Nursing shortage ‘already here,’ management a problem

While local administrators attribute the state and national nursing shortage to poor planning, high dropout rates, faculty shortage and the lack of standardization, one registered nurse attributes the shortage to poor health care management.

“They have no concept of nurse retention,” Kim Lushbaugh, a registered emergency room nurse, said of the upper management division of a local hospital. “They’re not doing anything to make us want to stay there.”

Married with two children, Lushbaugh said she needed a flexible schedule to balance her family life with work.

“It’s a fight all the time with flexibility,” she said. “I actually took a package with no benefits and less pay because that meant I was not obligated or locked into any contracts with the hospital.”

Part- and full-time nurses at local hospitals receive benefits and are paid about $4 more per hour than Lushbaugh, but they are locked in a schedule set by the hospital and rarely can change their schedule.

“I’m what you call a PRN (practical registered nurse), which just means I am an hourly worker,” Lushbaugh said. “It’s less money and no benefits, but it works for me.”

According to the Virginia Hospital & Healthcare Association, much attention has been given to nurse retention and the turnover rates in hospitals.

“We want to keep nurses happy,” said Barbara Brown, VHHA vice president. “We are in a people field. You need people to take care of people.”

While most registered nurses find themselves tasked with more responsibility than ever before, Lushbaugh said the responsibility also leads to more disgruntled employee relations.

“A lot of good nurses leave because of silly, silly stuff,” she said. “Stuff that management could have worked on. In my personal experience I see a mass exodus every 14 to 18 months where you have a number of nurses who are so fed up with being picked at and put down that they just up and leave.”

Lushbaugh said she believes ER nurses to be the most stressed.

“I really believe we have the highest patient-to-nurse ratios,” she said. “The public needs to be aware, however, that they’re contributing to the lack of care and timeliness.”

Lushbaugh said every patient that checks into the ER is viewed as an emergency.

“The majority of them are not actual emergencies, though. People need to be educated on what they should do. If your knee has been bothering you for a month, call your doctor. If you can’t get through, call the on-call doctor. Don’t run to the ER.

“You create longer waits, and people who are sitting at home having chest pains and shortness of breath who could be having a stroke will decide not to come in because they don’t want to deal with the wait.”

Jack Elcoate, a nurse technician at CJW Medical Center, said he has seen his fair share of high turnovers among nurses.

“Nurses are literally pulled in so many different directions at once,” he said. “They’re pressured by doctors, by patients and by administration.”

Elcoate said it is not only acute care nurses that are overstressed, but also nurses working in assisted living, retirement and nursing homes.

“I have worked in a nursing home before,” he said. “There were 30 patients to one nurse. That definitely takes a toll on you. We have the longest generation in the history of this country entering retirement age, and we’re also seeing younger and younger people with health problems.”

Elcoate cited long waiting lists for nursing schools as one of the biggest factors contributing to the nursing shortage.

“With the influx of patients and limited amount of space and schools, it’s very hard,” he said. “I know they can’t just hand out nursing licenses. It’s all about retaining the nursing staff they’ve got.”

Joanne K. Henry, director of VCU’s Community Nursing Organization, said health systems are well aware of the issue of high nurse turnover.

“Beyond schools, the employers of nurses can develop programs to encourage nurse retention,” she said. “We need to look at the work environment.”

Lushbaugh said the average citizen who may need medical attention now or later should prepare themselves for longer visits at the waiting room, limited availability of appointments and possibly fewer medical facilities state and nationwide.

Elcoate agrees and said people should be aware of the issue now.

“There is no future nursing shortage,” he said. “It’s already here.”