Even through a long day busy work in the hospital with the best shoes for nurses (means the best support), nurses still feel tired because of the nursing shortage. But recently, the need for nurses working at hospitals declined statewide and in almost all metropolitan areas. Local experts gave several reasons for the trend. Better pay has helped attract more students to nursing school. More graduates are seeking fewer available jobs. And more medical care is being delivered in outpatient settings, so hospitals need fewer nurses.
Outpatient Care, Higher Pay are Factors
Though the nursing shortage isn’t over, it’s “in remission,” said John T. Snyder, president of the Hospital Association of Central Ohio. “We don’t have the kind of problem right now we had five years ago.”
Statewide, the vacancy rate — the number of unfilled jobs compared to the available jobs — for registered nurses (RNs) dropped from 3.7 percent to 2.5 percent.
Those numbers are a big change when the RN vacancy rate in Ohio was 7.2 percent.
The need for hospital RNs declined in every metro area except Toledo.
Median salary of $34,779
In general, though, health care sources say the trend toward fewer nursing jobs at hospitals seems clear.
One factor is higher pay, which has helped fill nursing jobs that used to remain open for months. The median salary for a staff RN in a 12-state Midwestern region last year was $34,779, vs. a national median of $33,278. It had no specific figure for Ohio.
In addition, hospitals simply are hiring fewer nurses, said OHA spokeswoman Mary Yost. That’s because medical care is increasingly delivered in outpatient settings such as clinics and at home instead of in hospitals.
“With the move toward outpatient care, there’s a decreasing need for acute (in-hospital) care,” she said. “There are fewer hours people are spending in the hospital,” so fewer nurses are needed to care for them.
Riverside Hiring Declines
“Opportunities for employment are down in our area,” said Kathy Wickemeier, vice president of nursing practice at Riverside Methodist Hospitals.
Riverside hired 46 full-time, 12 part-time and 14 contingency nurses this year, compared with 160 full-time, 61 part-time and 40 contingency nurses.
Hiring was down in part because the hospital had a lower-than-expected turnover rate, 8.8 percent, among nurses, Wickemeier said. Also, Riverside hired lots of nurses last year in anticipation of the completion of its new inpatient tower.
The shifts in nursing employment mean that many hospital nurses are working harder than ever, said Doris Edwards, dean of Capital University’s School of Nursing.
“In hospitals, the numbers indicate there is an easing of the vacancy rate, but if you talk to any hospital nurse, they’ll still tell you they’re stretched pretty thin,” she said.
If You Want to be a Nurse Get an Advanced Degree
Hospital consolidation — pushed by the prospect of health-care reform — has led to an oversupply of nurses.
But prospective Florence Nightingales should not forsake their lab coats — jus get more training.
“We need to get more of the hospital nurses to health and wellness programs. And we need to increase the number of nurses with master’s degrees,” said Dr. Sherr Pontious, president, and dean of the Jewish Hospital College of Nursing and Allied Health.
Pontious and other health-care executives expect industry reform to continue to slice away hospital nursing jobs and depress nurses’ pay for those without college degrees.
Those professionals expect highly trained nurses to be in short supply. That group should command salaries approaching $50,000 a year. However, the Missouri Nurses Association points out that while the biggest need for nurses is in health and wellness, that field historically has been among the lowest paying.
Hospital nurses average about $15 an hour to start and can earn more than $20 an hour, nurses said. But the pay outside of hospitals generally has been below $1 an hour.
Local hospital nursing programs continue to receive three to five times more applications than they have classroom positions, administrators said.
“A lot of the applications come because of all the publicity about the growth o the field,” said Jean Horrall, director of nursing education for Lutheran Nursing School. “Five years ago most nursing school students were right out of high school. Now we see more adults looking for second careers.”
Lutheran Nursing School had 427 requests for its 100 positions open this fall. Jewish Hospital received 500 applications for its 90 positions.
Lutheran graduated 84 nurses. Jewish graduated 90.
Missouri has 46,597 nurses, the largest health profession in the state, according to the Missouri Department of Health’s Center for Health Statistics.
Of those, 19,093 nurses — nearly 40 percent — work in the St. Louis area and statewide 46 percent of active nurses report their specialty is critical care and emergency medicine.
However, hospital mergers are trimming the area’s excess hospital beds — which is trimming the need for nurses.
“We are seeing nurses laid off because of the mergers. In some cases we’re seeing unlicensed people retired instead of nurses,” said Gloria Broun, president of the Missouri Nurses Association. Broun said most of the unlicensed people were in rural hospitals.
That policy is potentially disastrous for patients, she said, because hospitals today allow only the sickest people to remain. “It doesn’t make sense that we give them less-trained people.”
The area’s biggest merger came when Barnes, Jewish, Christian hospitals combine into BJC Health Systems Inc. Missouri Baptist joined this year. BJC employs more than 15,000 and is St. Louis’ biggest health care conglomerate.
Other area hospitals under pressure to reduce costs are sending nurses home when hospital patient count is low. “People thought the cuts (in hospital beds) would happen in six to seven years. Now we expect it to happen in two to three years,” said Pontious, of Jewish Hospital’s nursing program.
Broun and Pontious both pointed out legislation passed in Missouri last year gives nurses with master’s degrees the right to go into independent practices with doctors and the authority to write prescriptions.
Pontious said health-care planners expect Missouri to have a shortage of 5,000 nurses, with nearly all the openings going to nurses with advanced degrees.
Jewish Hospital is phasing out its associate degree program in nursing and graduated its first class of nurses with bachelor’s degrees.
The school is also adding master’s degree programs for adult wellness and OBGYN/women’s health.
A hospital staff nurse with less than 10 years’ experience earned $32,635 a year, according to the Missouri Nurses Association. Broun said the current oversupply will continue to depress that salary.
The biggest demand is for nurses with advanced degrees, a group that makes up less than 8 percent of total nurses, she said.
Nurses with master’s degrees in four fields — clinical specialties, certified nurse midwives, nurse anesthetists and nurse practitioners — now average $43,000 a year.
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