CEO SUMMARY: It’s a story that will soon become a national headline. Even as laboratories struggle to find enough med techs to fill open positions, hospitals are facing an even bigger problem in getting enough nurses to keep units staffed and open. Recruiting nurses overseas is one solution—but will the American lab industry try the same strategy?
IMAGINE A STATE WHERE HALF the laboratories must close sections of the lab or scale back testing services because there aren’t enough medical technologists to do the work.
This hasn’t hit the clinical lab industry yet, but it’s already happening to hospitals in the United States. Maryland is a good example. Catherine Crowley, who handles nursing matters for the Maryland Hospital Association, recently declared that more than half of Maryland hospitals had closed units or scaled back services because there were not enough nurses to fill required positions!
Problem Will Get Worse
It’s now common knowledge among the laboratory community that there are not enough medical technologists to properly staff the nation’s laboratories. There is also recognition that the problem will get worse before it gets better.
That is why the shortage of nurses is an important trend for lab administrators to watch. Whatever methods are used to solve the nursing shortage can also be used to help address the med tech shortage.
More specifically, as pressure from the healthcare system builds for schools and universities to train more nurses, it will provide the lab industry with an opportunity to insist that funds and resources also be directed toward training more med techs.
One fact brings the nursing problem into sharp focus: since 1992, the number of nurses working in the United States has stayed almost constant. Yet during this same period, hospital admissions increased by 4.5% and outpatient volume grew by 20%. The aging baby boomers are expected to fuel a demand for health services so great that, by 2020, the nation may have 20% fewer nurses than it needs. These numbers are from the American Nursing Association.
In the short term, American hospitals are coping by hiring contract nurses. However, this raises labor costs. HCA reported that it spent $20 million more for nursing in third quarter 2000 than the same period in 1999.
The second strategy hospitals are using to attack the nursing shortage is to recruit nurses from overseas countries. This is something that clinical labs have yet to do. In October, Congress passed a bill lifted a ceiling on visas so an additional 60,000 registered nurses can enter the country.
The Wall Street Journal recently reported that O’Grady-Peyton International, based in Savannah, Georgia, had been recruiting for nurses in South Africa. Over 100 nurses attended meetings in six cities and as many as 20 were expected to be offered jobs and green cards in the United States.
One fascinating consequence of the global nursing shortage is that demand from developed countries pulls nurses from third world countries. Holland recruits in South Africa (because of language similarities). South Africa then recruits nurses from Ghana.
Of course, Canadian nurses come south to the United States. Then Canada recruits in Britain, which recruits from its former colonies. So many nurses left Jamaica that the country forced Britain to put a moratorium on hiring in Jamaica.
THE DARK REPORT observes that the nursing shortage will have a direct impact on clinical laboratories, if not immediately, definitely within the next several years. Predictions are that point-of-care and near-patient testing will continue to grow. Without adequate staffs of nurses, this testing will have to be done by other trained healthcare workers.
Regardless of whether POCT testing is done in the hospital, physicians’ office, or home care setting, there will probably not be enough nurses (and enough med techs) to do this testing.
For that reason, it is reasonable to expect that automation and miniaturization of lab testing equipment will be one way to cope with this dilemma. However, it also means that laboratories should revise their business plan to include strategies that accommodate this situation. Another solution may be to go overseas and recruit med techs.
Another Looming Crisis
Recognizing the shortage of nurses will eventually affect the way clinical laboratories deliver lab test services, there is another labor crisis looming on the lab industry horizon. This crises involves phlebotomy.
In an upcoming issue of THE DARK REPORT, we will provide startling business intelligence about how the healthcare system is about to become increasingly dependent on laboratories to handle phlebotomy.
The point of this intelligence briefing is to alert lab administrators and pathologists that the med tech shortage will not be an isolated phenomenon. Labs will also have to develop effective management strategies to simultaneously cope with the impact of too few nurses and an altered role for laboratory-provided phlebotomy.
The market trends leading to this situation are already in motion. During the next 18 to 24 months, more signs will become visible. THE DARK REPORT would like to hear from any hospital laboratory which is already changing its operational arrangements in order to respond to the shortage of nurses in that hospital.
In summary, the nursing shortage has implications beyond the parallels to the med tech shortage. As nursing labor becomes a more valuable commodity, the laboratory will be required to take on new responsibilities as a way of coping with this situation.