Interesting article in the Rocky Mountain News:. It was the front page of the Saturday newspaper in Denver(3-16-02):
Nursing crisis
Shortage of caregivers races toward crisis
By Michael Perrault, News Staff Writer
When it comes to Colorado's nursing shortage, experts see the makings of a perfect storm.
The state's shrinking pool of nurses hasn't kept pace with a 30.5 percent state population increase to 4.3 million in a decade. And 1.5 million more residents are projected by 2020, the fastest-growing segment being baby boomers who will require more health care.
The average age of Colorado nurses is 47, and nursing-school faculty average between 50 and 55, setting the stage for a retirement boom at the worst possible time, said Patricia Moritz, acting dean at the University of Colorado School of Nursing.
"The full brunt of the shortage isn't here yet," Moritz said.
Clouding the picture are nine new Front Range hospitals on the drawing board and several billion dollars in expansion projects, creating more beds and services that will require more nurses.
Meanwhile, the state's hospitals, clinics, nursing homes and other providers struggle to fill some 2,500 vacancies for registered nurses, licensed practical nurses and certified nurse's aides.
Hospital groups such as Exempla Healthcare and health plans like Kaiser Permanente are pouring significantly more dollars into salaries, benefits and recruiting efforts. It's a costly race to plug work-force gaps that have reached 15 percent to 21 percent for certain specialties. Employers have begun looking for relief overseas.
Some area nurses report that up to 60 percent of their departments are staffed by temporary agencies. Hospitals and other health care providers pay a premium to companies such as Denver-based Fastaff and U.S. Nursing Corp. that dole out $35 to $50 an hour to nurses who take on temporary assignments or fill in during strikes and crisis situations.
Chronic understaffing is pushing some nurses to exhaustion.
They find themselves juggling mounting duties, from checking blood pressure and tending to recovering patients' wounds to fetching water and juice, completing volumes of paperwork, emptying trash or carefully monitoring side effects of anesthesia.
Tiring 12-hour shifts often don't end because nurses are asked to work overtime. Stress builds, prompting nurses to jump ship or walk away from the profession. A two-year study of Colorado's nursing market shows more than 8,000 of Colorado's 43,000 licensed RNs have sought jobs outside the field.
"The reality is if we don't really start effectively addressing these issues now, we'll fall further and further behind," said Sue Carparelli, president and chief executive officer of the Colorado Center for Nursing Excellence.
The center is one of numerous initiatives statewide that mark a concerted effort by Colorado's health-care community to band together as never before to explore solutions to the crisis.
All-out recruiting
Telltale signs that Colorado is experiencing a serious nursing shortage include a wave of health care job fairs, pages of help-wanted ads and hundreds of job postings on health care provider Web sites.
On a recent Sunday, Clear Creek Care Center in Westminster offered $2,500 signing bonuses. Visiting Nurse Association, Planned Parenthood and the Boulder County Jail touted benefits packages.
Incentives range from $38-an-hour salaries for RNs to extra shift bonuses and paid certification. There are $25 monthly travel allowances, $50 stipends for perfect attendance, $300 quarterly performance bonuses, free medical, dental and life insurance.
The much-needed pay increases come after salaries for hospital staff nurses nationwide increased by only 2 percent annually from 1996 to 2000, said Susan Bianchi-Sand, director of the United American Nurses, AFL-CIO, the labor arm of the American Nurses Association.
"We can't hope to end today's nursing shortage without addressing the root problems -- poor work and care conditions and low pay," Bianchi-Sand said.
Increasing awareness about the shortage over the past year has brought about significant pay increases and a movement to improve conditions in Colorado, experts say.
"Usually, if you want something bad enough, you'll pay for it," said Patricia Prescott, work-force consultant for Robert Wood Johnson Foundation's Colleagues in Caring project.
Denver Veterans Affairs Medical Center, hamstrung by federal laws limiting pay and its ability to recruit in a highly competitive market, plans to roll out a program to repay up to $44,000 in nursing student loans, said Randy Emeterio, VA spokesman in Denver, along with numerous other benefits.
Nurses are glad to see salary and benefit improvements, but many are more excited about other kinds of changes.
North Colorado Medical Center in Greeley touts low patient-to-nurse ratios, on-site child care, flexible scheduling, relocation assistance for nurses and spouses, and shared decision-making with doctors and staff.
The fact that employers have begun asking nurses to help define how medical care is delivered is an important and encouraging sign, said Kristina Wenzel, RN and project director for the Colorado Alliance for Nursing Workforce Development Opportunity.
Giving nurses more autonomy, professional respect, cutting paperwork loads, streamlining documentation processes, and requiring less overtime will go a long way in luring and retaining nurses, Wenzel said.
Such improvements are vital, but no single activity or combination of activities will solve the problem even in a year, Carparelli said. "We are a long time getting here; it's going to take us a long time to catch up."
Future initiatives
The nonprofit group HealthOne Alliance served as a catalyst for a two-year study of Colorado's nursing shortage. It provided seed money to launch the Colorado Center for Nursing Excellence, which Carparelli hopes will establish partnerships to tear down barriers that otherwise might seem insurmountable.
Carparelli wants to bring together "good thinkers, good strategists and complex systems to leverage many resources." Over time the group's goals are to reduce the shortage, improve training, increase job satisfaction, slash turnover and make many other improvements.
Other initiatives are under way. With the help of nurses like Deana Gallegos, president of the local chapter of the National Association of Hispanic Nurses, the health care community hopes to recruit more minorities, young students and men.
That's critical as Colorado's pool of nurses and nursing faculty ages.
"(Nursing) is a physically demanding job, and people aren't going to stay at the bedside until they're 65 or 70," Carparelli said.
Colorado nurses cite drugmaker Johnson & Johnson's $20 million national TV ad campaign as an important corporate collaborative model aimed at elevating the image of nursing and attracting younger prospects. Dubbed the Campaign for Nursing's Future, ads feature the tag line "Be a Nurse; Dare to Care."
Likewise, University of Colorado Hospital is running TV ads simply saying "thanks" to nurses for their sacrifices.
Colorado nurses are watching legislation in California that could set a national standard by mandating nurse-staffing ratios. Federal and state laws could also funnel public dollars to recruit and train nurses.
For Cindy Adamek, a 19-year veteran nurse at Veterans Affairs Medical Center, the shortage isn't unlike shortages she's experienced. As 16 percent of the VA hospital's more than 420 nurses leave for other jobs, she finds the true rewards in providing care for grateful veterans like her father and uncles who served in America's wars.
Adamek is skeptical that this shortage will be resolved until society puts more value on nursing. Until then, it'll continue to take a very human toll.
"You have patients where it takes two people to get them dressed, but you don't have two people," she said. "How do you provide good care when there aren't enough caregivers."
March 16, 2002
Copyright 2002, Rocky Mountain News. All Rights Reserved.
