Among nurses in the United States who are 45 to 60 years old, 6% say they plan to retire within the next three years, 5% plan to seek employment in a nonnursing field, and 8% plan to work 20 hours a week or less, according to results of the 2008 AMN Healthcare survey. (AMN is a health care staffing agency.) Sent to 7,500 nurses in this age group randomly selected from a national database, the survey was returned by 1,831, or 24.4%. If the plans revealed by this survey are carried out, the clinical nursing workforce will lose approximately 169,000 full-time workers.

Because most U.S. nurses are 45 or older, it's important to understand the reasons so many are deciding to work part-time or leave the profession entirely. Of those who returned the survey, 10% said they were dissatisfied with nursing as a career, which is about the same proportion as those planning to retire or change careers, and 51% found nursing only somewhat satisfying. Seventy-five percent ranked "providing patient care" as one of their top three sources of job satisfaction, although 82% listed "insufficient nurse staffing" as one of their top three complaints. Moreover, 57% consider the nursing shortage worse than it was five years ago. Inadequate staffing may contribute to poorer patient care and to the long hours, stress, and physical demands of nursing, all of which were also cited as frustrating aspects of the profession by more than 20% of respondents. A majority of the nurses (62%) thought that the quality of nursing care has declined; only 44% said they would choose nursing as a career if they were starting all over again.

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When pregnant women wear seat belts, fewer fetuses die, according to a study published in the April issue of the American Journal of Obstetrics and Gynecology. Researchers analyzed data from 57 crashes involving pregnant women. Women who wore seat belts properly fared far better than those who did not. Of the 10 accidents in which the women didn't wear seat belts, eight ended in fetal death or serious complications, such as abruptio placentae, uterine rupture, or preterm birth; in contrast, only 12 (29%) of the 41 accidents in which women were properly belted resulted in major fetal complications or fetal death. Six other women used seat belts but wore them improperly; three of those crashes were associated with major fetal complications or deaths. Airbags did not worsen fetal outcomes.

According to study authors, properly wearing a seat belt reduces the risk of adverse outcomes by 84%, which could prevent 192 of the estimated 369 fetal losses resulting from auto accidents each year. In previous research, study coauthor Mark Pearlman showed that pregnant women are more likely to buckle up if reminded to do so by their health care providers. Said Pearlman, "Nurses who work with pregnant women can make a substantial impact on seat belt use simply by telling them to wear them."

Fran Mennick, BSN, RN