My son told me about this problem when he graduated with a Bachelor of Science in Nursing in 2010.
MORGANTOWN, West Virginia (Reuters) - A shortage of nurses at U.S. hospitals hit West …
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October 19, 2017 / 10:12 PM / Updated 5 hours ago
Short on staff: Nursing crisis strains U.S. hospitals
MORGANTOWN,
West Virginia (Reuters) - A shortage of nurses at U.S. hospitals hit
West Virginia’s Charleston Area Medical Center at the worst possible
time.
The
non-profit healthcare system is one of the state’s largest employers
and sits in the heart of economically depressed coal country. It faces a
$40 million deficit this year as it struggles with fewer privately
insured patients, cuts in government reimbursement and higher labor
costs to attract a shrinking pool of nurses.
To
keep its operations intact, Charleston Medical is spending this year
$12 million on visiting or “travel” nurses, twice as much as three years
ago. It had no need for travel nurses a decade ago.
“I’ve
been a nurse 40 years, and the shortage is the worst I’ve ever seen
it,” said Ron Moore, who retired in October from his position as vice
president and chief nursing officer for the center. Charleston Area
Medical’s incentives include tuition reimbursement for nursing students
who commit to work at the hospital for two years.
“It’s better to pay a traveler than to shut a bed,” he said.
Hospitals
nationwide face tough choices when it comes to filling nursing jobs.
They are paying billions of dollars collectively to recruit and retain
nurses rather than risk patient safety or closing down departments,
according to Reuters interviews with more than 20 hospitals, including
some of the largest U.S. chains.
In addition
to higher salaries, retention and signing bonuses, they now offer perks
such as student loan repayment, free housing and career mentoring, and
rely more on foreign or temporary nurses to fill the gaps.
The
cost nationwide for travel nurses alone nearly doubled over three years
to $4.8 billion in 2017, according to Staffing Industry Analysts, a
global advisor on workforce issues.
The
burden falls disproportionately on hospitals serving rural communities,
many of them already straining under heavy debt like the Charleston Area
Medical Center.
These hospitals must offer
more money and benefits to compete with facilities in larger
metropolitan areas, many of them linked to well-funded universities,
interviews with hospital officials and health experts show.
Along
West Virginia’s border with Pennsylvania, university-affiliated J.W.
Ruby Memorial Hospital in Morgantown is spending $10.4 million in 2017
compared with $3.6 million a year earlier to hire and retain nurses.
But
these costs are part of the facility’s expansion this year, including
adding more than 100 beds as it grows programs and takes over healthcare
services from smaller rural providers that have scaled back or closed.
J.W.
Ruby, the flagship hospital for WVU Medicine, offers higher pay for
certain shifts, tuition reimbursement, $10,000 signing bonuses and free
housing for staff who live at least 60 miles away.
Next
year, the hospital is considering paying college tuition for the family
members of long-time nurses to keep them in West Virginia.
“We’ll do whatever we need to do,” said Doug Mitchell, vice president and chief nursing officer of WVU Medicine-WVU Hospitals. NOT LIKE OTHER SHORTAGES
Nursing
shortages have occurred in the past, but the current crisis is far
worse. The Bureau of Labor Statistics estimates there will be more than a
million registered nurse openings by 2024, twice the rate seen in
previous shortages.
A major driver is the
aging of the baby boomer generation, with a greater number of patients
seeking care, including many more complex cases, and a new wave of
retirements among trained nurses.
Industry
experts, from hospital associations to Wall Street analysts, say the
crisis is harder to address than in the past. A faculty shortage and too
few nursing school slots has contributed to the problem.
Hospitals
seek to meet a goal calling for 80 percent of nursing staff to have a
four-year degree by 2020, up from 50 percent in 2010. They also face
more competition with clinics and insurance companies that may offer
more flexible hours.
Healthcare experts warn
that the shortfall presents risks to patients and providers. Research
published in August in the International Journal of Nursing Studies
found that having inadequate numbers of registered nurses on staff made
it more likely that a patient would die after common surgeries.
UAB
Hospital in Birmingham, Alabama, has invested millions to attract
nurses, but still has 300 jobs to fill. At times, nursing vacancy rates
in some of its departments has hit 20 percent or higher.
“We’ve
rarely canceled a surgery or closed a bed because of lack of staffing,”
said Terri Poe, chief of nursing at the hospital, the state’s largest,
which serves many low income and uninsured residents.
Last
year, the medical center covered nearly $200 million in unreimbursed
medical costs for patients. It spent $4.5 million for visiting nurses
during fiscal 2016, including $3 million for post-surgery services,
compared with $858,000 in 2012.
Healthcare
labor costs typically account for at least half of a facility’s
expenses. They jumped by 7.6 percent nationally last year, after
climbing at a rate closer to 5 percent annually in recent years, said
Beth Wexler, vice president non-profit healthcare at Moody‘s. The
spending has proven a boon for medical staffing companies like AMN
Healthcare and Aya Healthcare.
Missouri’s
nursing shortage reached a record high in 2017, with almost 16 percent -
or 5,700 - of positions vacant, up from 8 percent last year.
Thirty-four percent of Missouri registered nurses are 55 or older.
“Our
biggest challenge is getting the pipeline of experienced nurses,” said
Peter Callan, director of talent acquisition and development at the
University of Missouri Health Care in Columbia, which is expanding.
“There are fewer and fewer as people retire.”
Last
year, the academic medical center hired talent scouts to identify
candidates, Callan said. It spends $750,000 a year on extras to attract
and keep nurses, including annual $2,000 bonuses to registered nurses
who remain in hard-to-fill units and up to five years of student loan
repayment assistance. It offers employee referral bonuses and a chance
to win a trip to Hawaii.
Smaller hospitals
find it much harder to compete in this climate. More than 40 percent of
rural hospitals had negative operating margins in 2015, according to The
Chartis Center for Rural Health.
In rural
Missouri, 25-bed Ste. Genevieve County Memorial Hospital had to offer
signing bonuses, tuition reimbursement and pay differentials when
staffing is “critically low” in units such as obstetrics.
They
haven’t closed beds, but have hired less experienced nurses, raised
salaries and turned away at least one patient who would have been in its
long term care program.
“We’ve had to try
whatever it takes to get nurses here,” said Rita Brumfield, head of
nursing at the hospital. “It’s a struggle every day to get qualified
staff.”
To see the entire graphic on the U.S. nursing shortage, click tmsnrt.rs/2xQ9Y0K
Editing by Michele Gershberg and Edward Tobin
Our Standards:The Thomson Reuters Trust Principles.
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