Even as hospital officials run about as fast as they can to stay ahead of the state's shortage of nurses, Nevada's health-care industry increasingly worries that California soon will drain much of the region's nursing talent.
California legislation in 1999 established minimum hospital staffing levels for nursing one registered nurse, for instance, for every two women in labor.
When those requirements take effect, California will need 5,000 new registered nurses immediately and may be short as many as 25,000 RNs by 2006.
"Because Nevada borders California, it is anticipated that hospitals will conduct an extensive and intense recruitment campaign to entice nurses away from Nevada.
Such action will exacerbate Nevada's already critical nursing shortage," says a report supporting a plan to double the number of nurses educated in Nevada each year.
While California has delayed implementation of the nursing standards law several times because of a shortage of trained nurses, it's likely to begin phasing in the requirements soon, said Bill Welch, president and chief executive officer of the Nevada Hospital Association.
Welch told a legislative subcommittee last week that California Gov.
Gray Davis also pledged $60 million to expand the capacity of California's nursing schools.
That's worrisome here because Nevada nursing schools already are turning away qualified applicants, and nursing students from Nevada who are welcomed by California schools are likely to stay in the Golden State after graduation.
The aggressive recruitment that Nevada officials expect from California reflects, in part, this statistic: California, with 544 RNs per 100,000 population, ranks nextto- last among the states.
The only state with a lower ratio? Nevada, which has 520 nurses per 100,000 population.
The national average is 782.
And a study by the U.S.
Department of Health and Human Services says the Nevada nursing shortage only will grow worse.
In 2000, the federal study estimated Nevada had 11 percent fewer nurses than it need.
By 2005, the study predicted the shortage will grow to 15 percent.
This comes despite an average nursing salary in Nevada $51,200 in 2000 that ranked seventh in the United States.
(California, at $56,140, ranked first.) The rest of the region is in a similarly weak position to meet a strong demand for nurses in California.
Arizona was 17 percent short of nurses in 2000; Oregon had a 4 percent shortage.
Nationally, the nurse shortage stands at about 6 percent, and all of the muchreported causes for the national shortage apply in Nevada:
* Competition from other careers for the attention of women who once might have turned to nursing as one of a limited field of professions that welcomed women.
* An aging nursing force that finds 12- hour shifts increasingly difficult to handle.
In 1999, more than half the RNs in Nevada were 46 or older; less than 10 percent were under 25.
* Burnout among nurses who find themselves caught between cost-conscious administrators and their desire to serve patients as well as possible.
Changes in the health-care system mean people admitted to hospitals these days are sicker and require more sophisticated care than years past.
All those factors are magnified by Nevada's population growth.
Kaylene Opperman, an RN who serves as manager of recruitment for Washoe Health System, noted last week that the population growth of retirees in Nevada a group which uses a lot of health care service is the greatest in the nation.
Warnings from the health industry are blunt: "The nursing shortage in Nevada increasingly jeopardizes the ability of healthcare providers to provide timely access to healthcare services and, thus, represents a growing threat to the state's public health," said the Nevada Hospital Association in a 2001 report.
Next week: How Nevada deals with the nursing crisis.
