Texas, hospitals work to address nurse shortage
July 13, 2010, By JASON ROBERSON / The Dallas Morning News
The state is facing a shortage of 71,000 nurses by 2020 as demand continues to outpace supply, the Texas Department of State Health Services says.
Tens of thousands of qualified applicants have been turned away from nursing schools for at least five years because there aren't enough teachers to conduct classes or enough clinical sites where students can get hands-on experience.
Across the country, experts predict a shortage of more than 260,000 nurses by 2025.
If the shortage is not addressed, the lack of trained caregivers threatens to flat-line the government's health care overhaul law, of which many provisions, such as widespread coverage of the uninsured, start in 2014.
The number of nurses in the country is projected to begin decreasing after this year, according a report from PricewaterhouseCoopers, a tax and business consulting firm.
Many nurses are expected to retire just as baby boomers begin turning 65 and need more health care. The average age of a nurse faculty member in Texas is 54. Almost 57 percent of all nursing faculty will reach age 65 within seven years, according to the Texas Nurses Association.
In Texas, one solution is to create more nurses in its own backyard rather than import them from elsewhere.
The state tripled its appropriations for nursing education. The Legislature appropriated $14.7 million for the 2008-09 biennium but provided $49.7 million for the current biennium.
Texas business leaders, through regional chambers of commerce, worked with the health sector to create a pay-for-performance plan.
Nursing schools were put in one of two categories: high producers and low producers. High producers are receiving $20.5 million over two years; lower producers are receiving $9.5 million as a prod to improve.
This fund allocation attracted national attention and made Texas a feature of a May report, "Charting Nursing's Future," from the Robert Wood Johnson Foundation.
Incentives
Locally, some hospital systems are offering tuition reimbursement for people to become nurses.
For seven years, Arlington-based Texas Health Resources, the largest hospital system in North Texas, has teamed with El CentroCommunity College to generate nurses.
What's unique about Texas Health's program at El Centro is that it's designed for current employees who've been eyeing a career in nursing.
"You could be a kitchen worker and become a nurse," said Candy Baptist, director of clinical education at Texas Health.
Texas Health's registered nurses earn an average of $68,245 a year. That average does not assume any specific years of experience, and it does not include shift differentials or pay upgrades for additional certifications.
The program started with 13 students in 2003. Since then, 270 nurses, who have completed prerequisites, have graduated with an associate's degree and taken a certification exam to work as registered nurses. Class sizes have grown to 40 students each and as of last Wednesday, there was a waiting list of 13 people.
Tuition and books cost $15,000 for two years, which Texas Health pays in exchange for a promise to work as a nurse for one of the company's 13 hospitals in North Texas.
The hospital system also offers a program for the public through the University of Texas at Arlington in which it pays for schooling in exchange for work upon graduation. The first class, 10 students, graduated in August. Twenty-eight students are currently enrolled.
Inexperience
With the push to bring in more nurses, one worry is a glut of young, inexperienced people at patients' bedsides.
"Too much of an imbalance is always a concern," said Joan Clark, chief nursing executive at Texas Health.
Yet she doubts demographics will go that route anytime soon because of the weak economy. Many older nurses have delayed retirement, and some are working longer to make up the lost salaries of laid-off spouses, Clark said.
"It's kind of tipped the balance," she said. "We actually have less of a capability to bring in new nurses."
A couple of years ago, Texas Health's nurse vacancy rate was 5 percent. Today it's 2 percent, Clark said.
"It's a blip of improvement," said Clair Jordan, executive director of the Texas Nurses Association. She expects demand to return soon.
"Some of the attributes of nursing, like 12-hour shifts, make it hard to work after age 65," Jordan said.
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