Nursing

WHAT DO CONCIERGE SERVICES, gas cards, and contests complete with prizes have in common? They are all examples of some of the more creative attempts by hospital administrators to attract nurses. As we enter the second decade of the current nursing shortage, facilities continue to compete for a limited talent pool—and many are going about it in very interesting ways.

GOOD NEWS, BAD NEWS First, the good news: The national vacancy rates dropped in 2008 from 11.79% to 9.96%.¹ The bad news: The nursing shortage remains as present as ever. Of course, the nearly 2% improvement is a welcome revelation, but most everyone would agree it does little to alleviate the problem. "The reality remains that there just are not sufficient numbers of nurses," said Cheryl Peterson, RN, director of nursing practice and policy for the American Nurses Association, based in Silver Spring, MD.

In a nutshell, the aging population will place a tremendous demand for services on the healthcare system, and the need for new and replacement RNs could exceed the 1 million mark by 2016.² Meanwhile, the government estimates the country will fall short of the required nursing staff by as much as 500,000 in 2025.²

Nursing leaders haven't just sat idly by. Numerous programs and initiatives have been instituted to at least stall the shortage momentum. For example, there's greater interest in the profession, as evident by rising enrollments in educational programs for eight straight years.³ "Schools of nursing have worked very hard to expand the number of students they can accommodate. In 2000, 73,000 students were registered in entry-level baccalaureate programs. There are 141,000 students today, and that is good news," said Raines.

"There also are more of what I call second-career nurses," said Sarah E. Sinclair, RN, BSN, MBA, FACHE, executive chief nursing officer at Cleveland Clinic Health System in Cleveland. "They're coming out of a variety of professions wanting something more stable, which to them, nursing seems to be more stable. Now there are generational gaps between the traditional new graduates who are 20-something and the second-career graduates in their 30s or older, and the older baby-boomer nurses."

ECONOMIC INFLUENCES One can't fully assess the current status without examining the effect of the economic downturn. Interestingly, there's a positive, albeit temporary, side effect in that some clinicians are postponing retirement in order to cope with personal financial pressures, and therefore hospitals avoid greater vacancy rates.

"We don't have any statistics to verify that this is happening, but there's enough anecdotal conversation to confirm that nurses are staying put," said Sinclair.

Donna Herrin, RN, MSN, NEA-BC, FACHE, senior vice president and chief nurse executive at Methodist Healthcare in Memphis, TN, and the 2009 president of the American Organization of Nurse Executives, concurred. "A large portion of nurses are married or in a relationship where expenses are shared," she said. "If one of them becomes unemployed, then the nurse may pick up extra hours to compensate."

"The good side of that is that older nurses bring a wealth of experience and are mentoring younger nurses," added Raines.

Although this circumstance is helping hospitals retain staff right now, industry leaders issue a cautionary note. "My fear is that there is a temporary illusion that we don't have a nursing shortage because hospitals aren't hiring and, as a result, might begin to eliminate long-term programs," said Peterson. "We cannot feel as if the shortage has disappeared and lose all of our efforts."