Unlicensed Personnel Vs. Nurses: Education Is Critical
The U.S. is currently experiencing a shortage of nurses. It is estimated that half a million more nurses will be required by the year 2022. That is why more hospitals in the United States are searching for trained nurses, but have enacted a stopgap measure and have started hiring more unlicensed assistive personnel commonly referred to as UAPs. While UAPs have been incredibly helpful, they simply do not offer the same level of care as trained nurses. They can make mistakes and increase the probability of accidents at the health care facility.
To learn more, checkout the infographic above created by Ohio University’s Online Master of Science in Nursing degree program.
The U.S. Nurse Shortage
According to the United States Bureau of Labor Statistics, there are a total of 4,011,911 professionally active nurses. This comprises of 3,184,283 registered nurses and 827,628 licensed practical nurses. These professionals work in a variety of places and take up different duties in their profession. It is estimated that 56 percent of all registered nurses, who are professionally active, work in general medical and surgical hospitals. On the other hand, one in five nurses work in outpatient facilities while five percent of nurses work in nursing care facilities. The remaining nurses work in a variety of other medical and health care facilities, such as private medical consultancy offices, emergency response organizations, schools and the likes.
Since the year 2001, it is estimated that 178 percent of nurses who were active then have since left the service. On the other hand, only 44 percent of nurses have entered the workforce. This slow hiring has created the dilemma that medical and health care facilities are now facing. By 2022, the U.S. will need 526,800 new nurses, but there will still be a shortage because more nurses are still retiring, and the vacuum needs to be filled. The shortage of nurses is expected to last up to the year 2030. To ensure that nursing duties are taken care of, even with the shortfall of trained nurses, hospitals are hiring unlicensed assistive personnel.
About Unlicensed Assistive Personnel
UAPs, as they are commonly referred to, are unlicensed health care providers who are trained to assist registered nurses and take a supportive role. They basically take care of patient supportive duties that do not require specialized knowledge or any form of special training. This frees up time for nurses to take care of more important nursing duties that require specialized knowledge and training, such as administering medication prescribed by doctors to patients and watching over them in case of changes. According to studies, when a nursing vacancy arises, either due to retirement or nursing job cuts, roughly half of those vacancies are filled by UAPs. Currently, there are well over two million unlicensed assistive personnel working in hospitals in the United States. Examples of UAPs include nursing aides, orderlies, assistants, attendants and technicians.
The care activities handled by UAPs fall into two broad categories, direct and indirect care activities. Direct care activities include; feeding and grooming of patients. As you can see, these are nursing duties that do not require any specialized knowledge, so hospital administrators see it fit to delegate these duties to UAPs, who work under close supervision of registered nurses. Direct nursing duties include; transportation and housekeeping. This includes replacing bedding in hospital beds and taking patients to the radiology department for x-rays, CT scans and MRIs among other things. Studies carried out in Europe have shown that replacing nurses with UAPs can have deadly outcomes. The study made a number of observations. One of them was that properly trained nursing staff that have been registered and licensed to offer nursing services have a wide range of skills that can help to improve patient outcomes, thereby reducing patient mortality rates. When registered nurses are hired, patient ratings improve and quality reports on patient progress can be expected.
Why Hospitals are Hiring Unlicensed Assistive Personnel
The main reason why hospitals are hiring unlicensed staff to take care of patients is cost cutting. It is understood that hospitals have limited budgets, so they try to cut down on their payroll expenditure. According to a recent study on why hospitals hire UAPs instead of hiring registered nurses to bridge the shortage of nurses, it was found that 75 percent of hospital executives hired unlicensed assistive personnel to cut costs. Twenty-three percent of hospital executives noted that working to comply with the mandates of the Affordable Care Act in 2013 increased their costs considerably, so they had to find ways to cut costs while complying with all relevant laws. Please note that there are many tasks that a UAP can perform competently. Pushing a patient on a wheelchair to go for imaging in the radiology department, for instance, does not require any special skills. Before they start working, UAPs are normally trained to properly do the jobs they are authorized to do. They are also warned not to take up any core nursing duties, such as administering medication or talking to patients about their condition. That said, a properly staffed hospital will not require UAPs as the nurses will comfortably take care of their duties.
It is important to note that it is much cheaper to hire a UAP compared to hiring a full-time registered nurse. The annual salary of a typical UAP is only $25,710, compared to $43,170 and $67,000, respectively, that a licensed practical nurse and registered nurses are paid annually. This means that hospitals can save nearly $42,000 annually, when they hire a UAP to replace a registered nurse who retires, gets dismissed from service or leaves the service for one reason or another. This is a lot of money, and hospital executives consider this a great option for cutting costs.
While unlicensed assistive personnel can fill the nursing shortfall quickly and help hospitals to save money, they simply lack the training, skills and knowledge needed to run a hospital efficiently. In fact, they may significantly lower the quality of care offered at a facility.