Nursing shortage prompts summit Work conditions seen as problem

AUGUSTA – Maine is facing a nursing shortage crisis, but the state is not alone. The growing shortage is causing emergency rooms to back up, increasing the risk of medical errors and forcing hospitals across the country to scramble to find new nurses. The shortage led to a statewide summit Tuesday in Augusta.

“Maine cannot solve the problem on its own, but it can make a start and I think a start is being made today,” said keynote speaker Russell Cole, national strategy adviser for Superior Consultants, a Texas-based group. “I think all the key players are in the room and talking and that has not happened in all states.”

The shortages at state and national levels are dramatic. A study reported last year in the Journal of the American Medical Association projected the nation would be short 500,000 nurses – or 20 percent of what is needed – by 2020.

A survey completed in September by the Maine State Chamber of Commerce and the Maine Technical College System indicated a need for 1,584 additional registered and licensed practical nurses in the state by the end of 2002, while Maine’s public and private institutions will graduate only 531.

“Maine, like the rest of the country, will have to address this shortage,” Cole said.

He said the problem needs to be dealt with at state and national levels, and with both short- and long-term solutions. And he said it would take more than additional financial resources to solve the shortage. Nancy Formella, senior nurse executive at the Dartmouth Hitchcock Medical Center in New Hampshire, who addressed the afternoon session of the summit, agreed and said there is no single solution that will work everywhere.

“We have to work to get more people into the profession in the short term and look at the changing nature of the profession over the years to come,” she said, “We need to ask and answer what nursing will look like in 2010 and how we prepare for that change.”

In small group discussions, several nurses said working conditions are as much a problem as pay. In fact, the 11,430 registered nurses in Maine made an average $42,240 last year, according to Labor Department figures. Many said flexibility is a key to improving job satisfaction, not just pay levels.

“There are a lot of reasons why people go into the profession, and a lot of reasons why they do not,” said Helen McKinnon, president of Nursing Leaders of Maine and patient care administrator at Eastern Maine Medical Center in Bangor. “One thing is clear, we need to do more to promote the profession.”

McKinnon said nurses need to do more one-on-one meeting with students, at both the high school and middle school levels, to explain nursing and recruit new members to the profession. She said too many nurses actually have discouraged friends and family members from pursuing a career in the field and that has affected recruitment.

“It’s just one of many things we need to do,” she said. “As nurses, we need to do more to recruit new nurses.”

Some efforts to graduate more nurses are working, summit participants said, and need to be expanded. Jane Kirschling, dean of the College of Nursing and Health Professions at the University of Southern Maine, said a program based at the Lewiston-Auburn College has been successful.

“We have a lot of employers that are willing to pay for the courses if the person wants to enter nursing,” she said. “This is a public-private partnership that works and we should look to expand it throughout the state.”

State Sen. Susan Longley, D-Liberty, co-chairwoman of the Legislature’s Human Resources Committee agrees. But, she said that with the state facing a $250 million revenue shortfall it will be difficult to find additional funds to expand any program in the coming year.

“This is so important to the future of our state, I think we need to find the money to do something this session to at least chip away at the problem,” she said. “The kind of program where we can make the public dollar go further, like the partnership idea, is what we need to do.”

Longley said it is also important for Congress to allocate additional resources.

There are several proposals pending in Congress, including tax breaks for nurses and grants to schools that provide nurse training. None of the proposals has been funded.

“We need to roll up our sleeves and tackle this problem, because nurses on the front line of patient care are critically needed,” said U.S. Sen. Olympia Snowe of Maine. “Reimbursement challenges, government regulations and rising costs are all taking their toll on health care, and the added challenge of a critical work force shortage in direct caregivers threatens to undermine quality patient care.”

Snowe is co-sponsoring legislation that would provide federal funding for nurse education and nurse-aide training, and to establish a National Nurse Service Corps scholarship program. The measure also would provide tax breaks for nurses who serve in the program.

“Reversing the dwindling numbers of nurses will require a sustained commitment on the part of our federal, state and health care leaders,” said U.S. Sen. Susan Collins of Maine.

Collins serves on the Senate Health and Education Committee which last month approved a measure authorizing $35 million in grants to help train more nurses. It also would provide additional funds for students.

Dean Kirschling said nursing schools certainly could use additional federal aid. She said current federal programs are woefully underfunded and many Maine schools that qualify for help have not received funds.

But, with resources scarce at state and federal levels, it may be a year or more before additional funds are available to bolster nursing programs. Participants at the summit pointed out it takes four years to obtain a bachelor’s degree in nursing, and if additional resources are not allocated to address the nursing shortage, it will become a more expensive problem in the future.

“This is truly a penny-wise and pound-foolish situation,” Longley said. “We need to spend some [money] now, or we will have to spend a lot more in the future.”