Hospitals Struggle to Retain Nurses
Compared with other states, California is facing a "particularly acute" nursing shortage, the Inland Valley Daily Bulletin reports. According to a 1996 HHS study, California ranked 50th in the country in the number of registered nurses per 100,000 people, employing 566 RNs per 100,000 people compared to the national average of 798 RNs per 100,000 people. In addition, California's RNs are older on average than those in most other states, according to an American Hospital Association survey conducted this year. The average age of California's RNs is 47, compared to the nationwide average of 42.3. The Daily Bulletin attributes the shortage to a number of factors, including a limited number of slots in nursing education programs. California's 90 nursing programs "aren't producing nearly enough graduates to meet the growing demand of California hospitals," the Daily Bulletin reports. Karen Hanford, dean of the College of Graduate Nursing at Western University of Health Sciences in Pomona, said, "Fifty percent of the nurses in California were imported from other states. We don't produce nearly enough nurses for the jobs that are out there. Every school that offers nursing is full." In addition, the nursing profession has become a less attractive calling, with "flat" pay scales and "relentless" hours. Moreover, fewer women are now choosing nursing, a historically female-dominated field, over other careers.
Further complicating the nursing shortage, a new state law set to take effect Jan. 1 will impose staffing level standards at California hospitals. To remedy the situation, hospitals have employed myriad strategies to recruit and retain nurses. Upland's San Antonio Community Hospital has hired temporary nurses to "help fill the gaps." Vicky McCain, San Antonio's vice president of nursing, said, "We use registry staff from dozens of nurse staffing agencies. But there's a learning curve involved. It puts an extra burden on our nurses in terms of orienting the new people and showing them the ropes." And the expense of hiring registry nurses is "significant," according to Chino Valley Medical Center CEO Steve Dixon. Chino also imports "travel nurses" from around the country who are hired for several months at a time. Some hospitals are stepping up efforts to retain nurses through professional development programs. Pomona Valley Medical Center has established four distinct nursing levels -- novice, competent, proficient and expert -- and nurses' salaries are based on their designated level of expertise. Linda Johnson, Pomona's vice president of patient care services, said the hospital's goal "is to team the novices up with more educated nurses so they ... have a better opportunity for professional growth." San Antonio Community Hospital has employed a similar strategy. McCain said, "We're looking at the salary benefit packages we have, and we've also lengthened the orientation program for nurse graduates when we hire them. Now they have a three-month orientation under an experienced RN." The Health Care Association of Southern California has launched "critical" efforts to help "preserve and expand" nursing programs, lobbying state and federal lawmakers to increase funding for nursing education (Smith, Inland Valley Daily Bulletin, 11/13).
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