An acute condition: too few nurses; Employers show how to attract specialized workers when they're in tight supply - Agenda: Employment & Staffing

HR Magazine, Dec, 2002 by Diane Cadrain

"Nurses are nervous," says Camille Edwards, a registered nurse (RN) who is concerned about the effects of severe staffing shortages on her profession and her peers.

Edwards, a union organizer for the New York State Nurses Association, says many nurses arrive at work already worried that there won't be anyone to take over when their shift ends. "They're worried they'll be charged with patient abandonment if they leave, worried they might not be able to care for their patients with limited resources, worried about getting written up, worried about hurting patients," she says. "That takes a terrific toll on them. I've had nurses have strokes at the end of their shifts."

Another nurse, a 14-year veteran, says the metropolitan hospital where she works is "hiring unlicensed workers--people with incomplete nursing education-- because they can't find enough nurses. The new hires know nothing about dialysis, checking shunts, interpreting labs or monitoring EKGs. The doctors get angry with us because when they ask about a patient, we have to ask them to wait a minute because we're taking care of someone else. They give us extra patients, and all we can do is make sure they don't [suddenly worsen] on us."

The Scope of the Problem

The shortage of qualified nurses is stretching nurses on the job to their limits, driving them out of the profession in despair, compromising patient well-being and forcing HR professionals in health care companies to take extraordinary steps to find solutions, experts say.

The shortage "started in the early '90s, when hospitals decided to downsize" and when laid-off nurses turned to other professions, says Barbara Blakeney, MS, RN, president of the American Nurses Association (ANA). "We lost a lot of good nurses that way, and that made work more difficult and stressful for those remaining. Also, the nursing population is aging-- the average nurse is 43. And at the same time, baby boomer [patients] are aging, and they require more health care."

Working conditions have become so stressful for nurses that, according to a recent ANA survey, 75 percent of respondents felt that the quality of nursing care at their facility had declined in the past two years, more than 40 percent said they wouldn't feel comfortable having a family member in their facility, and 54 percent said they wouldn't recommend the profession to their family members.

According to the U.S. Department of Health and Human Services, in 2000 there was a shortage of 110,000 nurses (6 percent of the estimated number needed), and if nothing is done to ease the shortage, it will continue to grow--to 275,000 by 2010, to 507,000 by 2015, and to 808,000 by 2020.

Working Around the Problem

Nonetheless, many HR professionals in health care companies are dealing with the crisis head-on. "We increased the number of our recruiters," says Joseph Cabral, director of career services at New York Presbyterian Hospital (NYP). "And we make sure they understand that, with health care unemployment at 0 percent, recruitment isn't a 9-to-5 job. Recruiters have to make themselves available when the applicants are available--call people in the evening, come in at 7 for an interview and work job fairs on Saturdays.

"We also keep them in touch with the business," he says. "They have to have an appreciation for the bottom line and understand the product they're selling. They should constantly be asking, 'How can I sell you this hospital?"'

Peg Brubaker, vice president of HR Support Services at NYP, says: "You need the investment and support of senior management to help look at the recruitment picture, quantify your retention issues, look at the costs per hire. It has to be a collaborative effort: 'How do we solve this?"'

At Montana Hospital Association (MHA) Ventures Inc., which offers services and products to the association's member health providers, collaboration among member hospitals is key to filling nursing vacancies, says recruiter Lisa Helle. "We formed the Montana Recruiting Alliance, which is open to all facilities for an annual fee. Hospitals can place unlimited openings on our web site. We also place joint ads in the local media. If three facilities join in one ad, they get bigger ads and more exposure for less cost. It takes some of the pressure off hospital HR departments, and at the same time brings in more applicants."

Helle also finds it useful to attend career fairs. "You have to network with educational facilities--colleges, high schools, even middle schools," she says. "You talk to teachers and counselors. Tell them if a hospital is open for visits from interested students. We have to get more students in the pipeline."

Anthony Disser, chief nurse executive at Inova Fairfax Hospital in Fairfax, Va., also mines education resources for health care job applicants. "We have a summer camp for middle school students, giving them an inside look at what goes on," he says. "We also have summer extern-ships for nursing students on college breaks, in which they can earn money and have first choice for jobs when they graduate."