MISSOURI - A nursing shortage is coming, and despite local efforts to prepare, it will be hard to stop.
The Bureau of Labor Statistics predicts the number of registered nursing positions will increase by 26 percent between 2010 and 2020. The percentage is large enough to land nursing among the 30 occupations with the largest projected job growth.
The current nurse work force is aging. The average age for a registered nurse is 44.5, according to the American Association of Colleges of Nursing.
There aren't enough students to replace the nurses who will retire, says Dr. Kathleen O'Connor, Ph.D., the chair of the nursing department at Missouri Western State University.
Combined, the two forces spell trouble for health care organizations across the country. A 2012 report that appeared in the American Journal of Medical Quality predicted Missouri would be short 1,757 nurses in 2030. Kansas would be short 3,827. Nebraska, 238. Iowa, 1,243.
Area programs weighed in on what they're doing to prevent the 2030 predictions from coming true.
Fixing the shortage isn't as easy as accepting more students into nursing programs.
The Kansas State Board of Nursing limits how many students Highland Community College can take into its licensed practice nurse (LPN) and LPN to registered nurse (RN) programs. Highland Community College's LPN program holds 40 students. Its LPN to RN program holds 20, says Highland Community College's Director of Nursing, Cynthia Jacobson, who holds a master's degree in nursing. Highland gets about two to three times the applicants its programs can handle, Ms. Jacobson says.
Missouri Western also turns away applicants from its undergraduate nursing program; about 15 percent of candidates who qualify, says Dr. O'Connor.
Others schools can't expand existing programs. Northwest Missouri State University disbanded its in-house bachelor's of science in nursing (BSN) program several years ago. Dr. Mark Corson, the chair of Northwest's Natural Sciences department, said the decision resulted from a discussion with Northwest, Missouri Western and the state. There was concern about duplicating services, so Northwest switched to offering a pre-nursing program, which funnels students into other universities' BSN programs.
It also offers pre-nursing students RN certification through a collaboration with North Central Missouri College in Trenton, Mo. Northwest pre-nursing students can take classes with North Central Missouri faculty at the Northwest Technical School campus in Maryville.
The decision to switch over Northwest's program also reflected another limitation to the growth of nursing programs: clinical rotations. Highland, Missouri Western and nursing programs across the country run into the same problem.
"That's also a longer term issue for hospitals, having to handle the traffic for clinicals, so that we can produce the number of nurses we need to hire down the road," Dr. Corson says. "It's kind of a chicken and the egg issue."
Ellen Beaman, a nurse recruiter at Heartland Health, says the hospital coordinates as many student clinical rotations as it can. Some schools will do rotations during the night shift.
BACK TO SCHOOL
The new jobs for nurses also will require more education than positions did in the past. The Institute of Medicine is recommending more nurses seek higher education.
Two years ago, Highland Community College developed an associate's program that allows LPNs to get their RN certification.
Northwest and North Central Missouri College offer an online program to allow RNs to get their BSN degree. The schools plan to expand the program next fall with the addition of a new joint nursing director. Dr. Corson says both institutions will fund the new position, and the hope is to have someone hired by summer.
Missouri Western reopened its RN to BSN program in 2010, Dr. O'Connor says. The combination of online and in-person classes is designed for the working nurse, and unlike the BSN program, the RN to BSN program has room to grow.
But continuing education, too, will come with limitations in the future. Nurse educators need to have one educational level above the students they teach. While more nurses are going back to get their degree, experts still predict a shortage.
Neither Dr. O'Connor nor Ms. Jacobson say their institutions have had trouble filling faculty vacancies. Ms. Jacobson says she's always looking for nurse educators.
"If anyone's interested, they need to contact me ASAP," she laughs.
The good news is the nursing shortage is hitting later than expected.
"They actually predicted we would be in a real significant shortage now, particularly by 2015, but we've really seen the opposite effect, to be quite honest, because nurses have stayed at work or increased (their) amount of work," Dr. O'Connor says.
She says with the bad economy, many nurses prolonged retirement. Others went from working part time to full time.
Recent graduates actually are having a little bit harder time finding a job, Dr. O'Connor says. They all find placement, but it's not happening as quickly as in years past.
Heartland hasn't noticed any nursing shortage, either, Ms. Beaman says. The health system gets a steady number of applicants from Topeka, Kan., to Columbia, Mo., and hires new positions based on the patient use of services. When the demand does comes, she expects it to be in community health settings, not the hospital, however, as health care transitions more to outpatient care.
Jennifer Gordon can be reached at firstname.lastname@example.org. Follow her on Twitter: @SJNPGordon. ___