Florida is now critical

[natalie]

This makes me rethink heading south for retirement.

http://www.sun-sentinel.com/news/yahoo/sfl-rxnurse702.story?coll=sfla%2Dnews%2Dsfla

Nursing shortage hits critical stage in Florida

By Nancy McVicar

Health Writer

Help wanted: 8,400 registered nurses for jobs in Florida hospitals. But for now, there is little help in sight.

A new survey by the Florida Hospital Association shows the state's hospital nursing shortage worsened in the past year. Last year's 11 percent job vacancy rate has burgeoned to 15.6 percent, the FHA found.

In South Florida, the vacancy rate was even higher: 15.7 percent.

"A 15.6 vacancy rate is very serious," said Cathy Allman, the FHA's vice president for nursing and health care professions. "If we can't do something about it, it's going to become a public health issue. There won't be enough nurses to take care of patients in hospitals or nursing homes."

The FHA survey is taken yearly to track nursing vacancies, turnover rates, length of time it takes to fill a job opening, and areas of most critical need. About half the state's hospitals of all sizes and in all areas participated, Allman said. The 8,400 vacancies is the highest since 1988-89, she said.

The results show that many of the disturbing trends in the profession for the past several years are accelerating. Allman said the findings, released Friday, can be used by hospitals, legislators, nursing groups and others working to recruit and retain nurses and entice more young people to enter the field.

"It's taking an average of 90 days to fill a position, and in the meantime hospitals have to fill in for the nurse who is leaving," said Diane Horner, dean of the University of Miami School of Nursing. "The price tag for recruitment and orientation can run to $30,000, so clearly it's in everybody's best interest that nurses don't leave."

The overall shortages are the highest in a dozen years and are not expected to get better anytime soon. As Baby Boomers age and Florida's population increases, Allman said, 34,000 more nurses will be needed in the state by 2006.

In one category, the survey showed critical-care nursing vacancies were cited by 43 percent of hospitals as severe, and the shortage in pediatric critical care had leaped from 7.1 percent last year to 17.1 percent.

Despite the compelling need, however, fewer people are entering Florida nursing schools, the survey showed.

Enrollment dropped by more than 1,000 students from the 1998-99 school year, when 7,820 enrolled, to 6,674 in the 1999-2000 school year. Nationally the nursing school enrollment rate fell 20 percent in the past five years, the FHA said.

At the same time, the nursing work force is aging. The average age of nurses is 46 to 48, the FHA reported.

"That means they are going to be thinking about retiring," Allman said.

About 78 percent of the 171,000 licensed RNs in the state are working, with less than 60 percent of nurses in Florida working in hospitals, the survey showed. Increasing numbers are shifting to other settings such as ambulatory-care centers, nursing homes, home health, public health agencies and desk jobs in managed care.

Because of the shortage in hospitals, nurses often are called upon to work overtime, said Willa Fuller, a registered nurse and spokeswoman for the Florida Nurses Association.

"In some places you have nurses who are overworked, units that are closing, and some services that may not be available," said Fuller, who was not surprised by the findings.

Hospitals' minimum starting pay for registered nurses has grown from $12.22 an hour in 1993 to $14.96 in 2001, and maximum starting pay during that period has increased from $14.60 to $18.76, but non-hospital nursing jobs sometimes offer higher pay and better hours, Fuller said.

When hospitals have to fill the openings, Fuller added, they often turn to temporary help from nursing agencies.

"While the average salary for the nurse on the floor is $15 or $16 an hour, it is costing the hospital $50 or $60 an hour for the agency nurse. The nurse isn't getting all of that. Some of it goes to the agency, but the agency nurse is making more than the nurse on the floor."

The added costs are exacerbating a depressed financial situation for hospitals already squeezed by low reimbursements from managed-care health plans and cuts in Medicare in recent years.

The FHA survey showed Florida's nursing shortage outpacing the national average, which is 9.7 percent. Horner, who also heads the South Florida Nursing Workforce Coalition formed by area hospitals to develop strategies to recruit and retain nurses, attributes that to the state's demographics.

"We have a lot of elderly people in Florida, and also a high incidence of diseases such as tuberculosis, HIV-AIDS, and cancer. All of those things are very nurse intensive, so we have a lot of health needs that are particularly urgent in South Florida," Horner said.

Hospitals are using several strategies to hold onto their nurses, said Nora Triola, assistant administrator for patient care at Broward General Medical Center in Fort Lauderdale and chief nursing officer.

Broward General offers flexible schedules, bonuses, training programs for advancement into critical-care nursing, labor and delivery and the operating room, and other incentives to stay with the hospital, she said.

"It's very important for nurses to feel at the end of the day or the end of the week that they have made somebody's life better in a very positive way. It's a tremendously giving profession and if we can create the kind of environment where they can do that, they will stay," Triola said.

[Norbert Holz]

The situation you refer to is only in south Florida. Here in Tampa there are too many nurses. I'd thought of going to Miami to work because finding a "good job" here is impossible. Perhaps the hospitals would indicate just how much they needed nurses by compensation. 15-16/hr does not indicate a need. Agency only pays around 25. The compensation is only 1/2 of the problem. Once at work the nurse is expected to cary an unsafe load. I am not the first person who has recognized that pay and working conditions are both quite poor.

[-jt]

I have a friend who works in Tampa, got tired of the abuses staff RNs had to take & the low pay for staff (working agency she made $35/hr but the hrs were not reliable), so she quit the hospital & the agency, signed on with a travel nurse company & "traveled" right back to the same hospital as a "traveler nurse"....... with a contract & higher pay.... plus a stipend for housing allowance which pays her rent - and she is living in her same own house, in her same own community, worked in the same hospital & when that assignment was finished, she chose a different hospital in the same town instead of extending her assignment there. She is no longer subject to the inequities the staff is subject to because her contract allows for certain things - like when & where she floats to, which shift she works, whether or not she works w/e & how many, and of course, NO mandatory OT.

[Mijourney]

Hi. My understanding of South FL is that it is more culturally distinctive then other parts of FL and the South. If that is so, that along with the type of health problems natalie included in her post no doubt has a great bearing on staffing levels in the area. The only way that I see that hospital boards and administration can respond to the shortage is with much more pay, improved working conditions and hours, and benefits.

Natalie or -jt, do you know if there is a major effort to get the children and teenagers of the state of FL, especially South FL to take special interest in nursing?

[-jt]

I dont know about Florida in particular but I do know that Cherry Ames is making a come-back as the RN of the new millenium.

Also, there was alot of talk by this new coalition of nursing organizations about educating youngsters in grade school & planting the seed for nursing in schools, on TV, in ads, etc, but I dont see any details on their website outlining any specific plans yet. Wouldnt be surprised if Sesame Street added an RN to the neighborhood! Maybe I'll suggest it! ; ).... http://www.nursesource.org/chairs.html

btw, today I picked my daughter up from camp & at the end, the head coach (a schoolteacher) had a little party & introduced the staff, coaches & helpers on the podium. Then she made a big deal telling the 100 campers (girls - grades 3 - 8), their parents & guests about how the camp could not be safe without the most important person there...she went on with the accolades emphasizing the role of this person, without whom the camp could not exist.....the Registered Nurse.

She made sure to detail the number of years of emergency room experience the nurse had & how this RN was an expert in this work because of all that experience. She asked the campers how many had to see the registered nurse during the camp week & almost all raised their hands. She said they were very lucky to have an RN because there arent enough around & some places dont have any. She then asked them how they would feel if they had NO registered nurse. Thats where she left them & their parents & grandparents wondering. Then she introduced this wonderful role model........... STEVE the RN!

He got a standing ovation.

It would have all been so perfect....... if only the campers were boys!! ; )

[Huganurse]

..

[RNadvocate]

hey norbert!! remember us from lobby day in tallahassee? RATIOS ALL THE WAY!

[tlcprn2u]

In Florida, we are making waves with the Nurse Alliance of Florida lobbying for safe staffing ratios.:balloons:

[Sugarlucker]

Hello Norbert hope to see you soon.:rotfl:

[suzi_h]

I would think part of the problem is economics. If an RN is only bringing in $15-20/hr. it's not enough to survive down there. My in-laws are putting their 3/2 1400 sq.ft. house on the market for almost $300,000. My sister just sold her townhouse for $249,000. It's insane! The cost of living does not meet that of a working RN. Even with a double income, it is nearly impossible to get out on your own. Most people eventually leave. It's cheaper to go North, even just into Volusia couty, the cost of living drops significantly.

I graduated from high school down there (in Broward county where the Sun-Sentinel is published). I would have never stayed. Even a tiny efficiency (about the size of a single garage) w/out a kitchen runs you at least $750/mo.

Unless the hospitals are willing to up the pay to make it worthwhile to go there, recruitment will be pointless for out of towners--because it is insanely too much money to try to set up a life there. I often wonder how people down there make it on a "normal" salary. It'll be interesting to see how this works itself out over the next few years. Maybe the cities and counties could put some of that property tax to good use (God knows there's plenty) with scholarships for nursing and hiring some more teachers at the local community colleges and public universities. Hmmmm, we'll have to wait and see....

One more thing, Florida has a ridiculously high malpractice rate. They were recently thinking of capping the payouts on them. I don't know if they did or not. Could that have an impact on the number of nurses down there??? I know a lot of OB's and such were also leaving the state to practice elsewhere b/c they couldn't afford the insurance. What's going to happen to this state that pays nurses terribly LOW and can't keep dr's in the state either? I see the future of healthcare in SoFla going downhill rather quickly over the next few years. Not to mention all the immigrants from Cuba and elsewhere, coming over w/o health insurance, education, or money. For all of you wanting to retire there, go visit first... It might make you rethink your choice. Hate to be negative about my "home" but, seriously--every time I go back to visit, it's makes me want to leave a little sooner.

Suzi

[Norbert Holz]

Although I don't remember who you are by your nicknames here; I surely remember going to Tallahassee! Our elected representatives need to be educated on the crisis in Nursing! I will be working on this issue till the safe conditions we all need become a reality everywhere!

[canoehead, BSN, RN]

They would have to double the pay to even start attracting nurses. Plu Florida has gotten a pretty poor reputation on this board for mandatory OT, even in the face of natural disasters.