State grapples with shortage of healthcare workers

The jobs crisis in healthcare is threatening to get worse as providers in Nevada, like in much of the country, struggle to fill positions ranging from cardiologists and registered nurses to lab technicians and medical coders.

The problem is not new, but it is being exacerbated by a surge in demand from an aging population and an expansion of Medicaid and the new healthcare law, both taking effect next year.

In the next five years, nearly 59,000 seniors will be added to the Medicare rolls in Nevada and in the next two years 355,000 residents will become insured through Medicaid, employers or the newly-established Silver State Health Insurance Exchange. By 2020, 600,000 Nevadans will be added to the ranks of the insured.

That’s according to a recent University of Nevada School of Medicine report requested by the Governor’s Workforce Investment Board, Health Care and Medical Services Sector Council.

“Nevada Health Workforce Study” maps out the health care landscape and concludes that “Nevada’s health workforce falls well short of national averages for most of the key professions needed to ensure access to basic primary, preventive, and specialty services over the coming decade.”

The report is an initial step in defining the problem to best determine what to do about it, says John Packham, who wrote the study.

The data is based on the most current state employment data and probably underestimates the extent of the problem, says Packham.

To improve it, Packham is now working with several of the state’s licensing boards, including boards for nurses, osteopaths and respiratory therapists, to collect information about hours worked, plans for retirement and other useful data when the professionals renew their licenses every one to two years. Packham also plans before years end to survey local healthcare employers on job vacancies, turnover rates and other factors that will further fill in the picture.

“Sometime this year, I’m going to do a white paper on what to do about gaps in supply and demand,” says Packham. “My report would suggest we better attend to that pretty quickly.”

Packham thinks there are ways to bolster the existing healthcare infrastructure in the state before resorting to major and costly undertakings such as adding a medical school in Las Vegas. For example, residency programs could be expanded. The bulk of the state’s residency programs for physicians are located in Las Vegas; only three in psychiatry, internal and family medicine are in the north. The state might also consider loan forgiveness for students. A bill to allow nurse practitioners to practice in an office without a physician has passed the Nevada Assembly and is awaiting a vote in the Senate.

Packham is part of a new health care task force launched last week by Acting in Community Together in Organizing Northern Nevada, a broad coalition of religious groups founded last year with a goal of expanding jobs in the area. The Healthcare Jobs for the Future Task Force includes Nevada Assemblyman David Bobzien, the mayors of Reno, Sparks and Carson City and representatives from Saint Mary’s Regional Medical Center, Renown Health and local school districts.

“We don’t come into this with preconceived ideas,” says Pat Fling, executive director of ACTIONN. “We don’t want to presume what shortages are most important. We want that to bubble up from the meetings.”

Fling expects the task force to break into committees and meet monthly with a goal of making recommendations. ACTIONN would then search for federal, state and foundation grants to fund the action items.

In the meantime, local healthcare providers are doing what they can to attract and retain workers.

Renown, for example, struggles to find RNs, especially those experienced in surgical and intensive care, according to Michelle Sanchez-Bickley, vice president of human resources. The Reno hospital works with all area nursing schools to fine-tune curriculum and prepare students for the real world, and then offers a nursing residency program that gives the nurses experience in various specialties.

The hospital also has an apprenticeship program in pharmacy and respiratory therapy to train existing employees in new careers.

“A lot of it is trying to work with other businesses as to why Reno is a great place,” to work and live, says Sanchez-Bickley. “We’re really trying to get the word out about Reno.”