Answering The Call

As the nation's shortage of nurses grows even more severe, unprecedented efforts are being made to attract new recruits.

July 07, 2002|By Gary Gately | By Gary Gately,SPECIAL TO THE SUN

Sometimes, after a grueling 12-hour shift dispensing medicine to AIDS patients, pumping lifesaving blood into yet another gunshot victim, offering her hand and her ear to critically ill elderly patients, Marian Grant thinks back on her former life.

This always lifts her spirits and reaffirms her decision four years ago to abandon her career as a marketing executive and study to become a nurse in the emergency room at Johns Hopkins Hospital for a fraction of her previous salary.

Her epiphany came during a marketing strategy session at Procter & Gamble, where she worked in the Hunt Valley office. She kept thinking about the Govans AIDS hospice where she volunteered weekly, and how she had marveled at the nurses' compassion and, more than that, what it meant to their patients.

"It was one of those life-changing experiences," the 46-year-old Reisterstown resident says. "We're sitting there for hours debating the name of some lipstick, and I suddenly sat back and I thought, `I just can't do this with my life.' "

Grant's mid-career move to nursing is the sort of story hospital officials love to hear - and wish they heard more often. The traditional pipeline of young women fresh out of nursing school has dropped precipitously as women pursue other careers. So increasingly, hospitals are looking to non-traditional candidates like mid-life career changers, men and minorities to help ease a critical shortage of nurses.

The face of nursing is changing, and more often, it's looking like that of Doug Phelps. The former businessman became a nurse at age 50, and now works in the emergency room at St. Joseph Medical Center in Towson. He works alongside a former high school teacher and a former cafeteria worker, both training to become nurses.

Nationwide, the American Hospital Association says, 126,000, or 12 percent, of all nursing jobs at U.S. hospitals remain unfilled, and the U.S. Bureau of Labor Statistics projects the gap will mushroom by 2010 to nearly 500,000, leaving one of five nursing jobs unfilled.

At the same time, demand for care -- and nurses -- will soar as the population ages and baby boomers retire.

Heightening the sense of urgency, Harvard researchers reported in a recent New England Journal of Medicine results of a study showing the shortage of registered nurses at hospitals has led to more complications among patients, longer hospital stays and even deaths from treatable conditions.

"We are standing on the precipice of an unprecedented nursing shortage," says Mary Foley, president of the American Nurses Association. "Let there be no doubt about it: The current and emerging shortage of RNs poses a real threat to the nation's health care system."

The shortage already has forced hospitals to cut back on available beds and sometimes close entire units, postpone elective surgery and even temporarily close emergency rooms, sending patients to other hospitals.

Moreover, as the pool of potential nurses dwindles and demand continues to grow, overworked nurses at understaffed hospitals are abandoning the profession in record numbers. According to the American Nurses Association, nurses now leave hospital employment for good after an average of only four years.

The dire prognosis has prompted hospitals and other health care providers, nursing schools, national health organizations and corporations to launch an array of unprecedented efforts to attract and retain nurses. Among them: national recruitment drives, financial incentives like signing bonuses for new nurses, slick national advertising campaigns, tuition reimbursement and scholarships, paid professional development courses and more flexible working hours.

Johns Hopkins Hospital, for example, pays the tuition for courses Grant is taking to earn a master's degree at the JHU nursing school. To lure nurses, Hopkins also airs radio and TV ads, offers to pay moving expenses for nurses who relocate to work there and provides furnished apartments at reduced rates for those searching for permanent housing.

But recruitment alone won't fill the gap, nursing advocates say, without equal emphasis on retention through, among other things, increasing salaries and banning mandatory overtime, as some states have done. Nurses also demand more say in decision-making and say they're too often treated like second-class citizens.

"If we don't start addressing that work environment, it's not going to make a hill of beans how many we recruit," says Diana Mason, editor in chief of the American Journal of Nursing.

Expanding applicant base

Nationwide, a push to attract nontraditional candidates reflects fundamental shifts in demographics and the dynamics of the work force.

While women still comprise more than 90 percent of all registered nurses, the average age of RNs has climbed to 45, and those under 30 represent only 10 percent of the work force, according to the American Association of Colleges of Nursing. So when nurses leave, there's nobody to replace them.

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