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Health Care Recruitment: Preparing for another Nursing Shortage

Health Care Recruitment: Preparing for another Nursing Shortage

For nurse recruiters, the unthinkable happened in recession-wracked 2009: They were able to find nursing candidates and hire the nurses they needed, when they needed them. The economic slowdown reduced demand for nurses (fewer elective surgeries, fewer insured workers) and increased supply -- with their 401(k)s in trouble, many nurses came out of retirement or returned to full-time work from part-time.

But in 2010, although the economic recovery has been balky and nurse vacancy rates remain low, healthcare recruiters are looking to a future that looks a lot like the past. “We are all pretty much convinced that we’ll see a nursing shortage again in a year to 18 months,” says Veronica Zaman, executive director of workforce development and talent management at Scripps Health, a California hospital system.

What’s being done to address the expected reemergence of the chronic nursing shortage? Let’s sample public and private efforts to boost the future supply of RNs and advanced-practice nurses, primarily by boosting funds for education and building partnerships between hospitals and nursing schools.

Long-Term Nursing Shortage, Partial Government Solutions
For many years, the limited capacity of nursing schools has restricted the flow of aspiring practitioners into the profession, according to the 2009 annual report of the American Association of Colleges of Nursing.  In 2002, nursing schools were forced to turn away 3,600 qualified applicants due to shortages of faculty and other resources; by 2009, nearly 50,000 potential nurses were rejected primarily for these reasons.

Scarcity of nursing faculty and educational resources are at the heart of the shortage. Some 53.8 percent of nursing schools reported that insufficient clinical teaching sites contributed to their rejection of qualified applicants to entry-level baccalaureate programs. A 2009 AACN survey of 554 nursing programs found a total of 803 faculty vacancies; this translates to thousands of prospective students who had to put off or give up their aspirations to become caregivers.

Federal and State Assistance for Nursing
New and existing Federal programs take aim at the nursing shortage, though on a modest scale. The recently enacted healthcare reform package includes a number of provisions to expand educational opportunities for nurses and to bolster the ranks of nurse educators.  Through several programs the law provides more funding for nurses seeking the doctoral degree typically required for faculty appointments.

Some state governments are also awarding grants to increase the output of nursing schools. The University of Texas at Arlington College of Nursing recently announced that state funding will enable partnerships with two Texas hospital systems to enroll an additional 100 to 160 nursing students, most of them currently clinical or nonclinical employees of the hospitals. Some hospital staff will serve as faculty.

These government efforts will help, but won’t solve a shortage that’s projected to grow by hundreds of thousands of nursing vacancies over the next decade or so. 

 “The demand for nursing staff hasn’t stopped growing, even before healthcare reform kicks in by 2014,” says Barry Pactor, international director of HCL Consulting, a healthcare recruiter. “Our client hospitals have been very careful about where they invest, but they know they have to keep their commitment to nurses.”

Partnerships for Hiring and Retention
Many healthcare providers across the country, from university medical centers to community hospitals, are growing their own caregivers by partnering with nursing schools.

South Nassau Communities Hospital’s 8-week clinical program educates students from nursing schools at four area institutions: Adelphi University, Molloy College, Nassau Community College and New York Institute of Technology.

“The large number of students we have in our clinical program becomes its own recruitment opportunity,” says Gina Kearney, director of nurse education at South Nassau in Oceanside, New York. “And for their students who don’t do clinical work at our hospital, the schools let us offer breakfasts and other outreach events.”

Retention of experienced nurses is another strategic goal of these partnerships. “We’re looking to move nurses along and keep them here,” says Kearney. To that end, South Nassau offers advanced clinical programs in operating-room and emergency-department nursing. “These programs serve as a recruiting tool for external applicants and also attract our own medical-surgical nurses,” says Kearney, including applicants who are interested in specializing.

In the wake of a deep recession, “our recruitment rate remains relatively low, but recruitment continues,” says Kearney.

Even at prestigious medical centers where nurse vacancies went from low to microscopic during the recession, recruitment is ongoing. “Our current vacancy rate for nurses is 0.5 percent,” says Katherine Pakieser-Reed, director of the Center for Nursing Professional Practice and Research at the University of Chicago Medical Center, adding, “but you still have turnover.”

The medical center hopes that the quality of its clinical rotations will keep the institution in the hearts and minds of young nurses as their careers mature. “People expect that if a nursing student had clinical experience here, it might be your first choice out of school,” says Pakieser-Reed. “But it can also influence nurses’ decisions later in their careers. Having had clinical experience here, they know the high level of practice at UC.”

Hospitals Partner with Educators
To help grow its clinical workforce from within, Scripps Health has partnered with Grossmont College to place 30 employees in a nursing program. “We had many employees trying to get into nursing schools and facing very long waiting lists until just recently,” says Zaman of Scripps. “This partnership got our folks higher up on the waiting list.”

Scripps has responded to the perennial nursing faculty shortage by directly contributing to the pool of nurse educators. “We provide some seasoned, masters-prepared nurses as educators, which enables Grossmont to send more clinical rotations to us,” says Zaman.

The soft market for nurses together with recruitment initiatives such as the Grossmont partnership have enabled Scripps to dramatically reduce its RN vacancy rate, from 7.5 percent in fiscal year 2006 to 3.2 percent in May 2010.

Still, “we will continue to monitor our workforce activity, develop plans and hire to stay ahead of the curve,” says Zaman.

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