The ICU and its workforce play a central role in health systems’ – and patients’ – overall health, with the department accounting for 10 percent of total in-patient beds and 30 percent of in-patient costs. Six million Americans are admitted to the ICU each year. At the same time, critical care is taking a big hit from the physician shortage, with a projected short-fall of up to 22 percent by 2020. Compounding this, ICUs are facing increased cost pressure and scrutiny with regard to patient safety and quality. In ICUs, serious errors occur in 150 of every 1,000 patients and adverse events occur in 81 out of every 1,000 patients.
I’ve worked in healthcare for more years than I care to admit – as nurse, manager, supervisor, researcher, panelist, educator, preceptor and mentor. When I first started practicing, patients on the medical and surgical floors of today would have been in the ICU.
The technology and capacity to extend life creates new levels of complexity in care. Yet reports indicate the number of experienced clinicians at the bedside is shrinking. About half of the registered nurses in the U.S. have diplomas or associate degrees and the other half are prepared at the baccalaureate level or higher. Less than one percent of our registered nurses are doctorally prepared. An estimated 33 percent of the registered nurses currently working in the hospital setting will retire within 12 years.