A recent American Nursing Association (ANA) poll indicates that 18.8 percent of nurses in the U.S. do not work in nursing. A study by the Center for Health Outcomes and Policy Research reveals that 22.7 percent of nurses plan to leave their hospital jobs in the next 12 months. Despite record-breaking salaries and bonuses, nurses are leaving hospital jobs in droves, resulting in the nursing shortage that has captured the attention of the American public.

As a nurses, you know this shortage is not a new trend. Since the average nurse is 46, I'm sure many of you remember the "bonus" days of the early 1980s when a nursing degree and a pair of clean white shoes got you a job anywhere. Today we've come full circle – a nursing degree and some brain activity will do: "Thank you for the emailed resume. Can you start today?"

The reasons nurses are leaving the profession today are equally familiar. The complaints from two decades ago still apply: nurses are understaffed, underpaid, under-appreciated, under-insured and under-you-name-it. On top of all that, nurses must work 26 weekends and at least five holidays a year and endure nightmarish schedules.

In addition, today's nursing shortage is being intensified by three new phenomena: managed care, on-the-job health risks and alternative careers for nurses.

Managed Care Compromises Nursing Care

In spite of giving more than they have to give every day, nurses in all settings can no longer deliver the level of care of which they are capable. Nurses who remember the "good old days" battle the shame of knowing they're partially responsible for the deaths of 98,000 patients in hospitals every year. That death toll is equivalent to a jumbo jet crash every other day, yet the number doesn't even include patients who become victims of injury and illness while in the hospital.

Why are patients dying unnecessarily? Nurses have less time to see more patients. They have more to do and fewer tools to do it with. They must contend with increasingly complex equipment and less trained staff. LVNs/LPNs, nurse's aides and nursing assistants are replacing skilled nurses at the bedside. Yet nurses still get little respect and face more responsibility when everything turns sour. In this "dark age" of medicine the words "quality of care" are becoming an oxymoron.

This trend goes against our education and against our very nature as nurses. Certainly some people get into nursing solely to make a living and don't progress beyond that stage. They're part of the problem. For most of us, though, nursing is more than a profession – it's a calling that attracts the "best and the brightest" who want to make a difference in people's lives.

You won't find a more caring group than nurses. Try having an anaphylactic reaction at a lawyers' conference and see how many people come to your aid without a business card in hand.

Yet today, despite all our caring, we're denied the ability to provide quality care. With the exception of a few great facilities around the country, we can no longer find jobs that allow us to fulfill the mission we defined for ourselves when we entered this profession. No wonder so many nurses are quitting.

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