Florida is now critical

Nurses Activism

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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.

Specializes in Case Management, Home Health, UM.

Shoot, Florida was critical back in the middle-and late 80's, when I worked part-time at a small community hospital in the Panhandle for two years, with the WORST understaffing I have ever seen. It was so bad, that I gave up hospital nursing alltogether for fear of losing my license. Little has changed, since I left....

Specializes in ICU, nutrition.

with less than 60 percent of nurses in Florida working in hospitals

They act so surprised that there's a shortage. Who wouldn't work at a easier job making as much or more money with better hours (no nights, weekends, or holidays), without mandatory overtime? Money matters, but working conditions matter even more. With 12 to 16 hour shifts, heavier patients, sicker and sicker patients, higher nurse to patient ratios, 48 to 60 hour weeks EXPECTED, it's hard to blame anyone for leaving the bedside. And it's amazing that so many keep at it.

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.

Now see, that's just pitiful. I live in an area where wages are traditionally low and I started out in 2001 making more than that as a new grad RN. The cost of living in south Florida is ridiculously high. You can't afford to live there and make that amount of money. You probably couldn't live there on twice as much money.

But they can manage to cough up $60/hr for agency/traveler RNs because it comes out of a different column in the budget.

And they wonder why there's a shortage...

Specializes in MICU, neuro, orthotrauma.

Florida needs to wake up and start paying nurses what they are worth and staffing appropriately. There is not one nurse I know who would move down to Florida. They have the worst reputation of any state.

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.

That's wonderful. Yes it sounds like becoming a "travel nurse" is the way to go. How nice to be able to pick the shifts you want and no mandatory overtime. I bet she is not required to attend any boring "mandatory meetings" or to participate in any stupid x-mas gift exchange either.:chuckle

Specializes in ER.

Florida and Texas have made my "never gonna work there" list. Florida for the above mentioned reasons, and TX for that infamous Group one list.

Specializes in Specializes in L/D, newborn, GYN, LTC, Dialysis.

Please note, this is a 4 year old thread.

Specializes in Geriatrics, DD, Peri-op.

From what I see in Bradenton, Florida still looks critical.

I just started working on a Cardiac Floor a month ago. Most of the time, they try to keep us with 4-5 patients...but, it's because these folks are so sick. However, last night, they had night shift taking 9-10 because they just didn't have any staff. That's just too many.

I've left this job at least 50% of the time with my back massively hurting because we are short CNA's. There might be one for 25 patients and these patients are elderly and some are not able to do much for themselves. I have to do all of the "nursing" responsibilities and then adl's too. Some of these guys are on critical drips and such...so basically, if I'm not pulling on these people...I'm running the whole 12 hours.

Speaking of finding other jobs. I have an interview next Wed for a staff RN job at a nursing home. Monday-Friday. I'm not sure if I'll take it...but, it has to be less physical than what I am doing now. Usually, there are more CNAs in LTC..even if they are short. I don't think my back is going to take much more abuse (about 12 years now) and I am trying to figure out what to do. I just graduated RN school (was a CNA-LPN-RN) and am now thinking about what other career options that I have.

People just don't realize how nursing takes its toll.

I remember a thread about Florida on this site. I think it was called the "Hall of shame" when it came to nurses salary. I believe it said in that thread that of all the US states, Florida paid nurses the lowest wages of all states.:o

Specializes in Specializes in L/D, newborn, GYN, LTC, Dialysis.

I don't get why that would be if the demand is as great as you all say.

Specializes in Specializes in L/D, newborn, GYN, LTC, Dialysis.

It would seem places like this will create their own shortages in their insistence on paying such low wages. Who would move where wages are that low yet cost of living rising each year?

Florida has been on my "will visit but not work there" list for years. Texas too. I have added a couple of others but mainly, nursing is much the same everywhere right now, feast or famine with staffing and pay rates. Maybe one day, when we, as nurses, accept the fact that we are highly skilled and necessary for good patient outcomes, then these problems will be decreased. I do not think we can ever say eliminated because we can never predict what will happen on a given day.

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.

This is probably the number one problem with working down here. I live in Southwest Florida. Moved here in 97 and bought a nice house for 87k. Same house today is going for 250K. Unbelievable!!!!!!

The attitudes of these hospitals are pretty shocking too.:angryfire They don't want to ante up with the cash. It is a tough environment.

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