THE BURDENS on hospitals, both in Maryland and across the nation, keep growing.
Since Sept. 11 and the subsequent anthrax scare, hospitals have assumed a new role in preparing for unexpected calamities as part of the homeland defense strategy. This comes on top of a rapid rise in the number of patients in need of hospital and emergency room care across the country.
Consequently, hospitals face severe shortages of skilled employees in key areas. Sadly, the situation is getting worse, not better.
The latest Maryland Hospital Association annual personnel survey indicates a growing shortage of nurses, who are a key component in providing quality patient care.
The hospital vacancy rate for registered nurses grew in just one year from 13.9 percent to 15.6 percent. We now need 2,000 additional hospital-based nurses.
And the work force shortage in hospitals is not limited to registered nurses. Of the 42 hospital job categories surveyed by MHA, 18 categories had vacancy rates above 10 percent. The most severe shortages were in all nursing positions, radiation therapy technicians (21 percent) and radiographers (14.6 percent).
There's also a high number of unfilled jobs in hospital laboratories, medical records departments and respiratory therapy units.
At the same time, hospitals have been feeling the financial strain as the cost of providing care has outpaced what health insurers and the government pay. Personnel shortages have forced many hospitals to offer bonuses, incentives and higher salaries to fill these vacancies.
Yet it's a losing scenario for many hospitals. In the last fiscal year, 18 of Maryland's 52 acute-care hospitals sustained operating losses. The overall operating margin for Maryland hospitals was a mere 1.3 percent, leaving the state's hospitals in fragile financial condition.
The most pressing personnel need is for nurses, who constitute half of all hospital employees. Experienced RNs are retiring in droves, and there aren't nearly enough new graduates coming out of our schools of nursing. The shortage could reach 450,000 nationally by 2008 if more isn't done.
There is a bill in Congress, co-sponsored by Sen. Barbara Mikulski of Maryland, that would offer incentives for men and women joining the nursing profession through scholarships, public school outreach, mentoring and a national Nurse Service Corps. That bill, though, remains hung up in a House-Senate conference committee.
Most Maryland hospitals are working to turn this around. They have put together attractive financial and benefits packages for nurses and are implementing positive changes in the workplace.
They also are working with others to get the word out that nursing is a promising and financially rewarding career.
The U.S. Bureau of Labor Statistics confirms this. It lists nursing as one of the "hottest" careers of the future. And no wonder: According to the Nursing Management Salary Survey of 2001, the average starting pay nationally for entry-level nurses ranged from $16 to $17.70 per hour -- and this doesn't include hefty shift and weekend differentials, overtime or substantially higher rates for more experienced nurses.
Until these vacancies are filled, Maryland hospitals have to compensate without sacrificing patient care. Technology has been used to handle labor-intensive chores, save time and minimize errors, for instance, in dispensing medications.
Legislators -- both in Annapolis and in Washington -- regulators, educators and others must work together with hospitals to help make these professions hot careers. We need to spread the word that there is no greater job than being part of a community institution whose prime role is saving lives and healing the sick.
Cal Pierson is president of the Maryland Hospital Association.