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Preparing for a nursing shortage

Every day 10,000 Americans turn 65, and demand for care will rise
Kathy Aney

East Oregonian

Published on October 3, 2017 8:54PM

Nursing instructor Jessica Humphreys, right, demonstrates how to make an occupied bed with students Nildia Resendiz Rios, lying down, and Cristina Hernandez on Tuesday at BMCC in Pendleton.

Staff photo by E.J. Harris

Nursing instructor Jessica Humphreys, right, demonstrates how to make an occupied bed with students Nildia Resendiz Rios, lying down, and Cristina Hernandez on Tuesday at BMCC in Pendleton.

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Students Katie Hunnel, center, and Cherie Guenther, second from right, confer while identifying wounds during a nursing lab on Tuesday at BMCC in Pendleton.

Staff photo by E.J. Harris

Students Katie Hunnel, center, and Cherie Guenther, second from right, confer while identifying wounds during a nursing lab on Tuesday at BMCC in Pendleton.

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Students Tyler Clark-Robinson and Jesse Neveau practice the proper way to make a hospital bed during a nursing lab on Tuesday at BMCC in Pendleton.

Staff photo by E.J. Harris

Students Tyler Clark-Robinson and Jesse Neveau practice the proper way to make a hospital bed during a nursing lab on Tuesday at BMCC in Pendleton.

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Is a nursing shortage looming?

Maybe.

Maybe not.

At first glance, the situation seems dire. Our population is aging. According to the AARP, about 10,000 people turn 65 every single day. Nurses are getting older too.

Are we on the cusp of crisis as a 2016 article in The Atlantic declared? Between 2010 and 2030, it said, the number of Americans over 65 will increase by 75 percent. Demand for health services will soar. A third of nurses will reach retirement age in the next 10-15 years. Training enough nurses and finding enough faculty and enough clinical sites for the students to gain practical experience is daunting.

Susan Bakewell-Sachs, dean of the Oregon Health & Science University School of Nursing, doesn’t deny the demographics, but suggests taking a deep, cleansing breath.

Bakewell-Sachs stopped at Blue Mountain Community College recently on her way back from a white coat ceremony at Eastern Oregon University. The EOU nursing program is one of OHSU’s satellite campuses, and BMCC and OHSU also have a partnership.

Bakewell-Sachs sat with Carla Hagen, EOU’s associate dean of nursing, and Laurie Post, BMCC nursing program director, in a tiny conference room. The three are intimately acquainted with the complexities of training nurses. They mentally finish each other’s sentences and have formed a sisterhood of sorts from being together in the trenches of nursing education.

Bakewell-Sachs, who has read the Atlantic article along with a voluminous amount of nursing industry data, said she is not in panic mode.

“We’re not racing off a cliff tomorrow,” she said. “What you don’t want is to foster a ‘we need everybody to become a nurse’ thinking. This isn’t realistic. We need to ensure we have the capacity in our education system.”

The savvy Bakewell-Sachs switched to academia after caring for preterm infants in a hospital setting. She came to OHSU from a college in New Jersey in 2013.

The administrator worries somewhat about the bubble of nurses over the age of 55.

“We expected a retirement surge in 2008,” she said. “Then the financial crisis happened. As in many other fields, nurses didn’t retire when we expected them to. How quickly this will accelerate and leave us with gaps, we aren’t certain.”

She acknowledges that the so-called silver tsunami will bring a barrage of health problems.

“We have more chronic conditions, and the older we get, the more likely we get multiple chronic conditions,” Bakewell-Sachs said.

So why not just train more nurses? Finding faculty isn’t a simple matter. Nurses working in the field generally make more money than their counterparts in academia. Bakewell-Sachs readily admits she likely makes less as a nursing school dean than she would as a chief nursing officer at a hospital. The salary differential leads to problems finding nursing faculty, especially in rural areas such as Northeast Oregon. Faculty members need master’s degrees or doctorates, depending on their teaching level.

Hagen said she is currently searching for two full-time faculty members for the OHSU nursing school at EOU. Recruiting from outside the area is sometimes tough.

“I’ve really focused on growing my own within Northeast Oregon,” Hagen said. “They’re here because they want to be.”

Post filled two BMCC vacancies this summer with a BMCC graduate and an OHSU grad who moved back from out-of-state. Making staffing even more critical is a state board of nursing mandate that requires an instructor-to-student ratio of one-to-eight.

The EOU incoming class grew from 24-26 in recent years to 30 nursing students this year. BMCC’s incoming cohort has 24 nurses, up from 16 four years ago.

Finding clinical opportunities out in the community for all these students to practice what they learn is challenging. Hagen whipped out a printout that showed clinics, hospitals and other health care clinical agreements from a wide geographic area.

Once the students graduate, they are in demand.

“Usually they all have jobs before they graduate,” Post said.

Last year’s crop of graduates joined about 64,000 practicing nurses in the state, according to the Oregon Center for Nursing. The number climbed. Records show about 43,000 licensed nurses in 2010 and 52,000 in 2016.

Except for a hike in the number of nurses nearing retirement age, the workforce is also getting younger. About 12 percent of the nurses are male, which is higher than the national average of 10 percent. Around 88 percent identify as white.

Whether this constantly evolving workforce can handle upcoming demand remains to be seen. One can’t extrapolate from the national data and predict for any given area, said Bakewell-Sachs.

“Workforce planning is all local,” she said. “It’s very complex and it’s not an exact science. There are ways to plan for this.”

Planning doesn’t mean throwing the doors to nursing schools wide open, she said. OHSU accepts about 25-30 percent of eligible applicants. Ninety percent of them hail from Oregon and at least 70 percent of them stay in Oregon after graduation.

Training just the right number of nurses is a delicate dance.

“We don’t want to oversupply,” Bakewell-Sachs said. “We want all our students to have jobs. They are sacrificing a lot to go to school. They are taking on debt. We really want to make sure they are going to land well. We vary our enrollments around the state and we do that based on conversations with our clinical partners.”

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Contact Kathy Aney at kaney@eastoregonian.com or 941-966-0810.





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