Experts predict nursing shortage
Editor’s note: This story is the first in a two-day series examining the shortage of nurses predicted in Pennsylvania in the next five years and how local hospitals are addressing staffing issues.More students than ever are selecting nursing as a career, but the Pennsylvania Workforce Investment Board is still predicting a shortage of 17,000 nurses in the state by 2010. “This is the third shortage I’ve lived through,” said Rebecca Amberosini, the chief nursing officer at Uniontown Hospital, the largest of the three hospitals in Fayette County.
Amberosini said the first nursing shortage during her career came in the 1970s, as the job market expanded for women, with fewer people selecting nursing as a career.
“This shortage is different, because it’s a demand for care. The patients are changing. The population is aging. As they live longer, they need more care. The acuity of the care that people need is increasing, so we need more nurses.”
A Pennsylvania Nurses Association survey of nurses residing in Pennsylvania in 2002 and 2003 showed 1,313 nurses living in Fayette County, with 80.5 percent of them actively employed in health care, 1.2 percent unemployed and seeking employment in health care, 5 percent unemployed and not seeking health-care employment and 13.3 percent retired, students or employed in areas other than health care.
The survey noted that 789 nurses were working in Fayette County, including hospitals, home health care, doctors’ offices and other medical employment, with 16.9 percent between ages 20 and 34, 52 percent between ages 35 and 49, 28.8 percent between ages 50 and 64 and 2.4 percent over age 65. The countywide average for nurses working in Fayette County in 2002-2003 was 44.7. The average age of nurses working in Greene County was slightly higher at 46.8, while in Washington County it was 46.1 and in Westmoreland it was 46.6.
It is that average age that has some hospital officials in the county concerned about staffing needs over the next five to 15 years.
“The average age of our nursing staff is 47 years old. As people get older, they go into other types of nursing,” Amberosini said.
In an effort to keep the older nurses on staff, she said, Uniontown Hospital has been trying to develop opportunities for them that are less demanding physically but require the level of knowledge that comes with years of experience, such as case-management positions.
While each of the three hospitals in Fayette County faces the problem of an aging staff that might be leaving the profession in the near future, each has faced slightly different problems when it comes to recruitment.
Uniontown Hospital has been going through a growth phase, Amberosini said.
“We hired 72 nurses in the past calendar year, and over half of that was new demand,” Amberosini said.
James T. Proud, Uniontown Hospital’s director of human resources, said the hospital has been adding new services as the demand increases.
He said more patients are opting to have procedures done at Uniontown, and a change in regulations is allowing patients to have that option when it comes to procedures such as cardiac catheterization or having stents put in to open arteries.
“In 1990, we did our first community marketing research. They felt at that time that we were a way station. They would stop here and be treated, then go on to Pittsburgh or Morgantown,” Proud said. “As we continued to do these marketing studies, we saw this huge swing that we no longer need to go to Pittsburgh. Technologically, we’ve kept pace.”
The nursing staff at Highlands Hospital in Connellsville has very few vacancies. The vacancy rate is running about 3 percent there, according to Erma Hauser, chief nursing officer.
“We have about 100 nurses. We usually have two to three vacancies, much lower than the national average. On the other hand, when we have two or three vacancies, it hits us more because we are so small,” Hauser said.
The hospital feels the impact of the nursing shortage the most when nurses are out on leaves of absence due to illness, she said, adding that Highlands has little turnover in the staff.
“Most people tend to stay here and plan to retire from here,” Hauser said.
The lack of turnover and other factors can make recruitment at Highlands difficult, because there aren’t that many full-time openings at any one time, Hauser said. The nurses at Highlands and at Brownsville General Hospital Inc. are unionized, belonging to PSEA Health Care.
“We have to offer full-time positions to our part-time employees first. Our openings tend to be part-time,” Hauser said.
Brownsville General has had its own staffing problems in recent years.
“Right now, Brownsville General Hospital has some nursing vacancies. Up until now that has been related to its uncertain financial future,” said Gil Gall, the representative for PSEA Heath Care, the union representing nurses at the hospital. “Since the (investors) group took over, I think we’re going to see that turn around pretty quickly.”
In the past year, the hospital closed its intensive care unit due to budget cuts, then reopened it in the fall as part of an agreement with a group of private investors, Gary Gosai, Dr. Kamlesh Gosai, Dr. Jayesh Gosai, Dr. Anant Gandhi and Dr. Ravindra Mehta, turning the hospital into a private, for-profit corporation.
Gall said the Brownsville General staff has perceived the hospital sale as a positive step.
“Brownsville has had a history of fairly bad labor relations over the years, and they have taken steps to rebuild that trust,” Gall said of the new administration at the hospital.
Labor problems aside, the hospital also has been affected by the nursing shortage in general, according to Chief Executive Officer Mike Evans.
“The nursing shortage is real. We’ve had to go through some staffing agencies to get nurses in here. We’ve used some local agencies to help us staff our units, particularly our ICU, which reopened in October,” Evans said.
Evans said the hospital could use 10 to 15 additional staff nurses to replace its agency nurses. He said the hospital pays about $10 an hour more for the agency nurses, mostly to cover the agencies’ overhead expenses.
Evans said increasing the number of staff nurses also would help the hospital cut down on overtime expenses.
“If you don’t have the numbers, the nurses you do have need to cover,” Evans said.
Lori Spina, the hospital’s director of marketing and communications, said that although the hospital has been a private, for-profit facility since only March 7, nurse recruitment is already seeing a turnaround.
“We are currently actively recruiting nurses to hopefully get rid of the agency nurses in the future. People have been contacting us,” Spina said. “I think people are looking at the future of this hospital as being very bright, and they want to be part of that.”
Spina said the hospital not only will be looking for 10 to 15 nurses to fill the vacancies filled by agency nurses, but it expects growth over the next few years as it adds services. And, as the hospital grows, so will the nursing staff, to keep pace, she said.
Brownsville General employs about 70 nurses, with an average age of 43. Under their contract, nurses at Brownsville can retire at 55. Spina said 19 of the nurses could retire within the next five years, although only one would retire in that time period if the nurses continue to work until they are 65.
Monongahela Valley Hospital, like Highlands Hospital, has a low vacancy rate and low turnover.
“We run at about a 3- to 5-percent vacancy rate. We’re not as affected as some of the city hospitals. Many of our nurses live here in the valley and don’t want to travel. Most of our people retire from here,” said Sharon Munson, Mon Valley’s senior vice president for nursing.
Munson said the hospital hired 10 to 12 new nurses in the past year, primarily to replace retirees.
The hospital has started a scholarship program for area high school seniors and displaced workers, in an effort to attract more people to nursing. In exchange for a partial scholarship, the students agree to work at the hospital for two to three years after their graduation.
“We just hired our first two graduates in December, and we have three more coming in May,” Munson said.
Anyone interested in the scholarship program should contact Mon Valley’s Human Relations Department.