Nursing Shortage

An often overlooked contributor to the shortage of qualified nurses is the lack of spaces in nursing school programs and the shortage of qualified nursing instructors. There are many hoops to jump through and long waiting lists to endure to even jump through those hoops, and then more waiting lists after that. (Among them, the community colleges require that students become certified nursing assistants [CNA] before being admitted to the program--the community colleges offer very few and inconvenient CNA courses, and outside programs are expensive, have long waiting lists, and aren't well organized. The state board of nursing is of little help in locating current CNA programs.)
Fortunately, Banner Health and Scottsdale Healthcare are among the organizations who are trying to help students sidestep the waiting list and recruit new nurses for their facilities by creating and funding nursing programs through the Maricopa Community Colleges. If it were not for this, I would still be on a waiting list rather than nearly halfway through the program.

Air force and Army medical personnel can take the state lpn (license practical nurse) exam but Navy Corpsmen can't. Explain that to me. It makes no sense to allow the least trained military service personnel to take the test and not allow the most trained the ability to challenge the state exam. So all the corpsmen from the Marine Corps base in Yuma ARIZONA are ineligible to become lpn's in this state. They can fight and die but can't be lpn's in ARIZONA. Very logical.

herb, former navy corpsman in Mesa.

Air force and Army medical personnel can take the state lpn (license practical nurse) exam but Navy Corpsmen can't. Explain that to me. It makes no sense to allow the least trained military service personnel to take the test and not allow the most trained the ability to challenge the state exam. So all the corpsmen from the Marine Corps base in Yuma ARIZONA are ineligible to become lpn's in this state. They can fight and die but can't be lpn's in ARIZONA. Very logical.

herb, former navy corpsman in Mesa.

Congradulations on your topic! The professional nursing issue should be foremost on every healthcare consumers mind, before they enter any hospital. Prospective patients should investigate RN staffing levels and vote with their buisiness. Patients come to hospitals for the purpose of nursing care; If they could take care of themselves the insurance carriers would not reimburse the facility. Nurses are your link to saftey, ethics, and appropriate care. Continuing professional nursing assessments prevent complications and adverse events in the inpatient setting. Professional nurse interventions have a significant statistical effect on your recovery. The hospital exists to provide a service and make a profit. They are more interested in brand recognician, land and buildings than in patent care. The bottom line is the only line. You can see a physician in his office. His major buisiness concerns are his reimbursements, his office and and his malpractice. This is evidenced by the new " speed medicine model"( 5 min is considered a reasonable visit). Diagnostics can be done on an outpatient basis. You are not in the hospital for the food or view. You are in need of nursing care. Their are no patient care departments in the hospital that function independently of nurses.
I am very concerned regarding the nursing shortage as a public healthcare crisis. Patient populations have become more acute. If a patient is able to walk to the bathroom, discharge is imminent. Many RN's have left bedside nursing to persue more lucrative, less stressful, careers in healthcare and industry. Patient care nurses are expected to work 12.5 shifts in most hospitals. If there is not enough staff for the next shift ; you are expected to work that shift also. We are on our feet 90% of our workday wit heavy lifting and physical demands. Breaks and lunch are not a given.To make matters worse I am about the average age of a RN at 47 years old. Their are few nurses to replace me. I sometimes worry that I am at risk of making a significant error or ommision due to the volume and speed of critical multitasking that is expected. I think that most nurses, if they aren't in denial, would agree.
Their is an issue of unlicensed nursing staff that provides care to patients. Many hospitals use these caregivers to give the impression that their staffing is adequate. They look like nurses but they have a very limited education. They are not educated or legally able to perform assessments; this can lead to inadvertantly overlooking a critical finding or complaint.

With my practice experience in 5 states, I must admit that Arizona gets a poor rating from me in Nurse/ Physician relations, compensation and continuing career enhancement for nursing. Most non-teaching hospitals function on a cult of personal preference and physician convience rather than evidenced based care. Teaching hospitals are somewhat better. Superior nurses will, and have left these institutions to continue their career in Magnet and magnet style hospitals. These are institutions that subscribe to a philosophy of nursing as their #1 service.
They nurture the staff as valued employees and resources, rather than an expense.
We need positive exposure in the media as a profession, independant of medicine to attract recruits with aptitudes in science and healthcare. Many goverment programs tout a welfare to RN approach. I am sure that their are many qualified individuals in these ranks and I applaud these programs. These programs make an unstated assumption that nursing is a job, and that anyone can be trained to perform this function. I liken this attitude to believing that anyone can be a competent designer or engineer. We all know that this is not true. One must have an aptitude for math science and critical thinking. Another approach for recruitment is to hire head hunting firms to attract foreign trained nurses from Africa, India and the Philipines. Many of these nurses are recruited in almost indentured servatude from countries that also have a severe nursing shortage. They are paid much less than the prevailing wage. Unfortunately many of theses nurses are not culturally competent to the North American patient. There can be significant communication problems with patients and staff, that the hospital may ignore without intervention. There are legislated requirements to speak and write the prevailing language but many non-native speakers have difficulty with pronounciation of medical terminology and conversation. This leads to a higher rate of misunderstandings in a field than can have no miscomunications, especially in fast paced critical situations. Consider your comfort level, on a jumbo jet, whos' pilot could not understand the air traffic controller due to a language or communication problem. Lastly,it is a misconception that Registered Nurses are subserviant to physicians. Nursing is an independant Art that stands alone in healthcare. Physicians do not know how practice nursing; just as nursing does not practice medicine. We work within a philosophy of nurturing, wellness and patient education. We are your advocates in wellness and healing. We are bound to ethical care for patient and patient advocacy by our professsion. If, you have ever been critically ill, and close to death in a hospital, you know who saved you. I feel honored and privileged to be a nurse.

Air force and Army medical personnel can take the state lpn (license practical nurse) exam but Navy Corpsmen can't. Explain that to me. It makes no sense to allow the least trained military service personnel to take the test and not allow the most trained the ability to challenge the state exam. So all the corpsmen from the Marine Corps base in Yuma ARIZONA are ineligible to become lpn's in this state. They can fight and die but can't be lpn's in ARIZONA. Very logical.

herb, former navy corpsman in Mesa.

Please define for us listeners what is defined as a quailfied, or competent nurse?????

I was an LPN for ten years, and loved it. However, after returning to school to work on my RN, I made the decision to leave nursing entirely.

12 hour shifts, night shifts, weekends and holidays are no longer attractive, especially when the educational requirements to maintain one's license, let alone advance, are being raised to a ridiculous level. Increasingly hospitals are moving toward a Bachelor's requirement and an all RN staff. The part of nursing I loved was the hands on care. Taking Chemistry and college mathematics is of no interest to me - I was good at nursing drug calculations and classes directly pertaining to health care.

It seems tomorrow's nurses will have a great deal of book knowledge. In some ways this is a good thing. But it will exclude many people whose dedication and skill was in the hands on aspect of care. Nursing should think twice before making itself an elite profession open only to those willing to do bachelor's level studies. People with enough funding, prior educational preparation and resources to reach this new standard will have many other choices open to them. They are unlikely to want to devote nights, weekends and holidays to cleaning up a bloody patient after an accident, changing adult diapers, or dealing with the challenging but very rewarding situations that are the human side of nursing.

many reasons why there is a nursing shortage:

with the media exposure the blame of injury/death accidents are directed toward the nursing shortage. Nursing is the largest body of healthcare workers in the hospital setting. Nursing does not work alone, they collaborate with the physician, pharmacy, respiratory care/physical therapy/radiology, etc., who also have direct patient care. It is not just the nurse responsible for the patient, the fact injury and death does occur in a hospital setting should not be addressed to just the nursing shortage only.

Nursing board who governs the nurse's scope of practice does an outstanding job of investigating and follow up with complaints/concerns and issues associated with the delivery of care of the nurse, including c.n.a's. Issues filed have a very rapid response rate from the state board. Bomax is the organization that watch dogs the physician. When a complaint is filed, the time frame for investigation could be years and a slap on the hand is issued. EVEN FOR QUESTIONAL CAUSE OF DEATH RELATED TO SURGICAL PRACTICE.

It is not only the nurse again with events with patients.

The general public is becoming almost mentally abusive to the bedside nurse. Comments like: nurses kill people; you must serve me; are actually comments that we hear. Yes, we are a serving career we all chose however, a thank you will give the nurse a little pat on the back that goes a long way and effect the life span at the bedside.

Money is always an issue, but not the only one. NOw the IRS is requiring any little appreciation gift such as movie tickets to be taxes, PLLLLEEEEAAAZZZZEEEE.

We have the option to be mobile in programs offering travel nursing. travel nursing allows the nurse to move from place to place, experience change with assignment from 2 to 13 weeks or longer. This will do two things, help with temp nursing shortage but also increase the shortage.

Registry employment will pay the nurse the high $$ amount without obligation or benefits. Flexiblity is what is attracting the nurse in this program. The registry RN/LPN/CNA, in many registries are not required to work holidays, weekends or number of shifts. This is also attractive to the RN since many have other jobs and family.

Companies are working hard to help with the shortage, working with foreign programs to contract the foreign nurse to work. "GROWING OUR OWN" nurse refers to encouraging the student nurse to work with the hospital in turn hoping they will stay after graduation. Addition program are offered by the larger organization also to attract the pending nurse.

YOu talk about nursing shortage, lets address all the creative programs offered to help with this, lets educate the public that the nurse is there by choice to help and meet the needs, not an educated, forced career choice, non-caring human.

Respect goes both way, I believe that one of the reasons the nurse is leaving the bed side is because respect is lacking. We do the best we can, maybe recognition would be in order.

Kyle Burnis RN, BSN, CCRN
Nurse Recruiter

Why are there so few incentives offered by local employers to help students who could be their future hires? I recently went to get a job as a CNA to get the experience and take advantage of my employer's benefits which include paying my tuition, but as an adult with a family and mortgage and bills to pay, I can't afford to work for $9.75 an hour more than a couple of days a week. I have to make more money than that! I have to work a minimum number of hours a week just to get my tuition paid for, yet I can't afford to work that many hours at such a low rate of pay! Why not make it easier for nurses to get through school so they can start being nurses, rather than prolonging the student phase? It seems like some of the private insurers, drug companies, and other for-profit entities which are doing well could offer some help in a time when the state and federal government are helping so little.

1. If nursing is such a valuable and needed profession, then why do nurses start at only 40K a year? We're talking dealing with life or death matters. If you truly value quality health care, you need to pay for it. Nurses should be paid twice that amount. This is a highly skilled profession that also requires excellent people skills and caring. 40K these days isn't much of an incentive. It's barely a living wage if you've got a family, own a home, etc.

2. Why not offer better incentives for people who will change careers as adults? I am 40 and want to get on with my life. I don't have time for waiting lists and working for $9 something an hour as a CNA just so I can get some experience and get my tuition paid. It's a catch 22. You have to work 16 hrs a week to get tuition paid, yet who can afford to devote 16 hours a week to such a low rate of pay?
If an employer would offer me more support it would make the prospect of a career change much more lucrative.

3. Why don't the for-profit entities do more to help avert the nursing shortage? Insurance companies and drug companies could offer more financial help to students and institutions to help increase the number of programs and ease the burden of paying for school.

4. Recruiters at major hospitals need to be trained to look for quality talent and offer incentives to prospective nurses to hire and retain them.

I'm an older RN returning to the workforce. I see a great pool of nurses who have left the workforce, wanting to return. There are few programs, however, and there is little money to help take refresher courses. This would help the shortage. What can be done about this vastly untapped potential? Thanks.

BOTTOM LINE THERE ARE WAY TOO MANY COURSES TO TAKE TO BECOME A NURSE AND THERE'S NOT ENOUGH "HANDS ON TRAINING" IN ORDER TO BECOME A NURSE. IF THE REQUIREMENTS ARE NOT EASED, THE SHORTAGE WILL INEVITABLY BECOME WORSE. I KNOW BECAUSE I AM TRYING TO STRUGGLE THROUGH THIS DAUNTING PROCESS!

I’m a regular listener of KJZZ and also an employee of Banner Health. I noticed with great interest today’s topic on the nursing shortage for the Here & Now segment.

I’m proud to say that Banner Health has been very aggressive in developing solutions to address the nursing shortage. This includes establishing the Banner Center for Health Careers in 2003, which, through innovative partnerships with various education institutions, has developed a variety of programs to prepare qualified nursing professionals to enter the workforce.

Among those is the Banner Health Nurse Fellow program, a partnership between Banner and Gateway Community College that pays the cost of tuition, books and fees of 90 nursing students per year. In exchange for the education assistance, students commit to work for Banner for three years after completion of their nursing program. By October, we expect to have 120 nursing students enrolled in the program; the first class will graduate in March 2005.

Other programs are geared toward meeting the growing demand for Spanish-speaking nurses, including the Bilingual Nurse Fellows Program at Gateway and South Mountain colleges. Nursing students who are proficient in both Spanish and English can receive education assistance in exchange for an employment commitment.

In addition, Banner firmly believes in growing our own pool of qualified health professionals through a number of innovative programs geared to our own employees. The Essential Career Pathways program offers education assistance to entry level employees for hard-to-fill clinical positions such as RNs. We also offer the LPN-to-RN program which provides education assistance to Banner Health LPNs who wish to pursue associate degrees in nursing in exchange for a one year employment commitment.



In closing, Banner recognizes the need to find qualified nursing professionals and has been aggressively working with a variety of community education and other resources to quickly find and fill vacant nursing and other hard-to-fill positions.

Annamaria Szendroi

Program Manager

Banner Center for Health Careers

602-747-7800

Your program was well-intentioned but I think you could easily spend a week or more on this topic.

I felt that the members of your panel should have included actual working staff RNs and students. It seemed like they were putting a too-postive spin on everything and minimizing the very real problems out there.

Nurses don't get enough respect or pay. Twelve hour shifts are ridiculous. How can you provide good patient care at the end of a 12 hour shift? How can you expect people to work such long hours and make decisions impacting a person's life if they haven't had a break to eat all day?

It's amazing that anyone goes into nursing unless they really really want to do it.

The March of Dimes is debuting "Nurses of the Year Awards" this year to recognize and reward outstanding nurses across the state, champion the profession of nursing, support future nurses through scholarships and help fund its mission to help babies.
Health Net is proud to be the presenting sponsor of this event, set for Saturday, Nov. 13, at Desert Ridge.
To nominate a nurse, become a sponsor or learn more about the event, visit www.marchofdimes.com/arizona and click on the Nov. 13 Nurses of the Year link.
Susan McLeod
Public Affairs Manager
Health Net

As a home health nurse I was able to hear the majority of your discussion while driving to a patients home. I couldn’t wait to get home and hear the program in its entirety. After reading the posted comments I felt an urge to add my 2 cents. I have worked in the healthcare profession for 30 years. I have been a CNA a LPN an ADN and received my BSN at age 48. This has been such a wonderful experience that I will go on to receive my MSN next year! I love nursing and I love patient care. There is no greater profession. We in Arizona are fortunate to have the professional leadership that heads our community colleges, universities, and professional associations. Our hospitals and the AzHHA are very supportive of nurses. The AzBoard of Nursing is staffed with caring and educated nurses whose goal is to support nurses. There is no better time or place to be than a Registered Nurse in Arizona.