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Southeast Missouri is seeing a shortage of nurses in hospitals

Monday, June 25, 2012

Siv Balaketheeswaran of Cape Girardeau, a senior nursing student at Southeast Missouri State University, checks on her patient Wednesday at Saint Francis Medical Center.
(Fred Lynch) [Order this photo]
All signs point to a shortage of nurses and other health care professionals coming to Southeast Missouri. Regional educational institutions with programs in health care study are facing maxed-out resources. Qualified faculty to teach nursing courses are becoming increasingly more difficult to find, and slots for students to participate in clinicals at area hospitals and other health care facilities are full.

Those indicators for a shortage in the nursing field are seen in nursing schools nationwide. Schools have to limit enrollment at a time when more nurses than ever need to be graduating and entering the workforce, area nurse educators say.

The problem definitely isn't that no one wants to become a nurse. U.S. nursing schools turned away more than 75,000 qualified applicants from undergraduate and graduate nursing programs in 2011, according to a recent report by the American Association of Colleges of Nursing.

In 2010, a task force consisting of representatives of area hospitals, businesses and colleges was developed by the advisory committee of the Cape Girardeau Partnership for Higher Education for the purpose of analyzing a nursing shortage in Southeast Missouri. What that task force found, said Rich Payne, director of the career and technology center, was that there is a need to increase capacity in the region's health care education programs, but also that there was expansion already taking place.

The task force collected reports from the region's community colleges, nursing schools and universities that showed five examples of that expansion in the past year. The schools, including the Cape Girardeau Career and Technology Center, Mineral Area College, Three Rivers College, SoutheastHEALTH College of Nursing and Health Sciences and Southeast Missouri State University, all reported adding new bridge programs or expanded seats in existing programs.

Cheryl Essner, assistant professor of nursing at Southeast Missouri State University, has a conference with a nursing student Wednesday, June 20, 2012 at Saint Francis Medical Center.
(Fred Lynch)
The Career and Technology Center added seven seats to its LPN evening program. Mineral Area is starting a hybrid LPN to RN program and a paramedic to RN bridge program. Three Rivers was taking over LPN programs in southern counties to attempt to improve retention. SoutheastHEALTH is also starting a paramedic to RN program. Southeast Missouri State recently began online bridge programs.

"If you look at that collectively, it's a pretty good increase throughout the region on the nursing side," Payne said.

Jeannie Fadler, Saint Francis Medical Center's vice president of patient care services, said colleges in Southeast Missouri have been very creative in making bridge programs work for increasing the availability of nurses to hire, but that there is a definite need to continue collaboration between health care facilities and colleges so that the colleges can hopefully increase capacity in programs.

The availability of clinical space is definitely a limiting factor in student enrollment, said Donna Shirrell, dean of education at South-eastHEALTH's College of Nursing and Health Sciences. Shirrell and Southeast Missouri State University nursing department chair Dr. Gloria Green say too many students participating in clinicals at one time can become a burden for nursing units. The quality of experience students gain from their clinicals is also important, so sessions have to be scheduled at certain times to coincide with applicable hospital activities, Green said.

Green assisted the task force in examining the availability of clinical sessions at area health care facilities, including Saint Francis and SoutheastHEALTH, and found that adding more students to the number already participating would overstress an already stretched capacity and could result in detriments to patient care.

"Unless someone opens another 500-bed hospital, the numbers can't change," she said.

Shirrell said SoutheastHEALTH is constantly looking at innovative ways to provide clinical experiences.

Enrollment in Southeast Missouri State University's undergraduate nursing program is limited to 35 students per semester due to rules set by the state board of nursing. Ten additional seats have been available in recent semesters due to a grant that several state universities are using to hire more faculty and train students.

Interest in the university's nursing programs is high among students, Green said. During the spring semester, 671 had declared themselves as a pre-nursing major. But only a handful of those will ever reach enrolling for programs. The nursing department only accepts the "cream of the crop," Green said, by accepting only the highest grade earners. Green said she knows the situation is frustrating for students, but actually benefits the nursing program and later the employers who hire graduates, she said.

"We get the best, and that's who we want in nursing, certainly," she said.

It is, however, sad, she said, that even with the high acceptance standards in place, that the department can only take about half of even the best students.

SoutheastHEALTH's nursing school admits 90 students per year into a traditional nursing track, an LPN to RN accelerated track, an evening-weekend nursing track and a paramedic to RN nursing track. Those slots fill quickly, Shirrell said, and are filled for this year, next year and some already for 2014. Admission requires an ACT score of 21 and equivalent COMPAS scores. College GPA and other criteria are also used to make decisions on admission.

A shortage of nursing faculty, a root problem in not being able to expand enrollment, is also a factor that will press a nursing shortage and one that area colleges are working to head off at the pass. An aging nurse educator workforce is the main reason, research studies show.

Southeast Missouri State University's nursing department has had several retirements in recent years, and SoutheastHEALTH's College of Nursing expects some retirements in the near future, Green and Shirrell say.

The problem is worsened by fewer nurses opting to become nurse educators when furthering their qualifications because salaries are more for nurse practitioners, Green said. She's replaced four of five faculty lost at the university but is still working to find two more to fill the department's staff roster, she said.

The university is working to encourage its faculty to continue as nurse educators and expand their teaching qualifications by offering a program where they can be reimbursed for a portion of educational costs. SoutheastHEALTH has partnered with Cox College in Springfield, Mo., to offer an associate's to master's degree program to alumni in order to help prepare additional nursing educators for the colleges in Southeast Missouri.

The task force plans to meet twice annually to examine data on nursing programs and efforts to keep graduates of the region's nursing schools working in Southeast Missouri health care facilities.

Fadler said she is glad to see colleges already making moves to attempt to reduce the effect of a nursing shortage in the region.

"I'm not saying all the measures taken will completely stop it," she said. "But I am optimistic when I see that there is already a lot being done. It is very encouraging."

Shirrell said the nursing shortage so far has not been as severe as anticipated. With the economic downturn, many nurses have re-entered the work force or have chosen not to retire, she said.



Pertinent address:

1080 S. Silver Springs Road, Cape Girardeau, MO

One University Plaza, Cape Girardeau, MO

2001 William St., Cape Girardeau, MO

211 Saint Francis Drive, Cape Girardeau, MO

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Why doesn't this article include talking with the nurses that have already graduated and work locally. There are 3 hospitals in Cape not 2, talk to any nurse that works at either hospital and you will find the real reason for the nursing shortage, upper management making harsh decisions to rid themselves of qualified nurses with excellent experience and education that the hospital required and paid for, replacing them with the graduate nurse who doesn't make as much money and definitely does not have the life saving education that comes with experience. SE Health has decided to combine floors making nurses reapply for positions that they are qualified for, but not rehired due to the wages and benefits due them for years of service. They spend thousands and thousands of dollars requiring nurses to further their education, but consider them a liabilty because they justly deserve the wages they make. SE Health has recently done this to those who have dedicated their careers to them. SFMC refuses to hire a nurse if they smoke, but the nurse that has a multitude of health problems due to obesity will be hired. Their out of control spending on becoming bigger and better than the others takes away money needed to recruit and retain nurses. SE Health has spent millions of dollars on computer programs for the ER that do not link into the main system, I believe they are on the third multi million dollar program in the last 5 years and still can't get it right. We maybe be the baby boomers, but we still have years left to work. So the hospitals need to take responsibility for the mess they have created. Wanting everything for nothing so someone on carpet row can obtain a nice bonus quarterly, They no longer care that patients deserve premium care, they suck the payment systems for everything they can get ie Medicare, Medicaid, private insurance and self pay but refuse to hire nurses with the education and experience. They receive high dollar reimbursement but refuse to spend the money on the very people who take care of the patients. The nurses and nurse aids are stretched so thin that the patients are neglected and don't receive the care they deserve and pay for. Those that are self pay have to declare bankrupcy because they cannot afford to pay $15.00 for an aspirin that costs less than a few pennies, and their entire bill is made up of gross unjustified charges and billing, they send patients multi thousand dollar bills and turn them over to a collection agency immediately. Go to their websites, look for the open nursing positions, there are nurses available for these positions, but they are not willingly to take the responsibilty that they themselves have created for the mess they have made. You want the flip side to this story interview dedicated nurses that are being pushed out of jobs by management decisions

-- Posted by Sunflower Girl on Mon, Jun 25, 2012, at 1:34 AM

What she said! Spot on.

-- Posted by Yankee Station on Mon, Jun 25, 2012, at 7:44 AM

Go "sunflower girl". Upper management, as usual, pushing around the people that acutually do work. That's the reason unions are formed to protect workers from abuse like this.

-- Posted by stinker on Mon, Jun 25, 2012, at 8:38 AM

That's NOT the reason Unions are formed! Unions are from a bygone era and need to go away! I don't know why people insist on having to pay to work somewhere. Do the job you were hired for! Why do people expect things when they do their job. The ones who always bash upper management are usually ones who have been passed over for promotion or who are not smart enough.

Do your job and mind your business don't worry about others!

-- Posted by Bman69 on Mon, Jun 25, 2012, at 9:12 AM

Bman69....even though nothing will come of SunFlower Girl's remarks she is absolutely correct...and we all know it....that's what the problem is....no one cares what's happening with the economy as long as the same rich get what they want. She shouldn't mind her own business...there should be more like her speaking out until something is done....although I fear it's too late. She obviously knows what she is talking about.

-- Posted by Agnes on Mon, Jun 25, 2012, at 10:01 AM

Knew of this shortage three years ago. This isn't news!! Solution? Open up enrollment, get some of that stimulus money that others are getting, recruit out of HS, and get it done. Forget about Union talk you morons, and get to teaching and fill the void with quality people who are out there waiting to be recruited....!!

-- Posted by vietnamvet on Mon, Jun 25, 2012, at 12:34 PM

Bman69 did I hit a nerve when I mentioned management? Why should I mind my own business, there is nothing I stated that is not a FACT, SE Missourian reported one side of the story. I have never been passed over for any job that I have ever applied for, I just prefer not to be part of management because I could not go home and sleep at night knowing that I went along with decisions that cost people their jobs, their homes, food on the table for their kids, but most of all cutting staff that is there to take care of the patient. There have always been way too many nurses who have gone into management that forget they are nurses, none of them are willing put on a pair of scrubs and get back out on the floor and help do patient care when there is minimal staff available. You would probably be the loudest complainer if your call light wasn't answered immediately, and could care less that the nurse or cna may be working with someone down the hall that could be dying. "Why do people expect things when they do their job?" I can't believe you said that, who doesn't expect something from their job, such as respect, acknowledgement, especially those that represent their employer and have dedicated their career to said employer. I do agree with you regarding unions and personally don't feel nurses should be union, but it is coming to this area if employment conditions don't improve for nurses. Missouri is a right to work state, that means they do not have to give you breaks nor do they have to give you a meal break, look it up it's on the labor website. I assure you, I am "smart enough" to do their jobs, but disagree with their standards. I went to school to become a nurse, taking care of the sick is what I do and do it very well. Why don't you volunteer at a hospital, follow a nurse around and see what the conditions really are and then you can make an educated statement.

-- Posted by Sunflower Girl on Mon, Jun 25, 2012, at 12:38 PM

We need people with trained nursing skills, instead of everybody going to college to earn a four year degree to mount on the wall and be unemployed. Young folks right out of high school can learn this very important trade by applying for Nursing School where you will learn a skilled trade that is needed so badly in our health care system.

-- Posted by swampeastmissouri on Mon, Jun 25, 2012, at 3:47 PM

The young folks are trying to attend Nursing Schools in massive numbers. The Nursing Schools are only able to take ~10% of them. So 90% of the people that want to become nurses are just wasting their time. Besides training nurses is very expensive, and that is without even paying nurse educators enough to fill the demand (which would take ~100k salaries to entice RNs wanting to add a masters/PHD level specialty to choose education).

If I'm a college administrator at SEMO the only thing the Nursing program is good for is to suckering more students into attending, and then switching them to liberal arts, business, or some other field that doesn't require expensive supplies, clinical time, and smaller class sizes. You can run 3-4 generic college courses using dime-a-dozen associate profs for the cost of adding another nursing course and collect way more tuition.

-- Posted by Nil on Mon, Jun 25, 2012, at 4:34 PM

SunFlower girl is right on. "15 dollars for an aspirin"???

Lets be honest. Health care is "Big Business" period.

Our hospitals spend millions upon millions of dollars placing billboards up and down the interstate telling us how good they are. They purchase full page advertisements every Sunday. They are constantly adding new buildings. Why?

Because, they make so much money. That's why. They have to spend it to show "Non-Profit" status. In the meantime, average Americans are going bankrupt left and right when they face any extended hospital stay.

Doctors are hiring more and more clerical personnel in order to keep up with the mountain of Paper work created by the Health Insurance Companies. These companies all create complicated systems for filing health care claims in hopes the offices will give up.

The latest World Health Reports have the United States ranked far behind other industrialized countries on: 1) Health Care Cost 2) Health Care Access and 3) Mortality Rates.

Every other industrialized country has come to the conclusion that Health Care is a "Humanitarian Service". The United States remains in the dark ages and concludes Health Care is "Big Business".

Result, Pay, $15, for those Aspirin or a Collection Agency will be Calling!

-- Posted by UFO on Mon, Jun 25, 2012, at 5:42 PM

Don't go by the WHO report, it was a gamed survey. The measure was the socialization of health care, not the quality thereof. On the latter, the USA comes out looking pretty good. And, by the way, they also lump behavior into health care metrics, such that Cubs fans gobbling sausages every day with a six-pack of Old Style is somehow supposed to indicate a failure of our health care system.

-- Posted by Mark Rutledge on Tue, Jun 26, 2012, at 8:27 AM

You said it all Sunflower Girl! Management is the death of most businesses because they think they are the only ones worth paying when they don't do near the work they expect of others. As for hospital costs....You're dead on there too! I am all for unions for the workers. Nothing else will keep management in check.

-- Posted by Mudflopper on Tue, Jun 26, 2012, at 8:42 AM

My daughter is in a supervisory position, but not in one of the facilities mentioned, but worked there as a nurse and will tell you the same thing Sunflower Girl has. She has never been passed over and actually took a voluntary promotion to spend more time with her family at two different facilities.

-- Posted by 356 on Tue, Jun 26, 2012, at 9:27 AM

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