Posted on Tue, Mar. 05, 2002
Study recommends ways to ease nursing shortage
S.C. already has a problem, and it's going to get worse, report says
By LINDA H. LAMB
South Carolina's health planners want to make sure that when patients press their bedside buzzers, there are nurses nearby to help.
A six-year study, to be released today, suggests ways to handle the looming nursing shortage. They include a transfusion of state money for new incentives, talking up nursing careers to schoolchildren and recruiting more male and minority nurses.
An aging population plus the pressures of high-tech health care mean S.C. must keep luring nurses from other states, as well as strengthen training programs here, the study report says.
"Inadequate numbers of nurses translate into delays in getting treatment, shifting of care to family members, and increased costs for health care services, .'.'." according to a draft of the report obtained by The State.
Health care is an increasingly competitive business, but this study drew the cooperation of virtually every major S.C. school, agency and medical facility concerned with the need for nurses. Called the Colleagues in Caring Project, it was housed in the USC School of Nursing and bankrolled by a grant from the Robert Wood Johnson Foundation with matching private and public funding.
The state faces a 15,000-nurse shortage by 2015, said health economist Lynn Bailey, who helped gather research for the project. There's a shortage of 5,000 registered nurses in S.C. now, she said.
She put the problem in personal terms for South Carolina, which anticipates a 72 percent growth in its 65-and-older population by 2020:
"I'm 50 years old," she said. "This means there will be nobody to take care of me."
An older population means more people will need medical care. It also means more nurses and nursing teachers will retire: Among about 33,731 registered nurses in the state, the average age is 46.
Traditionally a female-dominated career, nursing is attracting fewer young women. Its starting salaries of about $40,000 are appealing, but long, pressure-packed shifts are not.
In turn, there are fewer nursing instructors for university and tech-school staffs, and 35 percent of nursing school faculty members are 55 or older.
The report says that between 1994 and 1999, 10,000 S.C. nurses left hospital jobs for jobs in other health care settings. That reflects a greater emphasis on outpatient treatment.
It also means the average hospital is turning into one big intensive care unit, adding to pressures on nurses. "People who are there are really sick," Bailey said.
Here and nationwide, nurses complain about being forced to work mandatory overtime in hospitals, which employ more than 60 percent of nurses in S.C.
Judith Thompson, who heads the S.C. Nurses Association, said this leads to shortages in hospitals. "People can work in outpatient settings and know that by 3 in the afternoon, they're done."
The report says South Carolina sees annual increases in both registered nurses and licensed practical nurses. Between 1988 and 1998, the net gains were about 1,100 RNs a year and about 100 LPNs - about 1,100 and 100, respectively.
But there still are more jobs than nurses, and the state relies heavily on out-of-state recruitment. Of new registered nurses, about half come from other states.
That's a concern as other states fund nurse scholarships
and hospitals offer signing bonuses of up to $14,000.
In January, California became the first state to act on an issue crucial to hospital nurses: minimum nurse-to-patient ratios. If other states follow suit, experts say, that could make it harder for South Carolina to lure nurses.
The report suggests ways to deal with the shortage, including:
* A state-supported center to gather data on the nursing work force and develop ways to increase it.
* A statewide plan to boost nursing education, including more state money for scholarships and nursing faculty. Also, state loan forgiveness for nurses who agree to work in needy areas and incentives to attract men and minorities.
* State grants to encourage recruitment and retention of nurses, build leadership skills, reward excellence and encourage better working conditions.
Several legislators said they agreed the nursing situation is urgent, but there won't be funding for it this year. The Legislature faces a budget shortfall of about $320 million for the budget year beginning July 1.
"We're desperate for more trained nurses, but there's absolutely no money for it," said state Sen. J. Verne Smith, R-Greenville.
Rep. Rick Quinn, R-Richland, said some legislators wanted to use lottery money for nursing scholarships, but that idea went nowhere. "I think this will be a higher-education issue," he said, meaning that proposals for increased funding might go before the education subcommittee.
Rep. Tom Keegan, R-Horry, chairs that subcommittee. He agreed with Quinn, noting that both universities and technical schools train nurses.
"This is a tight budget year, and there really isn't room for expanded programs or funding, '.'.'. but in light of the desperate need, I certainly feel that it is a matter we must address in the future," Keegan said.