Nursing shortage requires lasting solution, not a quick fix.

The current nursing shortage is different from previous ones because downsizing of acute care hospitals, decentralization through service or product line organizational structures, and development of alternative delivery modes have changed both organizations' and health professionals' roles and functions. In today's changing, tightly controlled health care environment, a nursing shortage would be far more serious than previously. Nursing resource planning must take into account the future health care delivery system and concomitant needs for specific numbers and types of nurses. Long-range planning for the nursing shortage must incorporate short-term activities to solve immediate staffing problems within the broader context of strategic change. In the future, attenuated growth of acute care facilities and continued development of care delivery in noninstitutional settings will affect nursing care and change both its clinical and management elements. Planning to meet future requirements for patient care services is focused on four target areas: Ensuring that the nursing staff is qualified for current practice and new services. Developing the nurse's role as patient case manager in the managed health care system. Establishing rewarding careers for nurses in clinical roles, management roles, and other specialized functions. Collaborating with nursing schools in clinical practice, research, and joint ventures. Planning to promote nurses' satisfaction in a variety of organizational settings includes the following: Developing ways to use nursing staff more effectively. Evaluating organizational factors that promote high-quality care. Developing efficient and effective health care teams. Establishing forums for promoting change.