Nursing challenges continue for hospitals and other healthcare providers

From the days when nurses worked with doctors in the Roman Empire around 300 A.D. to Florence Nightingale and the emergence of modern nursing, there has always been a need for more nurses. That hasn’t changed in 2017.

Despite average salaries of $67,930, more than $20,000 higher than the overall U.S. average, turnover in the profession continues to be high.

RNnetwork, a travel nursing company, asked 600 nurses around the country about their workload, work/life balance, the national nursing shortage and how respected they feel at work via email. Most nurses surveyed worked in hospitals, and were between 25 and 55 years old, RNnetwork said. The survey showed 49.8% are considering leaving the nursing profession, giving multiple reasons why. The most common reason was feeling overworked as 27% answered. Another 16% said they no longer enjoyed the work and 15% said they were spending too much time on paperwork.

Also, 46% said their workloads have increased when they are in the hospital or clinic, and 43% said their workplaces don¹t support a healthy work/life balance. Adding to that challenge is the pervasive sentiment that many nurses feel their full-time work doesn’t pay enough. So even though they already feel overworked, 45% of nurses are taking on extra jobs to boost their income. Of those, 34% have taken on extra medical work and 22% dabbled in travel nursing, the study said.

The Bureau of Labor Statistics forecasts 1.2 million RN vacancies will occur by 2022 as the average age of nurses is above 50 years. Meanwhile, 64% of respondents say a potential answer to the shortage is using travel nursing to fill staffing gaps. The survey found that 88% of responding nurses would consider working a temporary or travel job in the future, the study said.

There are an estimated 34,300 nurses in Arkansas, according to an April report from the Kaiser Family Foundation. That equates to one nurse per 87 Arkansas residents. Nationally there is one nurse for every 96 people.

Registered nurses in Arkansas earn an average $55,360, according to NurseSalaryGuide.net. RNs working non-metropolitan areas of the state earn less. For instance, the average wage in the Northwest Arkansas metro for registered nurses is $55,500, but in non-metro western Arkansas the average pay is nearly 20% lower at $46,370. In central Arkansas the average pay gap between metro and non-metro areas is 12.6%.

Healthcare providers and educators say the nursing shortage in Arkansas is a concern in virtually all the metro areas and rural communities.

RETENTION FOCUS
“Northwest Health is fortunate to have an average nursing tenure of eight years, but even with this, we plan to hire approximately 100 nurses this year. Our talent acquisition strategy includes a number of programs to attract and retain top talent,” said Christina Bull, spokeswoman for Northwest Health.

“We offer a comprehensive compensation package for incoming RN’s in addition to other incentives for recruitment including tuition reimbursement, a loan repayment program and sign-on bonuses. In return for receiving a sign-on bonus, the nurse commits to a minimum length of employment based on the bonus amount. Northwest Health also encourages employees to help identify new team members and offers a referral bonus for certain departments with open nursing positions,” she added.

But hiring them is just part of the solution. Once an employee is recruited there is a focus on retention.

“Managers also keep employees engaged in the organization and help maintain a positive working environment. Utilizing travel nurses is another way that we can alleviate the nursing shortage. Travel nurses can fill the gaps between full-time hires, cover for nurses who are off work due to health or personal reasons, and provide additional support during busy seasons,” Bull said.

Another strategy used by local hospitals to bolster retention is nurse residency programs. Washington Regional Hospital in Fayetteville launched a nursing residency program in 2016 and is now training its fourth cohort.

“We are finding it to be very successful in a couple of key areas. Since the program started in early 2016, our new-graduate nurse retention rate has increased 50%. In addition, and more importantly, we are getting feedback from the nurse residents – and the clinical staff with whom they work – that they feel more confident and are better prepared to care for our patients as a result of having experienced the nurse residency program,” said Steve Percival, vice president of human resources at Washington Regional.

Mercy recently launched a new nursing residency program which is designed to help beginning nurses elevate to specialities more quickly, but also provides a safety net for nursing who might feel overwhelmed in their new jobs.

Mercy Hospital President Eric Pianalto doesn’t think the nursing shortage will be filled during in his lifetime and that’s why Mercy continues to work on retention. He said once hired, Mercy nurses worked in teams so that everyone in the team works at the top of their credentials.

“We don’t want nurses doing paperwork that could be accomplished by clerical staff members, likewise we don’t want them doing jobs that could be accomplished by LVNs,” he said.

EDUCATION COMPONENT
The Fort Smith-based Arkansas Colleges of Health Education (ACHE) is working to alleviate the problem from the supply side. College officials announced June 27 creation of the Arkansas College of Health Sciences. The new college is a follow-up to its Arkansas College of Osteopathic Medicine (ARCOM), which broke ground in February 2015 and will welcome its first class of 162 students on July 31. The new 60,000 square-foot health sciences facility in Fort Smith will welcome its first classes in 2020.

ACHE reported a $15 million “anonymous gift” in support of the facility, which will house multiple disciplines, including therapeutic doctoral degrees, physician assistants, and other master and doctoral degrees to be announced.

A nursing shortage in central Arkansas is the reason CHI St. Vincent recently expanded its partnership with University of Arkansas Little Rock to train 40 additional nurses a year.

“Health care providers across the country are looking for ways to tackle this critical nursing shortage, and we see this investment in education as an important step toward preparing motivated students for an honorable and worthwhile profession in nursing,” said CHI St. Vincent CEO Chad Aduddell.

There’s a shortage of 700 nurses in central Arkansas alone, Aduddell said.

Pearl McElfish, vice chancellor of the Northwest Arkansas Campus of University of Arkansas Medical Sciences, said nurses are one of the critical components of the medical team especially as the population continues to age. She said the shortage could worsen as the population grows older.

McElfish said one key area where UAMS NW is focusing is helping more nurses get advanced degrees whether that is advance nurse practicer or doctorate of nursing. The university also offers a bridge program for RNs to get their bachelor’s in nursing. She said advance degreed nurses can function in a broader capacity.

Because obtaining the advanced degrees can be expensive, McElfish said private donors recently contributed $20,000 in additional scholarships to help reduce some of the costs.

“If the main problem is we don’t have enough nursing facility then training advanced practice nurses which can serve as instructors out in the field is one way to help. Right now in Northwest Arkansas we have 60 nursing students in the UAMS local programs,” she added.

When asked how earning advanced degrees might help with nursing retention, McElfish said having the advanced degrees allow for a much greater scope of practice and great mobility up the career ladder and chances for promotion.