Nevada's Nursing Shortage Could Become Major Crisis

Nevada RNformation, May 2004 by Timko, Steve

Nevada has fewer nurses as a proportion of its work force than just about everywhere else in the country, a recently released U.S. Census Bureau report on occupations shows.

The Nevada Hospital Association doesn't need a report to confirm the nursing shortage in Nevada, Executive Director Bill Welch said.

"If we want to look at the public health-crisis issue, the nursing shortage has got to be put there as one of the top crisesIoming down the pike," Welch said.

Some Las Vegas hospitals have already started putting hospitals on divert status because of a lack of nurses, meaning patients have to be sent to other hospitals for certain kinds of care, Welch said.

"We are going to have a very severe problem down the road," Welch said.

The state has a shortage of about 1,800 nurses, Welch said. Since Nevada ranks near the top of Western states in nursing salaries, he said offering higher salaries won't attract more nurses.

Welch said because Nevada doesn't have a state income tax, nurses make more money here than in California, even though wages are higher in California.

The hospital trade group spends $3 million a year recruiting nurses to come to Nevada and offers $1 million in scholarships, he said.

Compounding the problem is that many of the people moving to Nevada, the nation's fastest-growing state, are either retired or close to retirement and require more medical attention than younger people.

"We can't recruit the numbers that we need because the growth is faster than we can recruit," Welch said. "We need more than 700 new nurses per year to meet the growth."

Cathy Dinauer, chief of nursing at Carson-Tahoe Hospital, said the hospital is adequately staffed. Nursing shortages have come and gone in the 23 years she's been in the business, Dinauer said.

"We had periods of time when it was bad, but it was never really as bad as it was the last five years," she said. "It's just going to mean there's going to be fewer and fewer nurses taking care of people. . . ."

Recruiting students

Registered nurse Kellie Passaretti joined the Carson-Tahoe Hospital staff as a nurse five months ago, moving from Southern California. The hospital where she worked had adequate staff to help patients.

"When you're vastly understaffed, you can't provide the care," Passaretti said. "You can't watch what's happening. You can't monitor the people. People get well quicker if they're monitored."

The Nevada Legislature recognized the problem when it authorized money last year to double the enrollment in the University of Nevada system's nursing schools, said Alwilda Scholler-Jaquish, interim director of the Orvis School of Nursing at the University of Nevada, Reno.

In the fall of 2002, for instance, the Orvis School of Nursing admitted 47 new students, Scholler-Jaquish said. Last fall, enrollment increased to 86 students. Beginning with the fall semester this year, ,it will admit 64 new students and then 64 more in the spring of 2005.

Staggering admissions allows more efficient use of faculty and resources, particularly in what the school calls clinical experience, which includes on-the-job training in hospitals and home health services, Scholler-Jaquish said.

By next year, the Orvis School of Nursing will have enrolled more than double the number of nurses it had in the fall of 2002.

Rural nursing program

A decade ago Western Nevada Community College began to address the nursing shortages at rural hospitals by starting a rural nursing program that allows students from places such as Fallon, Yerington and Lovelock to get training.

"Students don't train in Reno and Carson City and decide they want to work in Hawthorne or Fallon or Yerington or Lovelock," said Bus Scharmann, dean of WNCC's Fallon campus. "We train people who will stay in their community and practice right there."

The rural nursing program uses interactive video that lets lecturers in Fallon talk with students in outlying areas. The program has had 70 students graduate and become nurses in the past decade. They include five of the seven registered nurses at the 15-bed Mount Grant Hospital in Hawthorne, including Janet Kollodge, director of nursing.

Without the program, Kollodge said, "I think we would be suffering like everyone else."

National effort needed

The Nevada Hospital Association's Welch said training more nurses is an important part of the solution but notes it will be at least three years before those nurses graduate and enter the workforce.

Welch said a national effort to recruit and train more nursing students is needed.

"If it's not done on a national basis, when we start producing these nurses in three years, we're going to have hordes of recruiters coming in trying to steal these nurses away," he said.

Scholler-Jaquish said it seemed a few years ago that recruiters would offer nursing students lunch and small gifts.

"Now the gifts are huge, like backpacks and all kinds of stuff," Scholler-Jaquish said. "Altogether, the things they get are worth $50 to $60 per student."

Passaretti moved to the area to be closer to family. She thinks it might help attract nurses to the Reno and Carson City areas if the hospitals would market the Sierra, the Pine Nut Mountains and Lake Tahoe to show this area is not like Las Vegas.