This makes me rethink heading south for retirement.
Nursing shortage hits critical stage in Florida
By Nancy McVicar
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.
Jul 7, '01
Last edit by Huganurse on Jun 30, '02