September 15, 2003|By Calvin M. Pierson
MARYLAND'S HOSPITAL personnel crisis rolls on despite concerted efforts by hospitals to stop it. Unless we reverse this alarming trend, patients seeking health care a decade from now - especially those in the aging baby-boomer generation - will be in for a rude shock: a lack of skilled health care workers to tend to their needs.
Earlier this year, the Maryland Hospital Association's annual personnel survey found 40 percent of the 42 hospital positions reviewed had vacancy rates of 10 percent or higher. In addition to the well-documented shortage of nurses, hospitals need more pharmacists, radiation therapy technicians, respiratory therapy technicians, radiographers and nuclear medicine technicians - to name a few.
The problem is not limited to hospitals. Nursing homes, home care and other providers are reporting shortages, too. Projections indicate that by 2005, 3,300 nurse positions will be vacant in Maryland. By 2012, demand will so outstrip supply that Maryland's nurse shortage could approach 17,000.
Short-term steps such as flexible schedules, higher salaries and heavy investments in technology to free nurses from paperwork so they can spend more time with patients have helped narrow the gaps and lure more students to nursing. But these steps won't be enough to reverse the long-term trend. We face a crisis in the making that requires the attention of top Maryland policy-makers.
Recent budget cuts to reduce Maryland's massive structural deficit make remedial efforts more difficult. But ways must be found to address this matter before these vacancy rates reach epidemic proportions.
Last month, the issue of health care work force shortages was the focal point of a health care summit in Annapolis, sponsored by the Governor's Workforce Investment Board. The summit highlighted the best recruiting and training techniques, discussed how they can be applied statewide, analyzed where Maryland falls short and what needs to be done about it.
It's ironic that recent efforts to stimulate interest in health care professions have generated so much interest that colleges and universities can't keep up.
Nationally, nursing schools rejected more than 5,200 qualified applicants last year. In Maryland, the University of Maryland School of Nursing turned away 200 qualified applicants. Other schools report similar experiences. The doors slammed shut on these eager students because of a lack of classroom and lab space, too few qualified teachers and insufficient clinical practice space - further hampered by a decline in public support for higher education.
We've got to reopen those doors. Anne Arundel Community College will add a nursing class in the spring. The Community College of Baltimore County, in conjunction with Union Memorial Hospital, is offering a new fast-track program for licensed practical nurses on its Dundalk campus this fall. Bowie State University added a new nursing program this year. The University of Maryland School of Nursing and others have increased their class sizes.
Still more needs to happen.
Even with a tight budget, the administration of Gov. Robert L. Ehrlich Jr. and leaders in the General Assembly should establish incentives for colleges to enlarge classes in nursing and other allied health occupations. They should create incentives for advanced high school courses that qualify graduates for immediate entry into nursing programs. Capital funds should be directed toward building and equipping new health profession classrooms at community colleges.
Distance learning is proving useful in other states to educate more health care workers. Students can go online and take classes via their computer. In Maryland, this approach is still in its infancy. Internet programming, with the necessary investment in faculty and technology, should be supported.
The private sector can play a role by offering financial support to school efforts to bolster student aid packages and by offering incentives to draw more people to health care professions.
Maryland's hospitals already give financial assistance to nursing students and lend faculty to colleges. Hospitals are expanding the use of technology to mitigate shortages and improve efficiency. But hospitals and other health care providers are constrained by their own budget predicaments.
In the long run, wise public policy will make the difference. If Governor Ehrlich and leaders in the General Assembly identify key work force shortages as priority areas for action, educators and health care leaders will respond.
The time to act is now, even in difficult fiscal times.
Calvin M. Pierson is president of the Maryland Hospital Association.
