Naval hospitals are weathering nursing crunch

Spirit of teamwork, good pay, education incentives help

September 09, 2001|By Liz Szabo | Liz Szabo,KNIGHT RIDDER/TRIBUNE

PORTSMOUTH, Va. - Jim Goss is something of a rarity. He's a hospital nurse who feels respected.

Goss said doctors have good reason to treat him well: As a Navy lieutenant, he frequently outranks them. Like all Navy nurses, Goss is a commissioned officer, a position of responsibility and distinction. But his colleagues at the Naval Medical Center Portsmouth value his opinion and experience in critical care no matter what their grade, Goss said.

That helps to explain why the naval medical center is the only hospital in South Hampton Roads, and one of a minority around the nation, without a nursing shortage, said Capt. Carlos A. Torres, director of nursing services.

"As you walk down the hallway here, you can't tell who's a doctor and who's a nurse" except by the acorn that physicians wear on their collar, Torres said. "There is a strong sense of team out there, a lot of collaboration. There's a lot of respect for what the nurse has to offer."

Nursing experts say the severity of the national shortage makes the Navy's success particularly impressive.

Locally, hospitals have had to close beds or units temporarily because they lacked nurses to staff them.

In a recent survey by Old Dominion University, nine local hospitals reported 500 openings for registered nurses, out of a total combined work force of 4,000. Hospitals face shortages for other key positions, such as licensed practical nurses and certified nurse aides.

Long-term solutions

The Navy, which has no shortage of nurses in its entire system, has fared better because officials developed long-term solutions, said registered nurse Justine Medina, practice director for the American Association of Critical Care Nurses.

Civilian hospitals obviously cannot copy all of the Navy's methods, such as obligating nurses to serve out lengthy contracts for fear of a jail sentence, Medina said. But nonmilitary medical administrators can take similar approaches, such as creating a culture of collaboration, where nurses are viewed not just as team members but leaders.

In that regard, Medina said, "they have done an incredible job, and it's really very impressive."

Lt. j.g. Shilonda Lyons always wanted to be a nurse. The Navy made it possible.

As a high school student, Lyons had good grades and too much money to qualify for Pell grants but not enough to pay for the colleges she wanted to attend. She enlisted in the Navy and, after three years, was selected for an officer training program for prospective nurses. The Navy paid for her to earn her nursing degree and college diploma. She's had the chance not only to care for patients, but to serve as charge nurse and team leader.

`I love the flexibility'

"I love the flexibility," said Lyons, who works at the naval medical center.

She is one of scores of nurses who have benefited from educational incentives that the Navy expanded after the last nursing shortage in the 1980s, Torres said. Those initiatives helped the Navy find the 350 nurses needed to fill its 3,000 positions.

One program allows sailors to go to school full time while receiving their regular pay. Sailors are required to serve additional years in exchange.

Lt. Mark Marino, a clinical nurse specialist at the naval medical center, began his medical career as a corpsman, a junior enlisted sailor who serves under a licensed nurse's supervision and whose functions are somewhat similar to those of an emergency medical technician. He went to nursing school through ROTC. Then the Navy paid for him to earn his master's degree at the University of Virginia.

"My only job was to go to school," Marino said. "Who else is going to do that for you? Humana's [hospital] not going to do that. Sentara's [hospital] not going to do that."

Indeed, some local hospital administrators say they can barely afford to spare their nurses for a few hours of training, let alone give them time off to pursue degrees.

But nurses aren't the only beneficiaries. Sailors who pursue a degree through the Navy agree to remain in the service several extra years, adding stability to the nursing corps.

Many civilian hospitals, by contrast, are plagued by heavy staff turnover, with some nurses changing jobs every few months. Others fill their floors with nurses from temporary agencies, who may work for only a single shift. The Navy's 8 percent annual attrition rate for nurses is less than half the rate at some hospitals.

Rebecca Rice leads a project on the nursing work force for the Robert Wood Johnson Foundation and used to head Norfolk State University's nursing program. "The civilian sector," she said, "could learn a lot from the Navy."

Naval advantages

Naval hospitals have some advantages over civilian ones.

Military brass can eliminate shortages in individual medical centers by moving sailors around, Medina said. Many civilian nurses would refuse that kind of request.

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