Archive for Sunday, July 12, 2009

Critical shortage

Number of nurses falling as need for care grows in an aging population

Angie Waldron, a registered nurse at Lawrence Memorial Hospital, helps patient Carrol Gerstenberger, 88, with a drink of water after taking his medication Friday, July 10, 2009. Waldron left her initial career as a dental assistant to pursue nursing and says she appreciates the challenges the job presents. Currently the health care system is experiencing a shortage of nurses and many experts believe that the shortage will continue with many nurses in the system nearing retirement.

Angie Waldron, a registered nurse at Lawrence Memorial Hospital, helps patient Carrol Gerstenberger, 88, with a drink of water after taking his medication Friday, July 10, 2009. Waldron left her initial career as a dental assistant to pursue nursing and says she appreciates the challenges the job presents. Currently the health care system is experiencing a shortage of nurses and many experts believe that the shortage will continue with many nurses in the system nearing retirement.

July 12, 2009


Statewide nursing shortage

A statewide nursing shortage has forced area hospitals to increase their efforts to train and retain nurses. Enlarge video

Although the economy has pushed some retired nurses back to work and kept others from retiring, there still is a shortage of nurses.

“In the state of Kansas, we have been experiencing a shortage in the last few years,” said Karen Miller, dean of the Schools of Nursing and Allied Health at Kansas University Medical Center.

She said that shortage is projected to increase as the population grows older and more nurses will be needed to care for chronic illnesses and aging issues.

Also, a large number of nurses are expected to retire in the next decade.

“Many nurses are my age, which is a youthful baby boomer age, and so that group is expected to retire and are working less and there are fewer experienced nurses coming behind us,” Miller said.

According to the American Association of Colleges of Nursing, there were more than 135,000 registered nurse vacancies in long-term care facilities and hospitals last year.

Some analysts expect that number to reach 500,000 by 2020.

And a nursing shortage can have a significant impact on patient care — it can mean life or death.

“The quantity and the quality of nursing care affects patient care,” said Debbie Ford, assistant dean of student affairs at KU School of Nursing. “So the more nurses you have, the better prepared those nurses are in a patient care environment — the better and the safer care of patient will occur.”

According to a report by the Agency for Healthcare Research and Quality, increases in registered nurse staffing was associated with reductions in hospital-related mortality and failure to rescue as well as reduced length of hospital stays.

Nurses are the heart of our health care system. There are about 3 million registered nurses nationwide, compared with about 600,000 doctors, Miller said. That’s five nurses for every doctor.

“A nurse is really at the center of patient care and responsible for coordinating many aspects of a patient’s care,” Miller said.

Fulfilling a demand

Nursing schools are working to fulfill the demand.

At Baker University’s nursing school, 160 students — the maximum amount — are enrolled.

Dean Kathleen Harr hopes enrollment remains steady.

“What tends to happen when the market tightens up like it is right now is that we see a decline in enrollment, and we cannot afford for that to happen. We need to keep numbers up and we need to keep putting them out,” she said.

KU has the largest School of Nursing in the state, with about 750 students. It has had more qualified applicants than available spots for years.

Those spots are limited primarily for two reasons: lack of clinical placements and lack of faculty.

Miller said state budget cuts affect the number of faculty they can hire.

“KU as an entity has experienced a significant budget reduction of 12 percent and so the School of Nursing, like every other state agency, has been touched by the budget reduction. We have fewer teachers than we had a year ago. Those kinds of situations are bound to impact our student enrollments over time.”

Training, retaining nurses

Lawrence resident Kate Rowden, 21, applied to KU and was put on a waiting list. Fortunately, she was accepted into Washburn University’s School of Nursing, which has about 300 students.

Rowden decided to become a nurse her freshman year of college because she can work in long-term care facilities, hospitals, or eventually teach or do research. Nurses also can specialize in areas such as pediatrics, obstetrics, physical therapy and surgery.

She isn’t certain where she wants to end up. First, she is getting her feet wet. Rowden, who has one year of school remaining, has a certified nursing assistant license.

Besides gaining hands-on experience through school, she has volunteered at Lawrence Memorial Hospital. This summer, she is working full time as a patient care technician for Stormont-Vail HealthCare in Topeka.

She is getting as much experience as possible to prepare her for the workforce, in hopes that her first nursing job isn’t too overwhelming — something that does happen.

“We have research that shows the first 18 months to two years of nursing is a difficult transition for people because it is such a demanding field, technologically and intellectually,” said KU’s Miller.

The KU School of Nursing and KU Hospital were selected to participate in a Nursing Residency Program in 2003. The project was conducted by the University HealthSystem Consortium and the American Association of Colleges of Nursing, with a goal to help recruit and retain nurses.

The one-year program used preceptors to provide special training during a nurse’s first year at KU Hospital.

The program — still in place today — is paying off. Nationally, 80 percent of nurses are still on the job after their first year. At KU Hospital, the number is 95 percent.

Other hospitals, including LMH, have introduced nurse retention programs as well.

Dana Hale, vice president of nursing services, said when she started working at LMH 13 years ago, it had a difficult time retaining nurses and often lost nurses to Topeka and Kansas City hospitals.

Today, the retention rate is better.

New nurses go through a hospital orientation process and then are paired with an experienced nurse for six weeks to three months.

“If more is needed, then they receive more,” Hale said. “We are constantly working with that person to see where they are at and how they are doing. We certainly want to make sure they are competent before we put them out on the floor.”

She said the concept has made a big difference. The turnover rate is about 6 percent, compared with about 20 percent nationally, she said.

The hospital employs 287 registered nurses.

“We have not used traveler nurses or agency nurses here in probably eight or nine years, which is huge,” Hale said. “That’s just almost unheard of. So, we just value the fact that we have our own nurses and can keep them here and they are committed to the organization.”

Rewarding career

Angie Waldron, 33, has been working on the primary medical floor at LMH since 2006. It was her first nursing job.

“There’s continued support throughout,” she said.

After graduating from Washburn University, she expected the career to be challenging. But it exceeded her expectations.

“You have to juggle a variety of tasks. You have to have an amazing memory. Your thinking skills have to be sharp and you fix things that aren’t necessarily direct patient care.”

She added that there’s always something to learn because of evolving technology, techniques and medicine.

“There’s so much to learn. It’s continuing learning. I mean you never stop,” Waldron said.

Of course, what she likes best about her job is providing hands-on care.

“You strive to take care of the patient and their family,” she said. “Of course, there’s times when you cry with the family. That part I love too, you know, learning from their experiences.”

Waldron has no regrets about pursuing nursing after initially being a dental assistant. She might eventually move to a different area of nursing, but for now she is content.

“There’s still so much I want to learn before I go on. I am happy right where I am at.”


midwestmom 8 years, 8 months ago

Hi Ljworld editor...

"Assistant" in caption is misspelled...

Please delete my comment after it's corrected.

Happy Sunday a.m.!!

PeachiePie 8 years, 8 months ago

There is not a nursing shortage...there is a shortage of nursing jobs because management forces nurses to work short-staffed in order to maintain their profit margins and won't hire much-needed staff. This results in an quicker burn-out rate for nurses, poor patient care, and increased turnover. Hospitals and clinics need to look at restructuring their administration and putting patients and staff first, not their bank account! I know, because Ive been there....and I WON'T go back!

caverdoc 8 years, 8 months ago

My wife is a registered nurse (and specialized in cardiology) and taught nursing in South Dakota. When she applied to Lawrence Memorial Hospital a couple years back she received a letter that "there are no positions open for her qualifications." In other words, LMH was more interested in hiring new, inexperienced grads rather than experienced nurses (it is a ho$pital, after all). Needless to say, it left an extremely poor impression.

So when you're in LMH with that cardiac disease or infarct, too bad you won't have an extremely competent cardiac RN. You will be getting" the be$t" that LMH think$ that you deserve. Hope your nurse can pick up the subtle EKG changes...

Dayle Hodges 8 years, 8 months ago much I could say here....However, I'll keep it short. I have a good friend, very experienced BSN. She has been looking for a job in the Lawrence/KC area for months. LMH blew her off in short order. Caverdoc appears to have a very valid point....Machiavelli seems to have it right too.

appleaday 8 years, 8 months ago

Peachie and Caverdoc are both right. I've been a nurse for 25 years and I've always said that the shortage is less related to salary dissatisfaction than it is to staffing issues. Hospitals, always looking for ways to cut costs, continually staff units at skeleton levels. When I was a staff nurse I went home most days feeling demoralized because I knew my patients deserved more but we didn't have the staffing to provide the care they needed. Staffing has gotten a little better in recent years but only because JCAHO required certain staffing levels. But most hospital CEOs are driven by financial and not safety concerns and they find ways to trim staff whenever they can. I still believe nursing is a wonderful career, like the nurse in the article says, and most of the veterans of the profession stick it out because we believe this and want to do what we can for our patients. LMH is not the worst, but, unfortunately, is typical. What I can't understand, is why CEOs think that constantly training new people is more cost-effective than retaining experienced people.

1moreopinion 8 years, 8 months ago

You can't even get a job at LMH unless you know someone. They take applications just as a process. Also, I am curious why this article is all about RN's. LPN's are very important too. The LPN's are the backbone of the RN's in every facility. I agree with caverdoc and Machiavelli. I have applied twice at LMH as an LPN. I never got a response.

pissedinlawrence 8 years, 8 months ago

Should I even make a comment here? I work at LMH and the work load is horrible at times...ok I better not say anymore cuz I will flood this page! lol Ugh my back hurts and I'm soo tired every time I get off work....must hold back comments...

I do like LMH by the way but they need more staff.

PeachiePie 8 years, 8 months ago

Now....if we only could get the 'Powers that Be' from LMH to read some of these comments...

Please, keep in mind that the biggest losers in all of this are our community's patients, especially those that don't have a choice but to go to LMH for their healthcare needs. Everyone deserves quality healthcare from qualified workers (who are valued members of the healthcare team, not disposable workhorses) in an organization that puts patient care and safety first, not the almighty dollar.

KansasVoter 8 years, 8 months ago

This is a different take on this situation, but maybe we should legalize euthanasia. If we had right to die laws in Kansas maybe our medical industry wouldn't be so over-worked.

UlyssesPro 8 years, 8 months ago

We should legalize euthanasia, but that won't (we should hope) solve too much of the problem.

Why don't we allow a certified nurse to do more (say administer some time-tested prescription) so they can form businesses independently outside LMH and compete with those suckers. If I had a choice, I would pay for house calls instead of gambling on bankruptcy with an extended stay at a hospital if I knew my nurse had more options then to tell me to wait for the Dr.

The more nurses, the cheaper it would be to hire an independent one once they all start competing for lawrencians' business. The more nurses can do, the more we'll realize we can avoid those sterile-smelling temporary morgues they call hospitals.

Or, If we are afraid that nurses can't handle more duties, we can all sit here and wait for Obama to save us.

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