Nursing shortage? Not here. But it’s coming, experts say

TRAVERSE CITY – The nursing shortage that's been reported nationwide is evident in Michigan with 2,500 positions currently vacant. That number is projected to balloon to 8,000 by 2010 and 16,000 by 2015, if current trends continue. "And that number is minimal," says Carole Stacy, director of Lansing-based Michigan Center for Nursing.

The Grand Traverse region is one of two communities in Michigan not currently facing an acute shortage of nurses. The other is Kalamazoo.

The question is if and when shortages will curtail the delivery of health services here.

An aging population is at the core of the problem-both patients requiring medical care and an aging workforce of nurses approaching retirement.

Locally, our growing population is an additional dynamic. "And the largest cohort is people 65 and older, a group that consumes four times the health care resources," says Jim Fischer, Munson Medical Center vice president and chief nursing officer.

The immediate impact of the shortage has been delayed regionally by a supply of registered nurses (RNs) who want to live and work in the Grand Traverse area, Fischer says.

The pay scale also has kept it an attractive option says Anne Ivers, director of nursing programs at Northwestern Michigan College (NMC). "Nursing is a job in this area that's at the top of the wage and benefits scale for workers with less than a bachelor's degree."

Another advantage here is that local nurses are staying in their positions beyond initial retirement age, Ivers says.

Vacancies for posted positions are running one to two percent locally compared to up to 20 percent nationally, Fischer says. Munson recruits graduates from nursing programs statewide and from NMC's classes.

Yet, the Grand Traverse region will experience shortages similar to the rest of the state by 2015, according to Stacy. Ivers agrees. "Down the road we're looking at shortages."

NMC typically graduates 70 to 80 registered nurses each year. Seventy-five percent of those graduates who apply to Munson are hired.

"Not every job is appropriate for a new grad right out of school," Ivers says. "They could hire all of our grads and still experience vacancies."

Another nuance is a shortage of nurses with advanced training – bachelors and masters degrees – who can oversee clinical training of student nurses as well as handle demands of a changing health care system.

"As we move into the future and patients are sicker in hospitals, what you see are more nurses who have critical thinking skills, advanced practice nurses who can deliver babies, administer anesthetic and oversee admissions and follow-up care," Fischer says.

Looking for long-term solutions to the projected shortage, Munson is using their own nurses to staff some clinical rotations for NMC nursing students so the college can admit more students.

"For the short term, we're working on creating a better environment for nurses to practice, focusing on retention and morale issues," Fischer says. Pay, benefits and workload for the 1,000 nurse workforce is examined yearly in comparison to other facilities in the state. Munson nurses were recently recognized for excellence by the American Nursing Credentialing Center, a status achieved by only three percent of hospitals nationwide, according to Fischer.

At the same time the nursing shortage grows, there's a waiting list for qualified students to start the state's 53 RN training programs that can be as long as eight years, Stacy says.

Locally, students who need to register for the anatomy and physiology course that's a prerequisite for the nursing program have been known to line up a day early for a chance to get into the class. "There's already a two to three semester wait for students (who have completed prerequisites), so we bottleneck at that class," Ivers says.

NMC has expanded opportunities by offering theory classes online. Students still need slots in the clinical sessions. "The Board of Nursing requires hours in specialties like mental health, obstetrics and pediatric," Ivers says.

RNs can also work toward four-year bachelor degrees through Ferris State University and the University of Michigan at NMC's University Center and online through Grand Valley State University.

Baker College in Cadillac is launching an associate degree RN program this spring.

Statewide efforts to address the problem include a recruitment campaign funded by Johnson & Johnson, which drove a million applicants to an already overburdened training network. There's also a public relations drive to recruit men to nursing and foundation grants to fund research into re-directing aging nurses into jobs that match their skills and physical abilities. The state has awarded $9 million in grants to increase training opportunities.

The same factors that have created a shortage of nurses are impacting other health professions, Stacy says. "All of the (medical) professions are going to need workers. Respiratory therapists, x-ray, lab and pharmacy are also on the top 10 lists for shortages. However, nursing is the largest and has the biggest impact on hospital care." BN

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