Nurses don't spend enough time actually practicing nursing -- and that may be the reason behind the perceived nursing shortage, according to an article in this week's British Medical Journal.

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Professor Steven Lewis said that evidence from the United States, Canada, and Germany found that nurses spend time performing functions not related to their professional skills, such as cleaning rooms or moving food trays.

Nurses also reported more pressure to take up management responsibility, taking them away from the direct care of patients, Lewis wrote.

Thus, although a shortage of professional nursing may exist, a shortage of nurses might not, he said.

Lewis said nurses spend much of their time doing things that should be delegated to others and not enough of their time doing what they are educated to do. He said it is inefficient, and it accounts for at least some of the widespread job dissatisfaction in the profession.

He said increasing the supply of new nurses would just make them perform even more non-nursing tasks, and system costs would rise because highly trained people are used inefficiently.

"Only when nurses are allowed to withdraw from areas of non-nursing activity and do what they should be doing will we know the true extent of the nursing shortage -- if it exists at all," Lewis wrote.