04/02/2001
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A shortage of registered nurses is forcing hospitals in some parts of the country to offer potential employees cash signing bonuses, child care and maid service.
At a recent career fair here, representatives of health care companies used plates of chocolate chip cookies and a bedpan filled with candy to entice graduating nurses to sign on the dotted line.
The Intercollegiate College of Nursing sponsors the twice-annual career fairs that are well attended by representatives of hospitals, long-term care centers and other health-related businesses.
For good reason.
In each of the past five years, an average of 3,000 fewer nurses graduated from baccalaureate programs, according to studies by the American Association of Colleges of Nursing.
The U.S. Bureau of Labor Statistics projects that by the year 2020, the nation will have 20 percent fewer registered nurses than it needs.
The shortage will be felt most acutely when baby boomers begin to retire around 2010, increasing the need for registered nurses, who will also start retiring.
"Without measures to reverse these trends, the nation is in danger of experiencing dangerous breakdowns in the health care system," concludes a recent study by four national nursing associations.
"Market demand combined with workplace issues such as workload, staffing, career prospects and pay are the primary reasons for nursing turnover," said Mary Foley, president of the Washington, D.C.-based American Nurses Association, which represents 200,000 of the nation's registered nurses.
"Unless these issues are addressed, strategies to increase the overall supply of nurses will not be successful," she said.
Nursing school enrollments have declined for years for a number of complex reasons, said Bronwynne Evans, an Intercollegiate College of Nursing professor who organized this year's career fair.
Many potential students are finding less stressful jobs elsewhere that have better hours and better pay, she said. The numbers of postgraduate nursing students also are declining, meaning there are fewer candidates for nursing school teaching positions.
Deans of many nursing colleges complain that many students are dissuaded from nursing careers because of outdated reports of cost-cutting and layoffs that occurred when many hospitals and nursing homes reacted to the influx of managed health care, said Anne Hirsch, ICN associate dean for academic affairs.
That has changed, and many health care facilities now have trouble meeting their needs for registered nurses, she said.
Some hospitals offer signing bonuses as much as $5,000, tuition and loan reimbursement programs, child care subsidies, flexible hours and other enticements, according to the American Organization of Nursing Executives.
Desperate for experienced nurses for its expanding cardiovascular unit, Community Hospitals of Indianapolis last year offered maid or lawn service for signing.
Evans said the career fair started four years ago in response to a critical shortage of nurses in long-term care facilities, but has since expanded to include hospitals and home-care agencies.
A steady stream of nursing students visited the booths and jammed the hallways between classes during the three-hour event.
Among those prowling the fair's booths was Jason Montgomery, who will graduate in May.
The 39-year-old spent 12 years in the U.S. Marine Corps before deciding to become a nurse. He thought of becoming a doctor, but medical school cost too much and would take too much time.
So he took courses at a local community college, concentrating on cardiac care programs before applying two years ago to the cooperative program of Washington State University, Eastern Washington University, Gonzaga University and Whitworth College.
When he graduates in May, Montgomery is thinking about returning to the military, "treating people in a profession I chose."
At one of more than two dozen booths, Sally Denton, director of nursing of the St. Joseph Care Center and Laurie Crane, its human resources director, offer candidates starting salaries about $2 an hour less than those paid by hospitals.
But the long-term care facility adjacent to Spokane's Sacred Heart Medical Center offers potential nurses advancement in other facilities operated by the Sisters of Providence, Denton said.
Many prefer the "controlled chaos" of a long-term care facility over the pressure of working in a busy hospital, she said.
Montgomery, among a small but growing number of men in the profession, said the shortage of registered nurses means he can pick and choose the job he wants.
"They're not only saying 'come aboard,' but also 'we'll teach you a skill and give you experience,'" Montgomery said. "You feel like you're wanted."
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