Indiana's nursing shortage could get worse

  1. Indiana's nursing shortage could get worse
    Image problems, high turnover and perceived job dissatisfaction among those already in the profession are some factors discouraging Indiana students from seeking a career in nursing.

    By Celeste Williams
    Indianapolis Star, May 28, 2002

    Terry Hobbs is fast on his feet. This shift in Methodist Hospital's Cardiac Comprehensive Critical Care Unit, he is the nurse in charge. To make it work, he's got to move.

    Hobbs is a rare breed. He is a man in a field in which women make up 96 percent of the ranks. Also, he works in a profession where demand is increasing and outstrips supply.

    The national nursing shortage threatens to throw health care into a crisis -- one that could leave hospitals, the profession's largest employer, gasping for nurses and aging baby boomers wanting for care.

    Indiana's health care system, which licenses 39,000 registered nurses, is in better shape than those in other parts of the country, state officials say. But with 2,200 vacant positions, the state has not escaped the problem, said Bob Morr, vice president of the Indiana Hospital & Health Association.

    "Indiana has a shortage of nurses just like everybody else," he said, although not as severe a one.

    Measured by the "vacancy rate" -- the percentage of budgeted, unfilled positions hospitals are recruiting for -- the national average is 13 percent. In some hospitals in Arizona, California and Florida, the rate exceeds 20 percent.

    "The Indiana (nursing) vacancy rate has been holding steady, right around 8 percent," said Morr. That is the level reached about 14 years ago, during the last big shortage.

    And those who monitor health care and staffing are nervous.

    "We are standing on the precipice of an unprecedented shortage of nurses," Ernest C. Klein, executive director of the Indiana State Nurses Association, said in testimony to the State Finance Commission in September.

    There are many reasons for the shortages, including fewer people entering the profession; its perceived image; high job dissatisfaction that pushes some to leave; high turnover; salaries that some think aren't commensurate with demands of the job; and working conditions, including mandatory overtime as a staffing tool.

    Then there is the age issue.

    The average age of a registered nurse in Indiana is in the mid-40s. National labor statistics show that nearly one-fifth of the nation's 2.7 million registered nurses could be ready to retire by 2006. The RN population under the age of 30 dropped from 25.1 percent in 1980 to less than 10 percent in 2000.

    And as baby boomers reach the age when health care is more of a priority, many nurses will be retiring and joining them, Klein said.

    Yet as the demand is projected to increase, the supply is not.

    The nation will need 450,000 additional nurses by 2008 to meet demand, and the supply of RNs is expected to be 20 percent short of that, according to the U.S. Labor Department. And fewer people are in the pipeline. Enrollment in nursing programs nationally is down 17 percent since 1995. At the University of Indianapolis, enrollment has dropped by 75 percent in the past 10 years.

    One of the big issues is the profession's image, said Angela McBride, dean of the Indiana University School of Nursing at Indiana University-Purdue University Indianapolis, where enrollment is up.

    "How many nursing students we take and how many we graduate has more to do with the perception of people on whether nursing is an attractive career."

    Experts say those perceptions include nurses not getting enough respect, working hard and for long hours, and having available more attractive ways to serve in the medical profession, including being doctors.

    There are efforts to make education more accessible, and Morr said hospitals in Indiana are helping.

    "Hospitals are spending more than $8.5 million a year in support of nursing education alone," he said, including donating to nursing programs. "They know their commitment has to be there, to be sure we have an adequate health care work force."

    Deb Sipes-Fears, a registered nurse in neurocritical care at Methodist Hospital, said staffing is a constant challenge.

    "About the point we think we're looking pretty good, our (patient) census goes up, and (we) need more nurses."

    Some hospitals offer signing bonuses of more than $10,000 to experienced nurses, while other hospitals pay bonuses to staffers who recruit nurses.

    Back at the Methodist coronary care unit, which is staffed with 20 RNs and two licensed practical nurses, Hobbs counts 11 patients in the 28-patient unit who are being discharged and a woman who is on her way up from an angioplasty. He hurries to make a room ready.

    Minutes later, Marie Dearringer is in a bed, a nurse bending over her.

    Wearing running shoes and blue scrubs, Hobbs, 38, maintains his frenetic pace for 12 hours a day, 31/2 days a week. The Ball State University graduate has been a nurse for more than a dozen years and intends to stay. His wife, Lisa, is a nurse at Indiana University Medical Center.

    Hobbs makes his way down the circular hall of the unit as if on wheels. He said he is aware of the shortage issue and the incentives and bonuses offered nursing school graduates to sign on.

    "It might get someone in the door, but a bigger question is retaining them."

    IUPUI student nurse Tara Stevenson sits in a 100-year-old patient's room, coaxing the frail woman to eat "just one more carrot."

    Stevenson, a 21-year-old junior from Marianville, Pa., said incentives or not, becoming a nurse is a calling.

    "I love being able to step into someone's life and help them."
    Call Celeste Williams at 1-317-444-6367.
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