Looming retirements spark new worries about nursing shortages

The recession helped curtail nursing shortages in northern Nevada.

Hospital executives worry, however, that the combination of an economic recovery and the aging of a cadre of baby boomer nurses may create a significant shortage within a few years.

Jeff Stout, chief nursing officer at Renown Regional Medical Center, says the hospital is still in a hiring phase and expects to bring on 60 to 70 newly graduated nurses during June alone. As the largest medical employer in northern Nevada, Renown has the greatest need for new nurses to complement its current staff of about 1,300 nurses.

Despite being adequately positioned today, Renown executives are looking several years ahead when the region fully recovers from the recession that has kept many older nurses working to support their households rather than retiring.

"There is a significant shortage that will come on the end of this economic situation or when the nurses who didn't retire decide to retire," says Jen Richards, director of nursing education and research at Renown.

Adds Stout: "We are seeing spouses losing jobs, and we have seen a tremendous amount of our nurses leave out of state because spouses can't find jobs. That has affected us more than we anticipated this year."

Northern Nevada Medical Center in Sparks is well-positioned for nurses primarily due to its smaller size, notes Carla Adams, chief nursing officer and vice president of clinical services. The hospital employs 166 nurses, and Adams says many have postponed retirement, often to support spouses who cannot find work.

And the widespread job cuts that thinned the regional workforce led many students to take a fresh look at opportunities in the nursing profession, Adams adds.

"Our positions are filled as a direct reflection of what has happened in the economy people are working a bit longer than they would have as far as retirement, and more people are looking at nursing as a great opportunity due to what has happened in the economy," she says. "They look at where they can make a great impact and a great living, and nursing is a very viable option."

Regional hospitals primarily seek to hire nursing studentsfrom colleges in the region since many of those students have completed their clinical studies at an area hospital and are indoctrinated in the hospital's practices and philosophies, says Kelly Espinoza, chief nursing officer at Saint Mary's.

"They are already dedicated to the organization and are involved in our culture," Espinoza says. "And they come prepared with a lot of what we are looking for."

Saint Mary's employs roughly 600 full- and part-time nurses, and the organization run by Catholic Healthcare West brings on between 12 to 20 new nurses each year depending on vacancy and turnover rates.

The Orvis School of Nursing at University of Nevada, Reno graduates between 90 and 96 registered nurses each year, Truckee Meadows Community College between 60 to 90, Western Nevada College about 35 and newcomer Carrington College graduated its first class of 19 nursing students last December. Carrington graduated about 30 new nurses this spring.

UNR is the only program offering a bachelor's degree in nursing, although Great Basin College offers an online RN to BSN program. Although new nurses with just an associate degree can work as registered nurses, advancement opportunities come much easier to those with more advanced education, says Renown's Stout.

"You have to have a BSN to advance in the field," he says. 'It is really a stepping-stone, a foundation. It opens up a lot more doors professionally. We look for our managers to have baccalaureate degrees or working on them, and we look for our directors to have master's degrees or working on them."

The four regional schools provide roughly 150 new nurses throughout the Renown organization each year, Richards adds.

Keeping pace with demand is a difficult task for educators. The American Association of Colleges of Nursing reported a 5.7 increase in enrollment in entry-level baccalaureate programs in nursing in 2010. However, the organization says nursing schools in the U.S. turned away 67,563 qualified applicants from baccalaureate and graduate nursing programs in 2010 due to insufficient number of faculty, clinical sites, classroom space and budget constraints.

Patsy Ruchala, director of the Orvis School of Nursing, says the school admits 48 new students each semester but it receives anywhere from 80 to 120 applicants.

"It is very frustrating not only for us but for students who want to pursue a baccalaureate degree," Ruchala says. "If we could accommodate every applicant we got, we certainly could certainly handle the workforce needs in Nevada."

Ruchala says national projections in coming years predict an even greater shortage of nurses than hospitals and care facilities experienced over the last decade.

"You are going to finally see people moving out of the workforce into retirement, and we are not only going to have to deal with general turnover but also with replacing those nurses who have delayed retirement."

Recruitment is crucial for each organization. The process often starts during students' clinical rotations. Renown also hosts large hiring fairs at the hospital in the spring and fall specifically to recruit local nursing graduates.

New nurses usually are hired into medical surgery and telemetry units so they can get a few years of working experience before seeking lateral movements, such as in the emergency room or critical care departments, Renown's Stout says. Others seek more education and transition into better-paying jobs with more responsibilities, such as nurse practitioners.

Hospitals also place significant attention on retention and employee engagement so as not to lose any new hires to different organizations or careers. St. Mary's offers certification bonuses to nurses who further their education or gain certification to work in a certain department, while Northern Nevada Medical Center offers a tuition reimbursement program so that nurses can advance their careers and still remain employed at NNMC.

"We put a tremendous investment in these individuals, so we want to help them be successful," Stout says. "It doesn't do anybody any good if we train them for a year and they seek employment elsewhere."