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Thursday, Sept. 4, 2008 02:08 pm

Critical condition

How Springfield is handling the nursing shortage

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Registered nurse and LLCC trustee Cinda Edwards
PHOTO BY RYAN WILLIAMS

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t's the first day of the fall semester and Cynthia Maskey, associate dean of nursing at Lincoln Land Community College, has already lost one of her teachers.

An adjunct nursing instructor gave up the part-time teaching position in Springfield for a full-time job with benefits in another city.

Despite the instructor's departure coming in the middle of the perennial day-one ritual of scaring the scrubs off entrants to the school's rigorous nursing program, Maskey doesn't have any hard feelings. She says the woman made a decision that was best for her family, plus she did Maskey a favor by agreeing to help out until the school finds her replacement.

Besides, that's just how it goes these days. "We snatch each other's faculty away all the time," says Maskey, who has spent her entire 21-year teaching tenure at Lincoln Land.

With the allure of big bucks at hospitals for nurses — the healthcare professionals who administer shots, dress wounds, and provide day-to-day patient care — it's no surprise that few are willing to put in extra study hours needed to earn a master's degree only to make less money teaching the next generation of nurses.

However, with so many new practitioners stuck in the bottleneck of nursing school, with too few experienced nurses to train them, members of the aging and ailing baby boom generation will not get the healthcare services they'll need. At Lincoln Land, for example, students seeking admittance to the registered nurse program can wait anywhere from a year to 18 months before being admitted.

Statistics are from an Illinois Department of Financial and Professional Regulation survey of 18 counties, including Sangamon County, in October 2007

The situation is the worst Maskey has seen in her two decades at the college, and is likely to strain Illinois hospitals, nursing homes, and even state prisons. Health facilities across the spectrum are facing severe understaffing problems, putting patient care and nurses' safety in jeopardy.

Maskey recalls surpluses of nurses in the mid-1980s and the mid-1990s, but no more: "In the past, there've been nursing shortages and nursing gluts. But that doesn't happen anymore. This is the shortage that is here to stay."

egistered nurses, who make up the largest segment of healthcare professionals in the U.S., have really been in short supply since World War II. In 2000, there were 110,000 fewer nurses than needed — a figure that is expected to triple by 2020. In fact, even the nurses will need nurses as the average age of RNs is about 47.

Illinois fully recognizes the scope of the nursing shortage crisis, as outlined in an Illinois Department of Financial and Professional Regulation workforce survey completed in the fall of 2007.

The report identifies an aging nursing workforce, challenges to recruitment and retention, and too few faculty as primary obstacles to alleviating the state's nursing shortage. Shoring up the state's pipeline of available nurses within five, 10, and 15 years is key, according to the report. In addition, it goes on to say, "While the issue of how to attract people into nursing is important . . . workforce planners have to begin thinking strategically about how to retain nurses already in the workplace," or keep "wisdom in the workplace."

Age is another factor, as many nurses are themselves baby boomers. In an 18-county region of west-central Illinois that includes Sangamon County, 64 percent of registered nurses are over the age of 45.

There have been attempts to intercede, however. In 2006, Gov. Rod Blagojevich authorized $3.5 million in initiatives aimed at offsetting the shortage of nurses in the state. Despite these efforts to bolster the number of nurses working in Illinois, critical gaps remain.

Nowhere is the need more pronounced than in state prisons. Earlier this month, Illinois Department of Corrections officials issued a directive ordering that inmates requiring acute medical care not be housed at Stateville or Pontiac correctional centers "until nursing staffing is improved."

Elwood Thompson, program director for Illinois Nursing Association, which represents healthcare workers, says his members, who provide care for inmates, guards, and civilians working in the prisons, are overburdened with huge caseloads.

Thompson says that at one prison, there's a correctional officer who just happens to also be registered nurse and sometimes steps in to relieve the staffing shortage.

"You're a nurse and a guard? Well can you nurse and guard at the same time? What kind of strain does that put on the employee?" he wonders. "That puts us in a quandary because we want [patients] to get the help. We want the services provided but we don't want some Band-Aid solution to end up being a long-term solution."

Stephanie Riney is a nurse at Memorial Medical Center.
PHOTO BY RYAN WILLIAMS

Derek Schnapp, spokesman for the IDOC, says that addressing the shortage is a priority for the agency as well as private companies with whom the state contracts to provide nursing care at IDOC facilities — Peoria-based Health Professionals Limited and Pittsburgh, Pa.-based Wexford Health Services.

"IDOC realizes that there is a competitive environment for nurses. There may be some shortages at some facilities, however, IDOC as well as our vendor, aggressively recruits nurses," Schnapp says.

Thompson, whose organization is currently in contract talks with IDOC, says he sympathizes with the current budget crunch but that the well-being of INA members is paramount.

"I feel for the state, but I feel more for my nurses," he says.

ursing professionals also say fewer young people are going into nursing. Even though LLCC's waiting list contains the names of hundreds of students, Maskey says she has seen fewer young people these days coming into the field that "involves long hours and hard work."

It takes "a special person" to be a nurse, agrees Sharon Canariato, director of nursing practice for the Illinois Nurses Association.

"You have to be caring and compassionate. I would want to see that kind of person in a nursing role. If they're just in it for the money, they won't be satisfied," she says. "There's nothing better than knowing you helped a patient or sitting with senior citizen and hearing their life story."

Recognizing the need, hospitals such as Memorial Medical Center in Springfield have set up programs to introduce high school students to the nursing field and put them on the path to eventually landing jobs through the hospital's Teens Experiencing Nursing, says Jennifer Davis, a Memorial human-resources director. In addition, 10 to 15 of Memorial's nurses serve as adjunct faculty to area nursing education programs.

Statistics are from an Illinois Department of Financial and Professional Regulation survey of 18 counties, including Sangamon County, in October 2007

Another reason for the nurse shortage, says registered nurse and LLCC trustee, Cinda Edwards is that more career opportunities exist for women today. When she was a young woman contemplating her career, she wavered between teaching and nursing. Although both fields ensured employment security, Edwards chose to become a nurse instead of a teacher. In the 29 years since graduating from Lincoln Land, Edwards, says she's seen more opportunities open up within the nursing field.

Many nursing students, she says, choose to go after more lucrative jobs as nurse practitioners and nurse anesthetists, who work alongside anesthesiologists and earn more than $100,000 per year, both of which require advanced degrees. Such specialties don't double as conventional nurses.

"It doesn't take the place of a nurse. You still need somebody that takes care of the patients at the ho­­­­­­­­­­spital and somebody that administers the shots, gives the medicine, does the IV, does the dressing change. And if you're going to school to be a nurse practitioner or a nurse anesthetist you're not really filling that role," Edwards says.

Additionally, Edwards, a nurse at Springfield Priority Care, says nurses nowadays devote more time processing insurance forms and dealing with other forms of red tape.

LLCC Associate Nursing Dean Cynthia Maskey
PHOTO BY RYAN WILLIAMS

"The insurance rules and all that are a huge part of the job so you spend a lot of your time doing paperwork and not the part that you enjoy — actually spending time with the patients," she says.

­­­The way Canariato sees it, nurses are just getting burned out faster, which puts patients and nurses' careers at risk.

"All of the research shows that when a nurse is fatigued, the chance of error skyrockets. If she makes a great enough error she could lose her license.

"It's hard to go into work every day when there's not enough staff," she says.

Contact R.L. Nave at rnave@illinoistimes.com

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