How much of the RN shortage is due to scheduling issues?

[MarsRover]

I have quite a few close friends that are RNs and LPNs, and I have as a result always been a fairly firm advocate and believer in the shortage of nurses. I hear it often on the floors and in the ER. In our hospital - especially in the summer - we often have to close down the ER or parts of it due to shortages. 

However, recently I have began to wonder something.  I was in the OR, which can have its own shortages, but including the scrub nurse there were 4 RNs in the room. In fact each OR that day had 3-4 RNs. 4 RNs is how many run the 16 bed acute section of our ER. I couldn't help but wonder do we really need 4 RNs who are quite skilled medical professionals in the OR? The US has scrub techs, and people to get equipment.

Similarly in bronchs and scope clinics I have been to again when parts of the ER is shut down, or parts of floors. With 4-5 RNs in the room, I will admit its normally 3. Does a doc running two bronch/endo/colonoscopy rooms truly need that many RNs?

There is a lot of talk about replacing certain physician tasks with mid-levels.. but to me this seems to be a fairly obvious area that LPNs could take over from RNs. Freeing them up to staff ERs, medical/surgical floors? 

 

Sorry for the ramble, wondering if anyone sees an obvious reason I am wrong. 

[NLengr]

In my opinion, we have too many RNs working in the OR. LPNs could easily do the majority of the work. It's organization and planning work to a large degree (making sure proper equipment is avaliable, planning how to get the OR to run efficiently that day etc.). It's very important and doing it well is a skill but it isn't like you need core nursing skills to do it.

Part of the overall "shortage" hype is political/union rhetoric. We could improve the shortage by more efficiently using the RNs we have (like using more LPNs in the OR and putting the RNs in other areas that need RN skills) but the union would never allow it. As far as they are concerned the solution to all problems is to hire more RNs, even if it will do nothing to help the underlying problem. Increasing RN jobs and pay is the only union motivation. For politicians, increasing RN numbers plays well with the electorate, no matter if it helps or hinders the system. Stuff that plays well with the electorate gets you reelected, which gets you that sweet retired politician pension when you retire or are voted out.