Nursing Shortage in Iowa Essay

Nursing Shortage in Iowa

Nurses are important health care professionals in our society as they perform life saving jobs. They are a necessity to our survival but their number is decreasing each year. Current trends show that there is an alarming scarcity of nurses across the United States. The National Center for Health Workforce Analysis reported in 2000 that the country has a nursing shortage of 110,707 (6%) and projected that by 2020 it will increase to 808,416 (29%). Just like any other state, Iowa is feeling the pressure of recruiting more nurses to fill in vacancies. Presently, Iowa has 38,464 Registered Nurses (RNs) and 10,093 Licensed Practice Nurses (LPNs). According to the state’s Board of Nursing, 60% of these nurses will reach the age of 50 and will retire by 2009. If this happens, the Iowa Council of Nurses said there will be a lot of vacant positions in hospitals, ambulatory clinics, home health/public health agencies, and long-term care. By 2010, Iowa will have a shortfall of 3,400 RNs and will grow to 9,100 by 2020.

Source: Iowa Department of Public Health

The main reason for the shortage is that more than half of the nursing population is old enough to retire. Average age of an Iowan nurse is 46. Currently, 69.0% of active licensed RN’s in Iowa are older than age 40. By the year 2011, 60.0% of Iowa’s RNs with current active licenses will be age 50 or older (Prouty, 2001, p. 2). In 2004, some 3,100 had already retired and the state loses an average of 600 nurses every year. The working conditions for nurses are physically demanding as well as emotionally. Most of the times nurses are overloaded with various tasks working overtime even on holidays and taking care of patients more than they can handle. Their efforts go unrecognized and they lack the opportunity to participate in decision making regarding patient care. Furthermore, admission to nursing education is also declining by about 40% while 49% of nursing teachers are set to retire within 10 years. Another factor is because of non-competitive salary. Nurses in this state receive the lowest pay rates with only $37,622 per year compared to the District of Colombia of $57,344 per year, considered to be the highest in the country. What’s more Iowa has the lowest reimbursement rates for Medicare and Medicaid disabling health institutions to retain, recruit, and compensate nursing staff. With this scenario, many leave the profession to seek better employment or enroll in non-nursing programs to have a more safe and high-paying jobs. The demand for nurses is growing but the supply can not keep up with the shortage.

Nursing Salary. Salary of nurses varies from state to state and mostly dependent on many features. Staff RNs working in the United States receive a base salary of $41,642. Half of the RNs in this job are expected to earn between $38,792 and $44,869. Nearly %67 of nurses is employed in hospital inpatient and outpatient departments. The remaining are employed in offices and clinics of physicians, home healthcare agencies, nursing homes, temporary help agencies, schools, and government agencies (Allied Physicians, 2005, ¶9). The salary structure is determined by years of work experience, work hours, position/title (staff or charge nurse, nurse manager, staff educator, and faculty), expertise/specialty (certified or not certified), levels of education (diploma, bachelor of science, associate degree, and master’s degree), primary work setting (hospital, out patient, community/home health care, long-term care, and school of nursing), hospital type (university, community, private, and military), and unit (medical, oncology, gynecology, psychiatric, intensive care, and operating room). In Iowa, wages are also measured by per capita income of local county and population, nature of work (full time, part time or holding multiple jobs), and intercounty commuting that considers how far nurses travel from their residence to their place of work.

Addressing the Shortage. The state of Iowa needs to establish a department designed primarily to resolve the issue of shortage. Its first mission would be to improve the working environment such as proper ratio (one nurse for every six patients and not over), give nurses more freedom to make decisions in patient care, offer career development with promotions or incentives, implement flexible working hours, present better benefits like higher wages or insurance/retirement plans, and provide nurses with safety protections and support systems while at work. This will retain many nurses and not result in the under staff of health institutions. As part of recruitment, Iowa should carry out a program of state and private sponsored nursing scholarships and loan forgiveness be encouraged and formulated in order to expand the overall pool of nurses and that special attention be given to shortage areas requiring special nursing needs (TFNS, 2002, p. 5). In coordination with various sectors in the community, the state must sustain an advertising campaign to attract a diverse workforce of nurses exposing the more enhanced image of the health industry with better benefits and safe work environment. Above all, a legislative action is necessary to amend laws that would abolish mandatory overtime, remove any obstacle that may hinder the license processing of qualified nurses, increase the state’s Medicare and Medicaid reimbursement to better compensate the nursing staff, and institute a lifelong health insurance plan universally available and affordable to all nurses.


Prouty, D. (2001). Iowa’s Nursing Shortage. Issue Review. Iowa Legislative Fiscal Bureau. Retrieved September 13, 2007, from

Allied Physicians, Inc. (2005). Nursing Salary Surveys. Retrieved September 13, 2007, from

TFNS (Task Force on the Nursing Shortage). (2002). Governor Vilsack’s Task Force on the Nursing Shortage in Iowa. Final Report. Retrieved September 13, 2007, from