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Tough economy shields area from nursing shortage

Friday, October 30, 2009 - Tough economy shields area from nursing shortage

By Gail Appleson and Blythe Bernhard St. Louis Post-Dispatch, October 30, 2009

There's at least one good thing to be said about this tough economy. It has temporarily shielded St. Louis and many other areas from a national nursing shortage that threatens to become the worst in history.

"We've got a little window ... a little hiatus," said Coreen Vlodarchyk, vice president of patient care services, the chief nurse executive at Barnes-Jewish Hospital. "This economy and the hard work done by many of our managers to reduce turnover is making our vacancies very low. Right now, it's even a little hard to find a job in St. Louis."

With spouses losing jobs and savings plans diminished, middle-age nurses are putting off retirement and part-time nurses are asking for more hours. In addition, people who were laid off in other industries are turning to nursing as a second career.

Phil Stalling went back to school for a nursing degree at age 43 after taking a buyout from a struggling printing company in Illinois.

"I thought at that time, I like science and I thought there was job security involved in nursing," said Stalling, now 56.

Stalling started with a two-year degree and is now working on a master's degree at Goldfarb School of Nursing at Barnes-Jewish College. As an operating room manager at Barnes-Jewish Hospital, Stalling said hiring requirements for nurses are more selective.

"We rarely hire anybody that doesn't have experience," he said.

The result is fewer openings, particularly for new graduates.

According to the Missouri Hospital Association, the overall vacancy rate -- a measurement of open positions -- for registered nurses in hospitals was 7.8 percent for the whole state at the end of 2008. St. Louis had a vacancy rate of 5.7 percent.

The Illinois Hospital Association did not have data for a comparable period. But St. Elizabeth's Hospital in Belleville is not "struggling with the shortage, which is very comforting," said Louis Pounds, manager of people services.

Vlodarchyk said a normal national vacancy rate before the downturn in the economy ranged from about 11 percent to 22 percent.

"We're (Barnes) at 3.6 percent vacancy now, which for a place this size is phenomenal," she said.

St. Anthony's Medical Center also has few openings with a vacancy rate of about 4 percent, down from 9 percent in July 2008. Certain nursing specialties, including cardiac intensive care and behavioral health, are more likely to offer job opportunities, according to the hospital.

George Mihaljevic left a nursing job at St. Anthony's in 2007 to work at a biodiesel plant but returned after the plant closed.

"There were other avenues, but I came back to what I know best," Mihaljevic said, adding that it wasn't difficult to get his old job back in St. Anthony's emergency department.

"People will always be sick, that will never change," he said.

At SSM Health Care, the overall vacancy rate for nurses is about 6 percent with the opening of St. Clare Health Center in Fenton creating more positions.

"We have positions available but not the variety. Nurses coming out of school don't have as many choices, said Debbie Walkenhorst, SSM regional vice president, human resources. "Vacancies and turnover are being artificially depressed because of the economy."

Some hospitals have reduced the perks often offered to lure nurses. Earlier this year, SSM temporarily suspended reimbursement for continuing education for all employees. The health care system, which runs seven hospitals in the St. Louis region, has indefinitely suspended its student loan forgiveness program.

But health care experts predict the situation will change dramatically as the economy improves. An aging baby boomer population means there will be an exodus of retiring nurses and nursing school faculty members at the same time there is an increasing number of hospital patients.

"It's a pipeline issue," said Michael Evans, dean and professor at the Goldfarb School of Nursing. "The shortages will be across the board and will spread out over the next decade."

Because registered nurses over 50 will soon be the largest age group in the nursing work force, their retirement over the next decade will lead to a projected shortfall developing by 2018, according to a study published recently in the journal Health Affairs. By 2025, there will be a shortage of 260,000 registered nurses. That's twice as large as any nursing shortage experienced since the introduction of Medicare and Medicaid in the mid-1960s.

However, area schools have been initiating programs and other innovations to try to meet the projected need. Those efforts include an increasing number of accelerated baccalaureate and advanced degree programs to turn out nurses and faculty more quickly.

Linda Ditzler will complete a one-year accelerated nursing program at Goldfarb in December.

"I felt like there was a sense of urgency because there was a nursing shortage," Ditzler said. The slumping economy doesn't worry Ditzler, who says nurses have many options, especially if they're willing to look outside of hospitals.

"I feel pretty hopeful about working somewhere," said Ditzler, 54. "You have to be willing in any career change to realize that you're probably going to have to come in at an entry level."

Students who already have a bachelor's degree in a non-nursing major can also become a registered nurse in 12 months through a program that was pioneered by St. Louis University School of Nursing. The program, the accelerated baccalaureate option established in 1971, was the first of its kind in the country. It was the brainchild of a former nursing dean, Sister Teresa Noth, who spent over three years earning a bachelor's of science in nursing degree even though she held a bachelor's degree in chemistry, said Teri Murray, dean of St. Louis University's School of Nursing.

Nursing schools aren't worried that there will be a lack of interest. The economy has already boosted demand to the point where schools are turning away many applicants because they cannot accommodate so many students.

"Nursing has been called recession-proof. People know nurses will be employed," said Juliann Sebastian, dean of the College of Nursing at University of Missouri-St. Louis. "But it's more than that. Nursing is challenging and rewarding. It's a field that demands the best of your intellect and the best of your heart."