calls for unionization, patient limits
By Ted Cox
Illinois needs to take steps now to avoid an impending nurse shortage, according to a new study released Thursday.
“The Illinois Nursing Shortage: Addressing the Need for Safe Patient Limits and Collective Bargaining” comes from the Illinois Economic Policy Institute and the Project for Middle Class Renewal at the University of Illinois at Urbana-Champaign. It calls for patient limits and unionization to meet what’s estimated to be the need for 19,000 new nurses statewide over the next decade.
The study cites the increasing need for health care as the Baby Boom generation ages, which will also manifest itself among nurses, as half are 55 or older now, and one in six is expected to retire over the next five years. It also says that nurses, 89 percent of whom are women, are typically overworked and subject to workplace harassment, which is driving many from the field.
“A number of factors, including below-average wages, high workplace injury rates, and other occupational hazards function as a barrier to retaining the professional nursing workforce that Illinois needs,” said Jill Manzo, one of the report’s three authors. “Failing to confront these issues will only serve to erode the quality of patient care in our state.”
Illinois ranks 22nd in the nation among states for the average nurse’s income, trailing not only neighboring states like Wisconsin and Minnesota, but even states that generally offer lower wages, such as Louisiana and Texas.
A recent survey found that more than 75 percent of nurses reported a problem with workplace violence, including physical attacks, verbal abuse, and sexual harassment. Three-quarters of all registered nurses also reported that understaffing diminishes the quality of their care. The report cited another study that found that insufficient staffing, high patient-to-nurse ratios, and the threat of workplace violence led 30 to 50 percent of all new nurses to change positions or leave the field completely within the first three years.
“Obviously, when nurses are already stretched thin by understaffing and lower wages than their counterparts in other states, the potential for this type of widespread workplace abuse only adds another obstacle to the retention of qualified care providers,” Manzo added.
According to the study, nurses suffer from overexertion, sprains, cuts, workplace violence, sexual harassment, psychological trauma, and other injuries, and Illinois nurses have the second-highest injury rate among their peers in the Midwest.
The study specifically suggests that unionization and setting patient limits would help retain nurses and bring others to the field. As it stands, only 17 percent of Illinois nurses belong to a union.
“The data show that unionization increases an Illinois nurse’s weekly take-home pay by 13 to 15 percent, and increased staffing results in fewer workplace injuries and better patient outcomes,” said study co-author Robert Bruno, a UIUC professor and director of the Project for Middle Class Renewal. “These dynamics not only boost the voices of care providers as patient advocates and the appeal of nursing as a profession, they also reduce employee turnover and injury costs that the current shortage imposes on hospitals and other health-care employers.”
Alice Johnson, executive director of the Illinois Nurses Association, said the findings are “consistent with our experience as a nurses’ union.” She said she often hears from non-union nurses who are “scared to speak up” when things go wrong at a hospital or clinic, because “when they do speak up, they might get retaliated against.”
Johnson affirmed that fewer than one in five Illinois nurses are union members. “The industry works incredibly hard to suppress the unionization of nurses,” she said. “They fight tooth and nail to prevent unionization, and once unionization happens they fight tooth and nail to stop the nurses from getting a contract.”
Johnson said, “Nurses choose nursing because they want to help people, they want to take care of people.” Many consider it “a vocation, not just a profession,” she said, adding, “It’s something that’s a true calling for them.”
Because of that, nursing unions can make the same case for improving overall care and medical conditions that teachers do in arguing for better schools, with the call for lower patient-to-nurse ratios equating to the call for smaller class sizes.
Collective bargaining “gives nurses a voice to have a say in their workplace,” Johnson said. “This is about creating a workplace where nurses are empowered to do the best work possible.
“It’s frustrating and stressful for them when they go to work and they’re set up in a situation where they can’t do their best, they’re set up to fail, because they don’t have enough staff.”
The study encourages Illinois to adopt patient limits like those enacted in California in 2004. California mandated that there be at least one nurse for every two patients in intensive care, three patients in labor and delivery, four patients in pediatrics, five patients in medical-surgical units, and six patients in psychiatrics.
“Hospitals that have implemented above-average nurse staffing levels have a 17 percent lower patient mortality rate,” said co-author Frank Manzo IV, ILEPI’s policy director. “After California implemented safe patient limits for nurses, the likelihood of in-patient death, the time spent in intensive-care units, and hospital readmission rates all fell as well.”
Johnson cited how state Rep. Fred Crespo, of Hoffman Estates, has submitted House Bill 2604 or the Safe Patient Limits Act in the current General Assembly. It would set patient limits under a variety of hospital conditions. It’s currently assigned to the House Labor Committee.