The nursing shortage: do we dislike it enough to cure it?

The current, and rapidly worsening, nursing shortage is likely to continue in the absence of fundamental changes in nursing education and salaries. Because both hospitals and nurses themselves seem to benefit in the short term from the current education and salary structure, I suggest that the fundamental change necessary to ensure an adequate supply of high-quality nurses in the future will have to come from outside these two constituencies. In this paper, I propose a long-range solution that comprises three basic proposals: 1) Create a nursing education system that clearly differentiates, in terms of salary and certification, between programs that educate registered nurses and associate degree nurses and programs that educate bachelor's and advanced-degree nurses. 2) Expand the nursing salary structure to reward long-term, career-track nurses. 3) Assign nursing responsibilities according to nurses' educational and certification qualifications.