Nursing is a competitive market here in eastern North Carolina, so landing a job isn’t the hard part, it’s filling the positions that’s the greatest challenge. There are occupational nurses who work at manufacturing facilities, private nursing care in homes, nurses who treat students in schools, and of course there are hospital nurses. It can be a stressful job with long hours but registered nurses have an earning potential of about $60,000 a year in North Carolina.
Right now is a good time to consider this career path because the whole country is facing a chronic nursing shortage. Our aging population needs health care workers and companies face greater challenges recruiting and hiring experienced workers. The deficit has been ongoing for decades, but several factors coming into play now are making it worse. CEO of the North Carolina Nurses Association Tina Gordon.
“The baby boomer population is so much larger than the younger generation and that population has started to retire. And so not only do those baby boomers need more healthcare because of their age, the baby boomers also include nurses, so the nurses are the ones retiring.”
Even though nursing is one of the fasting growing occupations in the country, Gordon says the supply of new, skilled nurses entering the workforce each year is still not keeping up with the demand.
“People are living longer, there are increasing incidences of chronic disease, and when you combine that with an aging nursing workforce, you have conflict.”
Impacts from the nursing shortage vary regionally, with some parts of the state having more need than others.
“The rural areas of eastern North Carolina are probably struggling the most to try to find qualified nurses to fill their position especially in areas such as long term care, psychiatric and mental health care. We also see some pockets of shortage in emergency care.”
At Carolina East Medical Center in New Bern, the nursing shortage is striking as more experienced nurses retire or ramp down to part time roles. Vice President Chief Nursing Officer Roseanne Leahy.
“Being in a moderately sized medical center in a very small community, sometimes it’s difficult not just in nursing, but in other clinical fields, to fill the positions that we have.”
In addition to increasing recruitment and retention efforts, Leahy says Carolina East is using as many creative staffing options as possible, such as incentivizing full and part-time employees to take on additional hours or even shifts.
All of the health systems in the region, including Carolina East are competing for newly trained nurses coming from local community colleges, the University of North Carolina Wilmington and East Carolina University’s College of Nursing. Leahy says they are offering enticing incentives to attract these nurses to New Bern.
“We provide sign on bonuses and relocation packages for registered nurses. And this year, we are doing something a little different. We are instituting a transition to practice nurse residency program. And we’re going to begin that with the new graduates for this year. And it’s a 12 month long residency program really intended to nurture that young nurse.”
At Vidant Medical Center in Greenville, impacts from the nursing shortage started showing up just within the past couple of months, most notably in specialty areas like intensive care unit, operating room, emergency room and labor and delivery. Senior Vice President, Nurse Executive Linda Hofler says they too are offering incentives for new nurses and they’re bringing in retired, experienced nurses for part-time positions.
“We’ve added more flexible staffing options for folks that maybe as they’re getting older, the 12 hour shift is not as friendly to older folks as it is to young people and so having that different shift work options. We also do a new graduate residency program which allows anybody that comes to us without experience to spend a very extended orientation with a very highly skilled trained coach so that they are feeling confident by the time they have to be independent caring for patients.”
It’s difficult to put the scale of the shortage into perspective because some institutions are just starting to notice the trend. At Onslow Memorial Hospital in Jacksonville, there is a steady infusion of nurses coming from Coastal Carolina Community College and Camp Lejeune military dependents. Still, Chief Nursing Officer Crystal Hayden said in an email that they are noticing fewer applicants for open positions and more competition for nurses on the job market.
While there’s no simple solution, universities and community colleges in North Carolina are in agreement that encouraging students to pursue a four-year nursing degree is a step in the right direction. Dean of East Carolina University’s College of Nursing Dr. Sylvia Brown.
“The Institute of Medicine put out a report in 2008 saying that we needed to increase the number of baccalaureate prepared nurses to 80 percent nationally. Currently, in North Carolina, we have about 40 percent of nurses prepared at a baccalaureate level.”
ECU partners with six community colleges in eastern North Carolina for the Regionally Increasing Baccalaureate Nurses program, or RIBN, which provides a four-year nursing degree option for students.
“They go to the community college and get the associate degree, become a registered nurse and then they finish their last year at ECU. So it’s a little more economical for them and it’s a way to increasing the capacity of educational preparation for the workforce.”
Craven, Lenoir, and Pitt Community Colleges, Beaufort County Community College, Roanoke-Chowan Community College and College of the Albemarle are a part of the ECU’s RIBN program.
“To add to that, we also have an online RN-BSN program that is for people who are already are nurses who want to come back and get a baccalaureate degree. They’ve graduated from the community college and they’re nurses and they come back. We currently have about 130 in that program.”
In mid-January, the North Carolina Community College board met to talk about the future of nursing in the state, and explore several recommendations seeking to increase the number of baccalaureate prepared nurses. One of which included letting two-year community colleges offer four year nursing degrees. The board later opted not to conduct a feasibility study. Senior Vice President for Programs and Student Services and Chief Academic Officer with the State Community College System Lisa Chapman says the board did provide recommendations to address the shortage, such as expanding the RIBN program at community colleges statewide and increasing RN to BSN online programs.
“This fiscal year, we are looking at developing a statewide communication and marketing campaign that really addresses educational options for nurses in the community college system. We have some programming with dual enrollment in the high school, that’s what we call Career and College Promise that can really help students begin the process and the course work they could use in their RIBN program, starting with some of those courses in high school.”
It seems like a plan is starting to come together to address the shortage here in North Carolina, but community colleges and universities alike must also solve an additional problem. North Carolina Nurses Association Tina Gordon explains.
“We have qualified applicants to nursing schools being turned away because there is not enough capacity in those schools to train those nurses and push them out to work on the other side.”
The impacts of a teacher shortage are being felt at ECU’s College of Nursing, which produces the most new nurses of any four year institution in North Carolina. Dean of ECU’s School of Nursing Dr. Sylvia Brown.
"There is a nursing faculty shortage, again because of the aging faculty that we have. We're just not able to keep up with the demands. We do have a doctoral program that prepares people to be able to teach and we also have a masters option that's called the Nursing Education Concentration. And so we prepare about 50 students each year, graduate from that program, that prepares them to teach in either the community college or in any university program."
However, Brown says not enough students want to become faculty because they can make more money in a clinical setting than in an educational setting. NC Nurses Association’s Gordon believes the state should offer incentives to entice nursing students to become faculty.
"People ask me all the time, what are we going to do about the nursing shortage? We've really got to go out and encourage some more people to become nurses. Well, that sounds great but truthfully, we have lots of people today who want to be nurses and are qualified to get into nursing school, but the space is not there."
There is not an easy solution to the nursing shortage here in North Carolina, but at least there is work being done to solve the problem. But with fewer nurses available to care for patients, there could eventually be a lapse in quality of care. This was evidenced in a new study from the University of Pennsylvania School of Nursing which found that inadequate nurse staffing and poor nurse work environments could affect patient care. The article in Science Daily.com says patients who received elective hip and knee surgeries in hospitals that were understaffed were more likely to require re-hospitalization.