Hospital RNs' and CNOs' Perceptions of the Impact of the Nursing Shortage on the Quality of Care

Peter I. Buerhaus; Karen Donelan; Beth T. Ulrich; Linda Norman; Mamie Williams; Robert Dittus


Nurs Econ. 2005;23(5):214-221. 

In This Article


Part one of this six-part series of articles on the state of the nursing workforce in the United States focused on the current nursing shortage and whether hospital registered nurses (RNs) perceived the shortage is getting better or worse (Buerhaus, Donelan, Ulrich, Norman, & Dittus, 2005a). Part two examined RNs' satisfaction with their present job and with nursing as a career, including their willingness to recommend nursing to others (Buerhaus et al., 2005b). In part three, we assessed awareness and reactions to the Johnson & Johnson Campaign for Nursing's Future among nursing students, RNs, and chief nursing officers (CNOs). The Johnson & Johnson Campaign is the largest private sector initiative in recent history aimed at helping recruit new nurses and retain those in clinical practice (Donelan, Buerhaus, Ulrich, Norman, & Dittus, 2005).

In part four of this series, we concentrate on determining how the current nursing shortage has affected the quality of patient care from the perspective of RNs and CNOs. Data for the study come from national random sample surveys of RNs conducted in 2002 and 2004, and from a national survey of CNOs conducted in 2004. Analyses of these survey data were accomplished as part of an ongoing collaboration among researchers at Vanderbilt Univer sity School of Nursing, Mass achusetts General Hospital, and Harris Interactive working to evaluate the Johnson & Johnson Campaign for Nursing's Future.

Before proceeding to describe the results of these surveys, we provide some background information summarizing key developments concerning efforts to improve the quality and safety of patient care in the United States. Over the past dozen years, many quality-oriented organizations, policymakers, and clinical and health services re searchers have made major strides in identifying the scope and incidence of poor quality and lapses in patient safety, understanding the reasons for their occurrence, and developing strategies for how hospitals and other organizations can improve their performance. The contributions of nurses to patient outcomes also have become more visible in recent years, and today nurses are being more readily incorporated into broader efforts aimed at improving the quality and safety of the U.S. health care system.


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