The average nurse in the United States is 47 years old, and to Linda Kresge, vice president of patient care at Sequoia Hospital in Redwood City, that signals trouble in the future. "There are 1.2 million nurses in the nation and a shortage throughout the world," she says. "As the population grows older [and nurses retire faster than replacements can be trained], being without adequate nursing care is a real fear."
Limited Training Capacity
To help solve the shortage and entice nurses to stay in the area, Sequoia Hospital partnered with San Francisco State and opened its own nursing school in Redwood City.
"We thought we would create 40 new nursing jobs a year," she recalls. "But there is a bottleneck in the industry. There are more people wanting to become nurses than actually can get into a school." Sequoia had 228 applications for its 40 openings.
Colleges are limited by budget constraints because nursing is a costly program.
"We began seriously recruiting about four or five years ago," she states. "International recruiting was not sizeable and we realized partnering with educational institutions was advisable."
Sequoia Healthcare District provided $10 million in funding to bring the school to San Mateo County. The hospital also put together a mentor program that pairs trained nurses with novices beginning a new career.
"We are hiring now," Kresge reports. "The operating room has the greatest shortage of qualified nurses who deal with the frailty of human life every day."
The average age of an OR nurse in California is 51 years and that specialty is not in the curriculum of most colleges that prepare nurses.
"If I could get an experienced OR nurse, I would hire him or her on the spot," she claims. "We would consider as little as two years experience and we would train."
Other enticements for nurses include a $7500 signing bonus for hard-to-fill positions and $3500 for traditional posts, $3000 annually to support ongoing education, relocation reimbursement, time off to pursue professional interests, overtime pay, and an opportunity to work 12-hour shifts with four days off every week.
"This arrangement gives people some home/life balance," she points out. "We also offer a rich retirement plan that encourages a nurse to develop tenure."
"There are critical shortages in the California nurse force," agrees Liz Jacobs, spokesperson for the California Nurses Association. "The problem is that the hospitals and clinics with lowest vacancy rates have the best salaries and best staffing opportunities, enabling nurses to work in an optimal environment. In short, nurses aren’t leaving the good jobs."
Jacobs says the picture changed in the early 1990s. "Managed care came along. Hospitals and clinics were forced to lay off thousands of RNs and replace them with lesser-paid caregivers."
As a result, many nursing school programs closed – and the die was cast for the deficit we see today. By the time HMOs realized that a strong contingent of RNs and LVNs was critical to quality care, the capacity to train them in sufficient numbers had been lost.
Retention Gets Attention
Faced with an ongoing shortage of nursing school graduates, the largest healthcare facilities use their strength and size to improve nurse retention.
"We’ve shattered the glass ceiling and, as a result, many of the top leaders are RNs," notes Jim Caroompas, spokesperson for Kaiser Permanente Regional. "The career path is vast, and if nurses want hands-on patient care we have many opportunities."
Managerial opportunities exist, as well as a number of educational posts for those employees who want to become licensed vocational nurses or registered nurses.
In addition to competitive salaries and benefit packages, Kaiser Permanente touts its diverse work environment as reason to be the workplace of choice for nurses.
"We have 19 hospitals throughout Northern California – as far north as Santa Rosa and south to Fresno," cites Caroompas. "If a nurse enjoys the mobility of working in different facilities, he or she can transfer to any one of those facilities and maintain seniority."
At its recruitment fairs, Kaiser encourages registered nurses to bring their knowledge and computer skills to work at Kaiser. Nurses who prefer working with those skills can sign on for the new advice and telephone nursing program. The system is the first and remains the largest healthcare system to open call centers where a member/patient of the Kaiser network can call with a non-emergency medical concern. The caller talks to an advice nurse who listens to the symptoms and suggests treatment or recommends they be seen by a physician.
It’s a growing opportunity within Kaiser, Caroompas adds, and is especially valuable in the areas of adult medical, obstetrics, gynecology and pediatric care.
"If an RN wants to work in a hospital setting but prefers no hands-on care, we have opportunities in medical quality, nursing research, improving the nursing experience and nursing educational programs," he relates. "We have opportunities in smaller medical office clinics where nurses play a key role.
"I honestly believe we have more career opportunities than any other healthcare system in the nation, and the best news for nurse jobseekers is that we are now hiring throughout Northern California. It’s a great time to look into what we have to offer."