Health care reform is on the back burner indefinitely. By the time you read this, we will have been in Iraq for 2 months. The top priorities now are the safety of our troops and our homeland. In the nation’s capital, we’ve been encouraged to set up safe zones with sealed windows, keep supplies of bottled water on hand, and have escape routes mapped out. Yet amid our anxiety over a possible terrorist backlash for invading Iraq, our preoccupation with preparedness for a potential biological or chemical disaster, and our concern for the welfare of our troops, I want to call attention to another national security crisis that lurks in the wards of American hospitals: the deepening shortage of registered nurses (RNs).

Unless we succeed in replenishing the supply of nurses and improving retention, the shortage is predicted to become so severe as to threaten the viability of our health care delivery systems. Our ability to respond to a bioterrorist attack or any mass casualty event will be paralyzed by not having enough nurses to function on the front lines. PAs who work predominantly in hospital settings know how serious the problem is becoming. Nurse shortages have come and gone in the 30-year history of the PA profession, but workforce experts predict that future deficits in the number of nurses will be unlike any we have experienced in the past. The US Bureau of Labor Statistics estimates that by 2010, there will be a shortage of more than 1 million nurses. This shortage is affecting all specialties and health care settings, and it won’t be remedied with recruitment campaigns and sign-on bonuses.

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