Nursing shortage hits valley
Blaine Manor refuses new residents; St. Luke’s hires
temps
"I could admit five more residents, but I
wouldn’t do that, because I don’t think I could provide the quality of
care I think these people deserve."
Gail Goglia, chief administrator of Blaine Manor
By TRAVIS PURSER
Express Staff Writer
Gail Goglia, chief administrator of Blaine
County’s only skilled-care nursing home, says she’s been forced to
turn away the frail and sick who seek admission.
True, there’s space available in the
county-owned Blaine Manor, but with just six nurses on staff, Goglia won’t
risk the unmanageable workload that accepting new residents might create.
More work, she said, could jeopardize her staff’s ability to do its job
well.
"I could admit five more
residents," she said during a tour of the home last Wednesday,
"but I wouldn’t do that, because I don’t think I could provide
the quality of care I think these people deserve."
Of course, Goglia would like to hire more
nurses. Adding just two would allow an increase of residents from 20 to 25
and create additional revenue for the financially struggling facility.
However, practically no one is interested in the job. Newspaper ads in
Twin Falls and Blaine County have announced the open positions since she
became the facility’s administrator Oct. 30, but "mostly, we haven’t
had people applying."
Ten miles north of Hailey’s Blaine Manor,
the new St. Luke’s Wood River Medical Center is experiencing a similar
problem. Since it opened its doors Nov. 19, the hospital has been
searching nationally for nurses to fill six positions in management,
critical care, surgery and obstetrics. So far, the hospital has received
few applications and has yet to fill the vacant positions.
Both Goglia and St. Luke’s Wood River
Medical Center director of human resources Maureen Askew believe the
valley is feeling the effects of a major nationwide nursing shortage that
appears to be demographic in nature.
Nationally, the nursing workforce is aging,
and fewer young nurses are replacing those who retire. At the same time,
aging baby boomers—those born between 1946 and 1964—are needing more
and more healthcare.
Nurses for a Healthier Tomorrow, a
coalition of nursing and healthcare organizations, attributes the shortage
to an 11-year baby bust that followed the baby boom. Fifteen years after
the bust, in 1990, there were 77 million boomers compared to 44 million
Generation Xers, creating the smallest pool of entry-level workers since
the 1930s. While the older generation grows, the younger generation
shrinks. The U.S. Census Bureau predicts that the boomer-to-buster ratio
may fall from 1.74 in 1990 to 1.6 in 2010.
That ratio’s effect on the nursing
workforce gained nationwide attention on June 14 when the Journal of
the American Medical Association published a study predicting that the
demand for nurses would be 20 percent greater than supply by 2020. The
average age of nurses had increased by 4.5 years to 41.9 between 1983 and
1998, the study discovered. Its principal author, Peter Buerhaus, and his
two co-authors predicted that within 10 years, 40 percent of registered
nurses will be at least 50 years old.
While demographics are shifting, enrollment
in nursing schools is down. The American Association of Colleges of
Nursing attributes that to media stories in the mid-1990s about the
falling numbers of inpatients, downsized hospitals and nurse layoffs.
Whatever the cause, in the fall of 1999,
undergraduate enrollments fell by 4.6 percent, dropping for the fifth year
in a row, the association reports. Moreover, because many nurses get their
two-year degrees from community colleges, which typically have a higher
average student age than four-year colleges, the average nursing graduate
is 31. At that age, they’ll have a reduced number of years to work.
Prominent news stories of the shortage
began in 1999, too recent to boost graduation numbers of students who may
have decided to enroll, the association’s Web site argues. Furthermore,
college and high school counselors might still be discouraging students
from entering the profession.
Other factors that may be contributing to
the shortage include a trend toward specialization, creating a higher
demand for nurses prepared in baccalaureate programs that emphasize
leadership, health promotion and case management.
St. Luke’s human resources director Askew
said, for example, she has particular difficulty finding a qualified
obstetrics nurse. She believes that’s because the job is so highly
specialized.
Then there’s the American Nurses
Association president Mary Foley who argues that one of the real problems
contributing to the shortage is poor working conditions such as mandatory
overtime, unsafe staffing practices and higher patient workloads.
While there’s no evidence those problems
exist at Blaine Manor, administrator Goglia said nurses working in
skilled-care nursing homes need a "different mindset" to cope
with the physical and emotional stress involved.
Attracting nurses to the Wood River Valley
has its own problems. Mostly, that’s due to the area’s high cost of
living. Blaine Manor’s salary of $12 to $24 per hour and St. Luke’s
starting wage of $17.78 may not be enough to persuade nurses to come here.
Also, Askew said, nurses are discouraged
from coming here because their spouses have limited employment
opportunities.
The effect of all this on healthcare is
difficult to determine. Though a 1999 Louis Harris & Associates public
opinion poll indicated that more than half of Americans believe the
quality of healthcare is affected "a great deal" by a shortage
of nurses, Askew said that at St. Luke’s "there is not a compromise
to patient care; I can assure you that."
She said the hospital uses up to six
temporary nurses to fill in the scheduling gaps. But that creates another
problem—because the hospital pays for their travel and housing,
temporary nurses can be expensive, especially when used long term.
Meanwhile, St. Luke’s staff nurses have
been working more hours, "at their discretion," she said.
For Goglia, not only is hiring qualified
nurses important for the frail and sick who need specialized care, and to
their friends and families, it may also be vital to the future financial
health of Blaine Manor.
Industry experts say reductions in Medicare
and Medicaid reimbursements mean that skilled-care nursing facilities with
fewer than 40 beds are no longer financially viable. Blaine Manor is
currently managed by Hailey Medical Clinic with a subsidy from county
taxpayers, but Goglia said the home could definitely use the $20,000 to
$25,000 increase in monthly revenues five more residents could bring.
However, Goglia was not optimistic about
finding the needed nurses soon. Any qualified local candidates would
likely already have applied, she said, and attracting someone from outside
the area is "highly unlikely."
Like many hospitals across the country, St.
Luke’s is offering a sign-on bonus—up to $3,000 or a 2000/2001 ski
pass—and help with relocation costs. The American Nurses Association
reports some hospitals offering up to $10,000.
Blaine Manor is not offering any
incentives, and in fact, Goglia has had to cope with some dissatisfaction
among her staff due to pay cuts that occurred just before she was hired.
Instead, Goglia focuses on the long-term
solution of sparking young people’s interest in the profession. Because
of our "mobile society," she said, "very few young people
have grown up knowing old people." But when the young experience the
old through school programs or employment, both groups become interested.
She has seen that first hand with the teenagers who work at Blaine Manor.
And the interaction is good for the residents. "They just love the
young people," she said.
***
Nurses for a Healthier Tomorrow (www.nursesource.org),
The American Association of Colleges of
Nursing (www.aacn.nche.edu)
