- Associated Press - Friday, November 27, 2015

JOPLIN, Mo. (AP) - Jessica Hill knew that she wanted to be a registered nurse and that she would have no trouble finding a job - anywhere she wanted.

That’s because the demand for nurses is once again a major health care issue. Local hospitals are wooing nurses with signing bonuses and other incentives to get them to come on board. But there was no need for Mercy Hospital Joplin to entice Hill.

“I knew that I wanted to work for Mercy and be a part of the ER family here,” said Hill, who received her clinical training at Mercy. She will graduate in December from the nursing school at Missouri Southern State University.

But Hill is fully aware that she could get a job anywhere with her degree in nursing because the demand is so great. It is estimated that an additional 1.1 million nurses will be needed within the next five years, according to the Bureau of Labor Statistics.

The Joplin Globe (https://bit.ly/1P1chQk ) reports that both Mercy and Freeman Health System have 60 openings for nurses. Both institutions have held recruitment fairs in recent weeks to fill those spots.

What is causing this unprecedented demand? Observers of employment trends in health care say a number of factors are coming together to create this perfect storm.

The big factor is a demographic one - the age of registered nurses in the United States. According to the American Association of Colleges of Nursing, 55 percent of the current registered nurse workforce is age 50 and older. One million registered nurses are expected to reach retirement age within the next 10 to 15 years.

The Affordable Care Act is another contributing factor because it has helped 16 million previously uninsured people gain coverage since 2010.

When those factors are coupled with the aging baby boomer population and the fact that more people are living longer with chronic medical conditions, the need for more registered nurses becomes clear. But how do you meet this unprecedented demand? The answer to that is not so clear.

Dr. Sheryl Hill, interim director of the School of Nursing at MSSU, said, “There was a nursing shortage when I was in school 25 years ago. This is nothing new.”

Nursing schools, like hospitals, are struggling to find qualified faculty. In fact, the nursing faculty shortage has become the largest component in the clinical nurse shortage. In 2014, 13,444 qualified applicants were turned away from master’s degree programs, and another 1,844 qualified applicants were turned away from doctoral programs primarily because of faculty shortages, according to the AACN.

The AACN said an additional 34,200 post-secondary nursing instructors and teachers will be needed by 2022. Of those, 24,000 will be new positions and 10,200 will be to replace current instructors.

At MSSU, Hill said, “We are fully staffed. But we could produce more graduates if we had more faculty and more areas for clinical training. In the near future, we could have two classes instead of one per year. We are moving in that direction.”

Right now, the school is producing 61 graduates per year, but the program receives 95 to 130 applications per year. The graduation rate for the 2015 class is 97 percent.

“That is far better than the national average, but typical for us,” she said.

Tina Lear, director of the Missouri Center for Nursing, said, “There is a shortage of nurses and its only going to get worse, and it’s just not hospital nurses. There are more opportunities for nurses than ever before. They are being hired by insurance companies, community health programs and schools. Emerging sectors are taking nurses away from hospitals.”

The center, she said, strives to improve the health of Missourians through nursing by offering leadership training to nurses. The center, as an example of its work, is trying to find ways to help military medics enter the nursing workforce.

She said studies show the quality of care increases as the education level of the nurse increases. “This means better quality outcomes,” she said.

Dennis Manly, chief nursing officer at Mercy Hospital Joplin, said, “All hospitals have a need for registered nurses. This is something we are constantly working on.”

About three weeks ago, Mercy staged a nurse hiring fair. Freeman put on one earlier this week.

“We had some applicants accept positions with us,” Manly said. “We would have liked to have had more. We offer them an incentive to sign and we offer bonuses to our employees who make a referral.”

Because both hospitals are seeking nurses, it is possible one may be pulling nurses away from the other.

“That does happen, but it does not happen a lot,” he said.

Manly said the hospital manages its nursing shortage by offering its nurses the opportunity to work open shifts to earn more money. It also hires temporary staff to fill the positions.

“This has not impacted care because these openings are in noncritical areas,” he said.

When an area doesn’t have enough health professionals, it is designated as a Health Professional Shortage Area (HPSA). Across the United States, there were 6,087 HPSAs as of April 2014. Missouri is among the states with the lowest percentage of needs met. It’s under 40 percent. Nationally, that rate is 60 percent, according to data from the Henry J. Kaiser Family Foundation.

Nurses are doing their jobs with too few hands on deck. According to the American Nurses Association, 40 percent of nurses report short-staffing in their hospital units and an increase in overtime, while 54 percent report excessive workloads. In addition, 96 percent say they’re fatigued before their shifts even start.

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Information from: The Joplin (Mo.) Globe, https://www.joplinglobe.com

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