Registered Nurses' Perspectives on Health Care and the 2008 Presidential Election

Peter I. Buerhaus, PhD, RN, FAAN; Beth Ulrich, EdD, RN, FACHE, FAAN; Karen Donelan, ScD; Catherine Desroches, DrPH


Nurs Econ. 2008;26(4):227-235. 

In This Article


This is a complex time in American politics. The economy is barely growing and may yet slip into recession, the war continues in Iraq, the President has historically low popularity ratings, the Congress fares no better, and the implications of the coming election for health care are unknown. Barack Obama has put forth a proposal aimed at moving the nation toward universal health insurance for all Americans. John McCain offers incremental and market-oriented approaches in keeping with the recent traditions of his party. Yet health care issues have not dominated these campaigns over the past 2 years. Rather, the war, the economy, the public's desire for change, and the issue of Presidential leadership have been most prominent.

As this historic election draws near, what do registered nurses (RNs) think of our nation's priorities? What issues do RNs care about? Which candidates do they think will be most effective in shaping our health care system and addressing the most pressing issues of our time?

Over the past several years, we have conducted national surveys to assess the views of RNs and other key stakeholders who are concerned with the RN workforce in the United States. Recent publications describe results from surveys of physicians, nurses, and hospital executives that identified and compared their perceptions about how the current nursing shortage is impacting nurses and the quality of hospital care (Buerhaus, Donelan, DesRoches et al., 2007), and a survey conducted in 2007 assessed the public's views of careers in nursing (Donelan, Buerhaus, DesRoches, Dittus, & Dutwin, 2008).

Our program of survey research also has focused on assessing the views of RNs. To date, we have conducted four national surveys of RNs in 2002, 2004, 2006, and 2008 including trended questions about the nursing shortage, nursing recruitment and retention, the hospital workplace environment, the impact of Magnet® hospital recognition, and the quality of care available to patients in acute care settings (Buerhaus, Donelan, Ulrich, Norman, & Dittus, 2006; Buerhaus, Donelan, Ulrich, DesRoches, & Dittus, 2007; Ulrich, Buerhaus, Donelan, Norman, & Dittus, 2005, 2007). These surveys were carried out by a collaboration of researchers at Vanderbilt University Medical Center, The Massachusetts General Hospital, and the Gannett Health care Group, and were sponsored by the Johnson & Johnson Campaign for Nursing's Future and the Gannett Healthcare Group. The Campaign, which began in February 2002, is a major national initiative (expenditures exceeding $50 million to date) aimed at increasing awareness of the nursing shortage, recruiting people into the nursing profession, retaining nurses in clinical practice, and increasing the capacity of the nation's nursing education programs, including expanding the supply of nursing faculty (see

Taken together, this body of survey research has allowed us to assess how the nursing workforce in the United Stated is changing. We have noted that RNs have strong and clear opinions about many issues — sometimes uniting in one voice — as in their perceptions of the nursing shortage — and sometimes expressing divided opinions about the best approaches to change or improvement in their workplaces.

In preparing to conduct the 2008 National Survey of Registered Nurses (NSRN), we added questions to our survey to measure RNs' attitudes about health care policy and the presidential election. In this article, some of the only data ever published on the policy perspectives of RNs during a presidential election year are presented. We also compare nurses with the general public on several issues facing our nation and the health care system.


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