A serious nursing shortage exists, not only in Utah, but in most of the nation. But a proposal by the American Medical Association for solving the shortage has drawn the ire of Utah nurses.

The AMA doctors would create a new category of health worker, the "registered care technologist." Such people would have much less formal training and would work under the supervision of a nurses--doing limited tasks such as making beds, bathing patients, changing bandages, giving some medications, and doing various hospital chores. With anywhere from two to 18-months of training, such helpers could relieve the nursing shortage, the AMA says.That might, indeed, be the case. However, certain flaws seem apparent in such a system. For example:

--One of the reasons for the nursing shortage is the relatively low pay for nurses and the difficult work shifts. Hospitals must be staffed 24-hours a day. The technologists would have the same tough hours and would certainly be paid less than nurses. What would be the attraction to take such a job?

__Hospitals already have registered nurses, licensed practical nurses, and technical registered nurses. Adding "registered care technologists" would further fragment and complicate the system.

--Nurses generally have more duties than they can handle. while less-trained helpers might ease some of the burden, the AMA plan calls for such helpers to work under the supervision of nurses, thus adding to their responsibilities--hardly an improvement.

--If hospitals, in their constant effort to keep the lid on costs, can't afford to pay nurses more, where are they going to find the funds to finance a whole new class of worker? Who would pay to train them at a time when Utah schools can't handle all the applicants they get for regular nursing education? Would the additional cost produce enough results to make it worthwhile?

--Quality of nursing care is a concern. The use of less well-trained people might begin with limited jobs in mind, but there would be a very real temptation to eventually assign them work they are not qualified to do. The tendency is to use what is available.

A small pilot program to see how such a system would work might be justified. But the long-term answers to the nursing shortage would seem to lie in the direction of better pay and working conditions for nurses, and to expand nursing education to handle more of the applicants seeking a nursing career.