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.

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.”