AHA: Nurse shortage, budget cuts hamper ER care

March 16, 2001
Web posted at: 1:52 p.m. EST (1852 GMT)

By Christy Feig
CNN Senior Medical Producer

WASHINGTON (CNN) -- More Americans than ever are visiting hospital emergency rooms, but financial cuts and nursing shortages mean help might not be available when they need it, a new report says.

The number of ER visits has increased 15 percent since 1990, according to the report from the American Hospital Association, and by 1998, one out of five Americans had been to the ER at least once. ER patients account for an estimated 40 percent of hospital admissions, the AHA said.

But financial pressures caused many rural hospitals to close during the 1990s, taking their emergency departments with them. In hospitals surveyed by the AHA, more than 800 emergency departments closed between 1990 and 1999.

VIDEO CNN's Christy Feig reports on the lack of beds and nurses that are plaguing U.S. hospitals Play video (QuickTime, Real or Windows Media)   ALSO Government projects shortage of nurses Some worry nursing shortage could put patients at risk Nursing mistakes cause thousands of deaths, probe finds   TRANSCRIPT Patricia Underwood, of the American Nurses Association, discusses the U.S. nursing shortage   MESSAGE BOARD Health care reform   RESOURCES American Hospital Association

One problem for hospitals is uninsured patients. Hospitals are required by law to take care of such patients when they come to ERs, but there is no federal program to reimburse hospitals and physicians for emergency services provided to those without insurance.

Also, the U.S. Department of Health and Human Services found earlier this year that growth in the nursing workforce has not kept pace with the country's population growth in the past four years. Some states are already experiencing a shortage of nurses, and a national nursing crunch could kick in as early as 2010, the HHS report said.

With the average age of nurses now 45, the association is recommending two steps to bring more young career people into the field: It says the government should give grants to encourage nursing careers, and it suggests creating tax incentives for people who go to school to become nurses or lab technicians.

The shortage of resources is making it more likely that people who go to emergency rooms may be sent elsewhere.

When a hospital is at capacity and cannot handle additional patients, the emergency department goes "on diversion," meaning it stops accepting patients by ambulance.

Another recent survey by the American Hospital Association found that 69 percent of responding hospitals had been "on diversion" at some point during the previous year.

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ENA - Emergency Nurses Association
American Nurses Association
Institute for Safe Medication Practices
Institute of Medicine

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