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“Humbling” — that’s the way Rebecca Erickson described her opportunity to testify before a congressional subcommittee on April 23 about the shortage of nurses in the United State’s health care system.
The UA associate professor of sociology made her first appearance on Capitol Hill to tell the House Committee on Appropriations Subcommittee for Labor, Health and Human Services, and Education that burnout accounts for a significant portion of the nursing shortage that has the potential to severely compromise America’s health care system. Rep. Ralph Regula, who chairs the committee, arranged for Erickson to testify.
As part of her testimony, Erickson proposed a pilot program of research and intervention to reduce the incidence of burnout and turnover among direct care nurses and increase their rate of retention. She asked that Congress provide $600,000 to fund the program.
“Congressman Regula referred to the testimony of public witnesses as ‘democracy in practice,’” said Erickson of the experience. “There was a lot of heartfelt testimony about the need for funding in the areas of health, medicine, education and labor. It was quite overwhelming.”
For the past 13 years, Erickson has conducted research in the experience and management of emotion, and the ways in which emotional processes affect the mental and physical health of individuals at home and at work. Her earliest and her most recent investigations target the occupational experiences of nurses and how the emotional demands of the nursing profession affect nurses’ health.
In her testimony, Erickson, who is chair-elect of the American Sociological Association’s Section on the Sociology of Emotions, cited a recent study that indicates that it is possible to make up much of the shortage in trained nurses by extending the work life of registered nurses. Statistics from the American Nurses Association (ANA) show that nurses typically leave hospital bedside nursing after just four years of employment.
“In 2000, 500,000 licensed nurses, or more than 18 percent of the (trained) nurse workforce, were not working in nursing,” Erickson told the congressional committee. “If only a quarter of these had been retained, or could be induced to return, a significant percentage of the 126,000 hospital nurse job openings would be filled.
“Solving the nation's crisis in nurse staffing requires that we understand why nurses leave direct care and choose not to return,” Erickson added. “The stressful work conditions experienced by nurses lead them to experience emotional exhaustion and low levels of job satisfaction.”
Burnout is a concern because the existence of large numbers of dissatisfied and emotionally exhausted nurses has a tremendous impact on the quality of patient care and the outcomes of treatment, Erickson noted.
“Because job burnout is named by the ANA as the condition that leads the average American nurse to leave hospital employment after four years, it is a particularly critical process to understand and disrupt,” Erickson said.
The funding requested by the UA professor would be for the federal government’s 2003 fiscal year, which begins Oct. 1. Committee staffers will spend the summer putting the appropriations bill together, based on priorities, so she won’t know for several months if her proposed research program will be funded.
If it is, Erickson, who joined UA in 1991, will likely pair with Summa Health System in Akron, where she has done earlier research work.
Erickson’s research program would include colleagues from the University’s Institute for Health and Social Policy and the School of Nursing as well as nurse administrators at Summa. Surveys and focus groups are part of the research as well. But the key component of the program will be nurses themselves — those who are doing direct bedside care.
“We’ll need nurses from all the hospital’s units to participate, so that we can accurately represent the range of working conditions and experiences,” explained Erickson.
Participants, who will be paid for their time, may be asked to keep detailed diaries of their workday experiences — both good and bad.
The research will focus on such issues as work overload, time demands, autonomy and prospects for job advancement.
“The outcome of the program will be to develop intervention programs that can affect significant changes in all these areas,” said Erickson.
She expects that results from this program would be applicable to other fields beyond nursing, such as teaching, where stressful and demanding working conditions and low job satisfaction also lead to burnout.
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