RN Hiring By Hospitals On Upswing

By Andy Miller
Atlanta Journal-Constitution


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Job vacancies show decline in Georgia

November 13, 2003

Seven years ago, Mary Anne Kester left the work force to stay home with her children. But last year, when her husband lost his job, Kester went back to work. "We needed some income,'' she said.

Fortunately, plenty of jobs were available in nursing, her former field.

After going through a nurse re-entry program at Piedmont Hospital, Kester, 43, is doing weekend shifts on the orthopedic floor of the Buckhead hospital. "At first I was nervous, but after I got back into it, it was good.''

Kester is part of a recent wave of registered nurses going into hospital work.

A study in the journal Health Affairs, released Wednesday, shows that hospital employment and wages of registered nurses rose sharply in 2002, suggesting an easing of the nursing shortage. A weak economy and an influx of foreign-born and older nurses has helped spark the hiring surge.

Separately, state health officials also reported that RN vacancy rates for Georgia hospitals dipped from 12.9 percent in 2000 to 10.4 percent in 2002. The Georgia rates are generally holding steady this year, hospital officials say.

But experts point out that the nursing shortage hasn't ended -- and it may worsen again soon. There's a huge need ahead for health care workers in Georgia, state officials say.

The Health Affairs study's lead author, Peter Buerhaus of the Vanderbilt University School of Nursing in Nashville, used data from the Census Bureau's household-based survey to find that RN employment in U.S. hospitals grew by more than 100,000 in 2002, a 9 percent jump from the previous year.

Meanwhile, RN employment in other settings, which had been increasing, fell about 1 percent in 2002, the study found.

Nurses who are older than 50 and foreign-born RNs account for much of the rise in hospital RNs. The weak economy also has driven many nurses -- whose spouses were affected by the tougher financial conditions -- back into hospital care.

The hospital nursing shortage began nationally in 1998, as nurses confronted stagnant wages, overly stressful working conditions and job opportunities in other settings.

Higher salaries have played a factor in the recent hiring spurt. Wages for hospital RNs rose almost 5 percent in 2002, double the rate for nurses in non-hospital settings, the Health Affairs study found.

"Salaries are going up, no doubt about it,'' said Jeff Prescott, a spokesman for Nashville-based HCA, which employs about 90,000 nurses in its 190 hospitals, 14 of them in Georgia. HCA's vacancy rates have dropped slightly, he said.

Lorna Martin, vice president of nursing at Piedmont, said RN salaries there have increased 5 percent to 10 percent. The hospital's RN vacancies are down slightly, she said.

Other metro Atlanta hospitals also report a slight lessening of hiring difficulties. "We feel the shortage has eased a bit,'' said Russ Davis, a spokesman for Northside Hospital in Sandy Springs.

Now full time

Some nurses formerly working part time have switched to full time, said John Hursh of Southern Regional Medical Center in Riverdale, where the vacancy rate during the past two years also has fallen.

Hospitals credit strategies such as re-entry programs for nurses who have been out of the hospital work force. And they cite loan and scholarship programs for nurse education programs.

Mary South, 53, of Senoia started nursing school in 2000 to help support herself after a divorce. South began work in May as an RN at Southern Regional, which, along with other aid programs, is helping to pay off her school loan.

RNs from other countries are likely to play an increasingly large role in U.S. nursing, the Health Affairs study said.

Anabelle Espinoza, a nurse from the Philippines who has been at Piedmont Hospital since 1988, said many nurses come to the United States from her native country because of the higher wages and better medical technologies.

One week's salary in the United States equals one month's salary back home, Espinoza said.

Yet Myra Carmon, president of the Georgia Nurses Association, said recruitment of foreign nurses isn't the answer to the RN deficit. "Other countries have nursing shortages and are left with a deficit of nurses,'' Carmon said.

The improved RN staffing picture means a softening hospital demand for temporary agency nurses, Vanderbilt's Buerhaus said.

ATC, an Atlanta company that supplies temporary RN help to hospitals, has sustained a 30 percent revenue drop this year because of less demand for temp nurses, said Bill Dallas of ATC.

"Because of the weak economy, a nurse may have become a primary breadwinner in her family,'' Dallas said. Some nurses are seeking a health benefits plan for their families, he added.

"Many of us believe this is a short-term phenomenon'' until the economy picks up more steam, he said.

Georgia hospitals have focused harder on retaining nurses, says Debbie Hatmaker, chief programs officer for the Georgia Nurses Association.

But she added that nurse-patient ratios appear to be the same as during the height of the shortage.

Carol Cooke, a spokeswoman for the American Nurses Association, said working conditions still must be improved. She cited proposals for minimum nurse-patient ratios and ergonomic aids to help older nurses.

"Mandatory overtime is really a killer for nurses,'' Cooke said. "It leads to burnout and errors.''

A recent national Institute of Medicine report found that many hospitals and nursing homes are endangering patients by allowing or requiring nurses to work more than 12 hours a day.

Retirement issues

Despite the hiring improvements, Georgia's RN outlook remains fragile.

The state Department of Community Health points out the median age of the state's RNs is 48. "Many nurses will begin to retire when baby boomers retire,'' said Ben Robinson, DCH's manager of work force initiatives.

Meanwhile, he noted, the state's population will continue to grow.

By 2010, Georgia will need more than 140,000 new and replacement health care workers -- about 30,000 of them RNs, the state says.

Nursing experts, though, point to a lack of education capacity.

U.S. nursing schools turned away more than 5,000 qualified applicants because of shortages of faculty and space in 2002, the Health Affairs study said.

"Right when we needed the nurses the most, we can't take those who are interested,'' said Buerhaus, who called for strong action by Congress to meet this need.

Martin, of Piedmont, added that Georgia nursing schools have seen an increase in applications, ''but 50 percent are turned away, because of not enough faculty.''

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