CONTACT: DEREK MAURER
Iowa City IA 52242
(319) 335-8964; fax (319) 335-8034
Release: Oct. 5, 2000
National health policy expert to discuss crisis in nursing
IOWA CITY, Iowa -- The nursing profession is "at a crisis point and
a decision crossroad" and needs fundamental reform, according to a national
health policy expert who will speak at the University of Iowa Wednesday, Oct.
11. Nancy M. Valentine, Ph.D., is special assistant to the secretary and advisor
to the under secretary for health in the U.S. Department of Veterans Affairs.
She will deliver the second Geraldene Felton Lecture on Health Policy at 7
p.m. in the Senate Chamber of the UI's Old Capitol.
Valentine's talk is sponsored by the UI College of Nursing's Organizations,
Systems and Community Health Nursing area of study. A reception cosponsored
by the Iowa City Veterans Affairs Medical Center will precede Valentine's
talk beginning at 6 p.m. Both the talk and reception are free and open to
The crisis Valentine sees is a growing shortage of nurses that one study
predicted could leave the profession well below the number and types of nurses
needed by 2020. This shortage is caused by considerably fewer people entering
the profession at the same time that changes in health care -- an aging population,
growing technological sophistication and the shift toward community based
primary care and care management -- increase the demand for nurses. Valentine
said past shortages were caused in part by nurses leaving the profession or
temporarily leaving the workforce altogether; when employers raised salaries,
nurses "came out of the woodwork" to rejoin the workforce. "Now,
there's no woodwork," she said.
According to Valentine, nursing as a profession must decide how to reconcile
its own internal contradictions if it hopes to meet the challenges ahead.
"We're the only group that calls itself a profession that has so many
points of entry," she said, noting that graduates of two-year, three-year
and baccalaureate nursing programs all sit for the same licensing exam. "These
multiple tracks have given nursing great flexibility and have served to bolster
the workforce in earlier shortages," Valentine said, "but they're
potentially confusing to both employers and the public." Consequently,
consumers may not understand the connection between the greater complexity
of health care and the need for more nurses with baccalaureate and graduate
Valentine likens the need for change in nursing education to that experienced
by the medical profession a century ago, when reformer Abraham Flexner catalyzed
public support for higher educational standards for physicians. "We really
need our own modern day Flexner of nursing," Valentine said, "someone
or some group to focus public attention on the problem and develop potential
In her talk, Valentine plans to offer several avenues for possible action.
To address the need for more nurses with higher levels of education, she points
to the Veterans Health Administration's earmarking of $50 million over the
next five years to allow nurses with associate degrees and nursing diplomas
to earn bachelor's or higher degrees in nursing. In fact, the UI College of
Nursing and the VA Medical Center in Iowa City teamed up to offer the first
program for VA nurses under the initiative. Now in its second year, the program
provides more than 60 nurses at VA facilities in Iowa City, Des Moines and
Knoxville with all the courses and materials they need to earn bachelor's
degrees at no cost to themselves.
Valentine also believes employers cannot be held solely responsible for
addressing the issue and that federal support for nursing education should
increase substantially. While nursing is the largest health profession with
2.5 million members, Valentine said, the federal government devotes its resources
disproportionately to physician education at a time when there is a predicted
oversupply of physicians and a severe shortage of nurses. "There needs
to be a redistribution of funding based on actual need," she said.
Ultimately, Valentine said, the public's demand for quality health care
will drive reform of every aspect of health care. "People are becoming
hyper-aware of quality issues and making all health care professionals more
accountable," she said. "The public is going to force us to pay
attention to its need for the best possible health professionals."
The Geraldene Felton Lecture on Health Policy was established in 1998 to
honor Geraldene Felton, Ph.D., who served as dean of nursing at the UI from
1981 to 1997. The American Academy of Nursing plans to name Felton, who currently
serves as director of the National League for Nursing Accrediting Commission,
one of its "Living Legends" at its national conference in November.
She resides in Iowa City.