Nursing Wages Rise, Shortage Continues
Last updated Saturday, March 17, 2007 7:26 PM CDT in Business
By John L. Moore
The Morning News
"We're hiring. Come on in," said Steve Percival.
Percival, director of human resources at Washington Regional Medical System, and his counterparts at other hospitals have a tough job trying to keep their hospitals fully staffed with nurses.
Without enough nurses, hospitals sometimes temporarily close beds. With hospitals in Northwest Arkansas operating at or near capacity much of the time, a shortage of nurses can be felt quickly.
The health care industry has bemoaned the nursing shortage for more than a decade, warning that as the Baby Boom generations age, more nurses will be required for the additional patients.
The U.S. Bureau of Labor Statistics projected in 2005 more than 3.1 million registered nurse jobs would be available by 2014. That would add more than 700,000 new jobs for nurses. The only industry projected to add more jobs to the economy in the next several years will be retail sales.
If other projections from the American Hospital Association hold true, the country could have a shortfall of 600,000 nurses by 2020, said Mike Meeks, senior vice president for Northwest Health System.
MORE OPTIONS
Traditionally the laws of supply and demand would seem to apply. The demand for nurses would drive wages up, and more people would train to fill those higher paying jobs. But despite wage gains, the nursing shortage continues, said Paul Cunningham, senior vice president of the Arkansas Hospital Association.
"We're in the process of conducting a tracking survey of the vacancy rate in our hospitals, and we can definitely see there is going to be a shortage," he said.
In Northwest Arkansas, the average hourly wage for a registered nurse rose from $17.27 per hour in 2001 to $23.20 per hour in 2006, a 34 percent increase, Cunningham said.
However, the nursing shortage persists.
Claudia Williams, chief nursing officer at Washington Regional, said nurses have more career options now.
"Used to, nurses went to the hospitals to work, now there are so many more opportunities outside of the hospital," Williams said.
Managed care organizations, insurance companies, doctor's offices, nursing homes, diagnostic laboratories, pharmaceutical companies and medical software companies all take their share of nurses, Williams said.
The average salary of a registered nurse in Oakland, Calif., is $80,270 per year, according to a 2007 Minority Nurse magazine article.
"My experience is that you can offer all the money in the world, but if the work experience is not a positive one, then it's not going to matter," said Michele Stewart, vice president of patient care and chief nursing officer of Mercy Health System of Northwest Arkansas in Rogers.
WORK LOAD ISSUES
Hospitals are having to think about more than just money in getting new nurses and retaining the ones they have, said hospital officials.
The salaries have gone up for nurses, but so have the work loads in recent years, Stewart said. There's more paperwork and patients are typically sicker now when they are in the hospital. Because outpatient services and specialty clinics have changed the system, only the most ill patients are in the hospital and they spend less time there, Stewart said.
"It's a very difficult job and we have to continually think about what we can do to make their job as easy as we can," she said.
Stewart said flexible work schedules and teaching opportunities within the hospital for more experienced nurses are some ways to help retain more nurses.
Stewart said the hospital has incentive plans that are based on professional development for the nurses. The best way to keep people is to create a great work atmosphere and provide them with ample opportunities to develop professionally, she said.
Mike Meeks, vice president of human resources for Northwest Health System, said hospitals now accommodate a wide variety of work schedules to help retain experienced nurses and attract new ones. Younger nurses coming into the field have a different lifestyle and set of expectations, he said. Some more experienced nurses who have been in the business a long time area also finding opportunities in training incoming nurses in the hospital and may not want to work 12 hours shifts now.
"If you want to work a certain shift, we've probably got it. We offer 6, 8, 10 or 12 hours shifts - whatever it takes," he said.
None of the hospitals would discuss the details of incentive plans they offer, given the competitive nature of hiring nurses in Northwest Arkansas.
Incentive and bonus plans are a part of that, but work schedules and flexibility are another, Percival said.
Newly minted nursing graduates used to expect to come work night-shifts at the hospital for a few years after they got out of school, Percival said.
They have so many choices, they don't have to do that now," he said.
TRAINING SHORTAGE
But everyone agrees that more nurses have to be trained.
Even with the pay increases there is a bottleneck in getting a larger supply of nurses into the health care system, Cunningham said.
"If you had to pick one major problem, at least in my opinion, it would be the lack of qualified nursing faculty for the nursing schools throughout the state," he said. "Regardless of the number of students wanting to enter nursing, there won't be enough faculty to teach them. The students won't be able to get in, because the schools won't be able to teach all of them."
Cunningham said many faculty members of nursing programs are approaching 50 and beyond and are thinking about retirement in the next five to eight years.
Nursing schools at both NorthWest Arkansas Community College and the University of Arkansas have expanded their programs in recent years, but recruiting nursing faculty can be a challenge, officials for both schools said.
The community college offers a two-year registered nurse program, said Monte Gagliardi, dean of health professions at NorthWest Arkansas Community College. Recently the school introduced an accelerated program that takes about 15 months to complete. A $1.9 million grant through the U.S. Department of Labor initially funded the program.
"We're now taking in about 70 students per year, where we were typically having 35 to 40 students in a year," he said.
Gagliardi said the problem with recruiting faculty is more difficult for a four-year program such as UA's.
"One of the things we're trying to do at our school is to bring on some part-time and clinical instructors with bachelor's degree," he said. "They have great experience, and we're trying to bring them in and mentor them and encourage them to go back and get the advanced degrees."
One of the difficulties in recruiting nurses into the teaching field is pay, he said.
Nurses with advanced degrees can often make more money working in a hospital than they can teaching he said.
But college administrators can't simply raise those nurse educator salaries to meet the salaries in a clinical setting.
"There has to be some equity for all faculty in the different disciplines," he said. "It's a tough nut for administrators."
The University of Arkansas has had an open position for a nurse educator with a doctorate degree for more than two years, said Tom Kippenbrock, director of nursing for the Eleanor Mann School of Nursing at the university.
But the school has significantly expanded the number of graduates in the past few years he said.
In 2003, the school graduated 24 nurses from it's four year registered nurse program. This year, the school expects to graduate 110 students, he said.
Even with that increase, though, the school still has to turn down fully-qualified students each year.
"In the fall we had 130 applicants for 50 positions," he said. "The lowest grade point average we have is a 3.4."
IMPORTING HELP
Kippenbrock said there is a renewed interest in the field of nursing over the past decade.
"Our students are very aware of the salaries, and they know that with their jobs, they can go anywhere in the country and work," He said.
Many hospitals also offer some kind of education reimbursement or loan payoff for new nurses who sign on with the hospital, he said.
Even if schools in Arkansas could somehow manage to turn out the 1,925 nurses a year -- according to a 2001 Legislative Commission on Nursing -- the state needs, the hospitals couldn't absorb that many new nurses, Percival said.
Hospitals have to take in a mix of newly trained and experienced nurses. A nurse coming out of school will typically need six months to a year of orientation in the hospital environment depending on their specialty, Percival said.
All the area health systems have recruiting programs to recruit nurses from other states, but most states have shortages as well.
Washington Regional also has brought in some nurses from the Philippines, Percival said.
"Back in the fall of 2004, we hired 25 nurses from the Philippines. We got five of them over before the country ran out of visa numbers to allow workers into the United States," Percival said.
Percival said the hospital hopes to bring the rest of the nurses it hired in the next 18 months.
Percival said hospitals in the area have to look at the whole picture. Salaries, incentives, professional development, recruiting and retention all play a part. But answering the nursing shortage in the nation, or even statewide, is a tough task and there's "no magic answer that's going to fix the problem," he said.
Registered Nurses Hourly Wage
Year Arkansas % Change Northwest Arkansas % Change Little Rock %Change
2006 $22.65 9.2 $23.20 1.6 $24.70 5
2005 $20.73 22.9 $22.83 32.2 $23.52 31.3
2001 $16.87 NA $17.27 NA $17.92 NA
By The Numbers:
$48,256: Annual salary for a registered nurse in Northwest Arkansas in 2006
1925: Number of new nurses needed each year in Arkansas
703,000: Projected number of new jobs added for registered nurses between 2004 and 2014
Reader Comments (18 comment(s))
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Anonymous Nurse wrote on Mar 20, 2007 2:53 PM:
Cindy wrote on Mar 20, 2007 10:38 PM:
It takes a special person wrote on Mar 21, 2007 3:02 AM:
It takes a special person wrote on Mar 21, 2007 3:04 AM:
Cind wrote on Mar 21, 2007 9:12 PM:
Nurse who cares...... wrote on Mar 22, 2007 12:03 AM:
Cindy wrote on Mar 22, 2007 10:02 AM:
Anonymous Foreign Nurse wrote on Mar 22, 2007 1:50 PM:
Puri wrote on Apr 1, 2007 7:35 PM:
Rodin wrote on Apr 2, 2007 7:58 PM:
Rentalnurse wrote on Apr 15, 2007 2:53 AM:
IndianaNurse wrote on Apr 15, 2007 12:05 PM:
sashakoko@yahoo.com wrote on Apr 15, 2007 1:58 PM:
foriegn nurse wrote on Apr 26, 2007 7:42 PM:
lynntou2003 wrote on Nov 4, 2007 10:59 AM:
Not already registered?
Cindy wrote on Mar 20, 2007 11:18 AM: