Retirements, graduate expectations aggravate health care shortage
When Mesa County qualifies up to 7,000 more people for health benefits through Medicaid starting in 2014, expanded access to care could be jeopardized unless many more trained, experienced nurses show up to fill the scores of new nursing jobs expected to come open.
The recession temporarily slowed demand for registered nurses with bachelor of science degrees, at least in Denver, but experts expect it to “blow wide open by 2015,” said Sarah Thompson, dean of the University of Colorado College of Nursing.
In fact, demand will be so great Colorado colleges and universities probably won’t be able to keep up, Thompson told a group of about 30 health care professionals during a meeting at St. Mary’s Hospital last week.
“Nationally, we’re going to face a dire nursing shortage again pretty soon,” Thompson said. “Exactly how that will play out in Colorado, we don’t know, but one could guess it will come about the same time as the national trend.”
Colorado will need to graduate an average of 3,000 new nurses each year for the next 20 years to meet the anticipated demand, a 2012 study by The Colorado Center for Nursing Excellence said.
Those nurses will need to know more about the business side of modern medical practice than in the past, several who attended the meeting told Thompson.
“It’s more than any one school can do,” Thompson said. “We have meetings two or three times a year where all the nursing deans and directors get together and try to talk about what we can do, who we can be partners with.”
Right now, 1,900 nurses graduate annually from the state’s colleges and universities, but only 50 percent of those do so with a four-year degree, the Center for Nursing Excellence study said.
Fewer than 1,000 graduate with a two-year nursing degree annually, Thompson said.
Because the ranks of experienced nurses will soon be depleted by a wave of baby-boomer retirements, the expected nursing shortage could be even more difficult to overcome since new graduates want to spend fewer hours on the job and more time with family, several who attended the meeting told Thompson.
“I was trained that you stay until a patient’s stable. You take care of whatever’s in front of you, no matter what the hours,” said Debra K. Bailey, a nurse practitioner with a doctorate who heads Colorado Mesa University’s Health Sciences Department.
“But I recently read an article that said about 60 to 70 percent of physicians are burned out,” Bailey, who attended Thompson’s talk, said after the meeting. “We aren’t in a position to lose a single nurse or a physician. We have to keep them healthy. I think the younger generation is seeing this. You know, you give and give and give and then something’s got to give and then (you) leave the profession.
“I don’t know if it’s a work ethic or actually a really healthy mental awareness of a long-term career,” she said.
The retirement of experienced nurses from the hospital workforce also will drain the pool of qualified faculty at nursing programs across the state, Thompson said.
“Colorado has an aging faculty, thereby creating an urgent need for new faculty. The state needs a pipeline of 75 new faculty per year” to fill the gap, the Center for Nursing Excellence study said.
“We’re having a hard time getting faculty (at CMU),” Bailey said.
Nationally, there are 1,200 faculty positions open in 600 colleges of nursing, which makes it tough for CMU to compete, she said.
CMU’s ability to help turn back the nursing shortage is further complicated by the fact that of the 60 full-time faculty Bailey oversees, only five hold a doctorate, compared to CU, where nearly all the faculty hold a doctorate, she said.
State nursing programs, which are often forced to compete for funding, faculty and clinical training spots for their students, will have to find ways to cooperate in order to have a chance to overcome the expected shortage, Thompson said.
“Many of us … are beginning to collaborate very strategically with community colleges … to accelerate the process of baccalaureate preparation because we know that reduces mortality in hospitals,” Thompson said.
Nurses with four-year degrees are in demand at acute care hospitals where patients are sicker and require a higher level of care, Bailey said.
Hospital mortality rates can be reduced by as much as 50 percent when a larger number of baccalaureate-prepared registered nurses are on staff, according to the Center for Nursing Excellence study.
“We all know that a bachelor’s degree-prepared nurse that’s experienced will save a life at the bedside,” Bailey said.
“What the hospitals say is they aren’t able to hire new graduates at the acuity level they need,” she said.
CMU saw 140 applications for its four-year nursing program this fall but could accept only 36 due to limited resources, including a scarcity of hands-on, clinical training positions at area hospitals, which are “maxed out,” Bailey said.
Similarly, CMU saw 70 applications for its one-year licensed nurse practitioner certificate program but could accept only 32, she said.
Though LPNs are not normally hired to work at acute care hospitals, they perform many other key functions at nursing homes, assisted living centers and urgent care centers, Bailey said.
“All of our students are getting jobs. What the students may tell you is that they aren’t getting their dream jobs,” she said.
“We encourage them to dream big,” Bailey said. “They do want to work in emergency rooms and intensive care units and so they know they have to do some medical surgical work, some lower acuity, and get some experience, but that doesn’t mean they have to stop dreaming that (after) a year, they’re going to be in an ER, (after) two years, they’re going to be in a nurse practitioner program. It’s a fine line of not discouraging a dream versus realistic expectations.”