HEALTH: NATIONAL SHORTAGE PUTS NURSES IN DRIVER'S SEAT

A national supply-and-demand problem in the nursing field is allowing local nurses to control their salaries, hours and career advancement.

Southeast Missouri State University's nursing school is nearly filled. Meanwhile, St. Francis Medical Center in Cape Girardeau has 15 openings in its more than 400-member nursing staff. Southeast Missouri Hospital reports a similar challenge recruiting enough highly trained nurses to fill all its shifts.

Even so, the problem is much greater in metropolitan regions, including St. Louis, a situation that's allowing Cape Girardeau nurses to move north or at least earn a hefty extra income splitting their time between the two cities.

Reasons for the shortage vary, but most agree that the aging population contributes the most. Not only are patients, most of whom are baby boomers, getting older and living longer, nurses are getting older, too. The average age of the registered nurse is about 45.

The U.S. Bureau of Labor says half of the current registered nurse workforce will reach retirement age within 15 years.

Area nursing coordinators say local patients need not worry about the shortage yet -- they're filling the gaps with part-time workers and overtime shifts.

But local nurses say the situation has bittersweet results.

Registered nurse Crystal Young, 38, of Cape Girardeau, is working on a master's degree, working part-time for LifeBeat and Southeast Missouri Hospital in Cape Girardeau, and she drives to St. Louis to work in the emergency room of DePaul Hospital every weekend.

She makes $35 an hour working the weekend shift at DePaul. She hears two other hospitals in the St. Louis area paying $48 and $55 an hour for weekend shifts.

But the career empowerment comes with a price.

"When you are there working, you're under the gun," Young said. "You're working harder because you don't have as much help. Therefore you burn out a lot easier a lot faster."

Factors in the nursing shortage, other than the aging population, include managed care cost-cutting, the need for nurses to become more specialized within their field and more career opportunities for women who generally make up a large percentage of the profession.

Recruiting efforts

Janet Weber, coordinator of a continuing education program at the Southeast Missouri State University Department of Nursing, said her school is producing as many nurses as ever -- there are 21 registered nurses continuing their education in her program, which accommodates only 22.

"But we're still concerned, so we're doing recruiting efforts," she said. "It's a real thing. If the shortage is worldwide, we're not going to be exempt from it."

Weber said she has read of hospitals offering up to $8,000 sign-on bonuses to nurses and advertising significant salary increases for key specialties, such as pediatric or emergency room nurses.

The shortage, Weber stressed, is not among nurses aides, but among baccalaureate, master's and doctorally prepared nurses who are highly specialized.

Betty Brooks, a 24-year nurse studying at the university, said shortages in nursing are cyclical.

"It has ups and downs," she said. "I think our community is fortunate with the schools of nursing that we have. That may be why we don't see the shortage in our faces as much as some of the other areas do."

Most experts agree that the key to turning the shortage around is recruitment and retention.

Both Cape Girardeau hospitals actively recruit nurses by going to job fairs, working with students at the local nursing schools, advertising on the television and the Internet, sign-on bonuses and self-scheduling.

Patient care

Until the cycle moves on and the shortage is resolved, patients can protect themselves by asking a few questions before entering the hospital.

The American Nurses Association suggests patients ask about the education level of nurses who provide care and how much rest nurses get between shifts.

Jeannie Fadler, vice president of patient care services at St. Francis Medical Center, said it is common for hospitals to have openings almost all the time, but said she would certainly like to see all the positions filled.

"We certainly have excellent nurses here who have addressed any demand that the patient loads dictate," she said. "They've just been wonderful about that."

Sharon Stinson, director of patient care services at Southeast Missouri Hospital, said Southeast trains its nurses to work in more than one area so that they can go from one floor to the next, giving the hospital a little breathing room when it comes up short-staffed.

The nurse-to-patient ratio at both hospitals depends on the seriousness of the illness and how many patients are there. For example, severe cardiac patients typically get their own nurse, but there is only one nurse for every four cancer patients.

As word gets out about the shortage, Weber said more people who never considered nursing as a career are beginning to inquire about it. She said that pleases her because she knows how self-fulfilling and rewarding the profession can be.

"I think people are beginning to call and say, 'I hadn't really thought about nursing, but now I hear there are going to be lots of jobs. I hear the salary's going up. I hear there are a lot more opportunities. Tell me what this means,'" she said.

WHAT TO ASK

Before being admitted to a hospital, consumers can find out the number of registered nurses on staff by asking a few questions:

* Will I have an RN caring for me?

* How many patients are assigned to each RN on the unit where I will most likely stay?

* Are those RNs routinely required to stay beyond their schedule shifts?

* What is the hospital's policy on requiring a defined amount of time off for rest before returning to duty?

* How does the hospital provide for RN staffing when there is an unexpected shortage in the unit?

SOURCE: American Nurses Association