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Saturday, Sep 23, 2023

Extent of Nursing Crisis in Debate

It seems as though nurses should be easy to count. People would generally expect the LAUSD to know how many teachers there are in Los Angeles, or the LAPD to know how many cops there are. But nailing down the exact number of how many people are licensed to perform a complicated profession like nursing is a lot harder than it seems, and the Schwarzenegger administration disagrees with nurses’ unions on the number of nurses in California. Most hospitals in the Valley say there is a desperate need for more nurses, especially after the state became one of the first in the country to legislate nurse-to-patient ratios. Some, however, say that they’ve been able to reduce turnover and hire more nurses full time. The governor has apparently decided to proceed under the assumption that there is a critical shortage of nurses, promising to spend $90 million over the next five years to expand community college nursing programs. Schwarzenegger has not been popular with many of the state’s nurses after claiming that they are behaving like special interests by protesting his attempt to delay stiffer ratio laws that were to take effect in January. Starting last month, representatives from his administration have been visiting hospitals across the state to explain his plan to hire and educate more nurses throughout the state. On Monday, April 25, Labor and Workforce Development Center Secretary Victoria Bradshaw visited Verdugo Hills Hospital in Glendale to explain the plan and collect input from hospital and community college officials. Bradshaw said that California hospitals currently have 14,000 open positions for nurses, and not nearly enough to fill those positions. By 2010, she said, that number will have jumped to nearly 50,000, as older nurses retire and an older population logs more hours in hospitals. Private and community colleges only graduate 6,000 nurses a year, she said, and even have to turn applicants away. “Last year alone, we had 10,500 applicants to nursing schools, qualified applicants. And only 60 percent of those applicants got accepted, because there wasn’t enough room for them,” Bradshaw said. “As a result of that, what we do is import nurses. Forty five percent of the nurses currently in the state of California came from someplace else.” Bradshaw said that the governor’s plan consists of collecting $90 million in equal parts from the state, private industry and local foundations. Every year, the state will deliver $18 million in funding for nursing education at community colleges. Looking for feedback Leonard LaBella, president and chief executive officer of Verdugo Hills Hospital, said he supported any efforts to educate more nurses. “I think it’s a good thing they’re looking for feedback and recommendations from the folks that are going to be impacted (by the plan),” said LaBella, adding that the hospital spends up to $2 million every year on temporary nurses. “Anything that produces additional nurses or offers tuition assistance for eligible candidates or advances RNs or LVNs to degrees that allow them to teach is a good thing.” The California Nurses Association, however, said that while expanding nursing programs is one of its top priorities as well, the governor’s administration is using outdated figures in talking about available nurses. “The rumors of the shortage are greatly exaggerated,” said CNA spokesman Chuck Idelson. In 2002, Idelson said, the U.S. Department of Health and Human Resources projected the demand for RNs would outstrip the supply by more than 18,000 by examining trends that were in place in 2000. Idelson that after the ratio law was signed in 1999, nurses who had left California started returning and more moved here for the first time to find nursing jobs. Additionally, he said, turnover rates slowed and fewer nurses retired. Idelson said that by the CNA’s count, there are 22,000 more nurses in the state than the HRSA predicted. Some hospitals, he said, have taken advantage of this reversal. “Hospitals that are making good faith efforts to hire permanent nurses are able to so do. The best example is Kaiser Permanente, which actually has a waiting list as its seen its turnover rates plummet,” Idelson said. Signed into law in 1999, AB 394 required the Department of Health Services to set up specific nurse to patient ratios in California Hospitals starting in 2004, something that Kaiser said it’s been doing for years. “Kaiser has made this a major goal for the last eight years, to make sure we had enough work force,” said Donna Moore R.N., Nurse Executive for Kaiser in Woodland Hills. Strict requirements Kaiser has had stronger nurse ratio requirements than California requirements for years, Moore said, and those requirements coupled with a strong benefits package have made it easier for the company to maintain its nursing staff. Although the state and the CNA disagree on the number of nurses available in California, hospital administrators say the impact of the ratio law has been to raise all nurses’ salaries to the point that new graduates can demand up to $60,000 a year. This is a cost many hospitals say they can’t bear, no matter how many nurses are available. Hospitals, along with the CNA and the state, do seem to agree with the assessment that there needs to be an expansion of the nurse education system in light of the aging of nurses and the patients it treats. The CNA is pushing its own education funding bill through the Assembly, AB 232 which would distribute $45 million over two years to community colleges to support nursing programs. Meanwhile, community colleges are using their own creative solutions to make sure more nurses graduate and enter the workforce. One of the programs Glendale Community College participates in, said Sharon Hall, Director of Nursing Programs, is a partnership with California State University, Los Angeles to promote baccalaureate degrees in nursing. Students who want to apply for the nursing program at CSULA can take prerequisites and their first year of nursing at Glendale or L.A. Trade Technical College, and transfer to advanced nursing coursework at CSULA as students afterward as some students drop out.

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