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By DENNIS GRUBAUGH
p01 nurse(SIUE photo by Howard Ash)

Kevin Stein, third from left, an instructor and assistant director at the SIU School of Nursing, works with students in the simulation lab. His specialization is in nurse anesthesia.
    Millions of baby boomers are preparing to exit the workplace, and nurses are leaving with them.
    The result could be a calamity in the health-care industry if not enough men and women enter the field in coming years, some say.
    Illinois may soon face a shortage of registered nurses across all specialties, as an aging workforce readies to retire, according to a survey by the Illinois Department of Financial and Professional Regulation – Illinois Center for Nursing.
    Nursing schools in Southwestern Illinois have been reacting to the shortage for years, stepping up their programs to meet the growing need.
    Conducted during the 2014 Illinois RN licensure renewal period and released this year, the workforce survey was structured to capture data on the demographics, education and practice focus of RNs in Illinois. More than 90 percent of individual RNs completed licensure renewal via the on-line platform. The voluntary survey was completed by 52,902 RNs, representing 31 percent of the total RN population in Illinois.
    The results confirm what has long been a worry for some professionals.
    “Approximately 40 percent (of the respondents fell) in the 55 to 65 age bracket and had plans to retire in the next five years,” said Dr. Laura W. Bernaix, a registered nurse and interim dean and professor in the School of Nursing at Southern Illinois University Edwardsville. “This similarly mirrors the national statistics that indicate we’re going to be seeing a reduction in the RN workforce.”
    In 2013, 55 percent of the RN contingent nationally was 50 or older, she said.

    “Just by virtue of that there is going to be a high replacement rate going forward all the way to 2022, or possibly even 2030,” Bernaix said.
    The shortage is going to extend to all areas where a registered nurse can be employed, both in the practice arena and in nursing education.
    “Not only will we be losing nurses to retirement, but our nurse educators are primarily in the older age bracket as well,” she said.
    As a result, both nurses and their educators are in demand. Voids are expected in specialties such as psychiatric, school, home health and community health. Those specialties currently have significantly fewer RNs (ages 25-35) in the PhD education pipeline to replace the retiring RNs, according to the state survey.
    Baccalaureate, or four-year-prepared RNs, are most in demand.
    “Approximately 45 percent of all hospitals are now requiring their new hires to be baccalaureate-prepared, while 76 percent are preferring the baccalaureate-prepared nurse,” Bernaix said.
    The Institute of Medicine weighed in a couple of years ago, saying 80 percent of all nurses should have that four-year degree because such training produced improved patient outcomes.
    “In addition, many hospitals are looking to achieve Magnet status — a credentialing designation that’s of high regard — which encourages hospitals  to increase their percentage of baccalaureate-prepared nurses,” Bernaix said.
    SIUE’s School of Nursing has been fully accredited since 1970. The enrollment is about 1,300 each year, between graduate and undergraduate students. On average, each year SIUE graduates approximately 250 undergraduate students in its baccalaureate program. They receive a bachelor of science in nursing.
    Tuition and fees at SIUE run a little more than $10,000 per year. That doesn’t include room and board if students live on campus, Bernaix said.
    Shari Banovic, director of nursing education at Lewis and Clark Community College in Godfrey, said the shortage is an ongoing topic at the two-year program level, and every effort is made to get students to continue education after they’ve left the college, including more community clinical work.
    The school graduates around 50 to 60 students per class, in each of two graduations a year. Most LCCC nursing grads land jobs soon after college, she said.
    Lewis and Clark has a state of the art facility in which to learn — The Daisy and Roger P. Templin Nursing Building, where every student has a computer.
    “We have simulation labs with high fidelity mannequins that we can simulate pretty much any type of clinical experience,” Banovic said. That would include emergencies, something that student nurses don’t always get to see in clinical settings.
    “(The classroom) is kind of a safer environment. If they make a mistake on our mannequin, it’s not such a big deal,” she said. Among those mannequins is one for maternity.
    The LCC nursing building also contains numerous hospital beds that mirror what’s found in the hospital setting.
    There are a variety of strategies that schools and agencies are using to respond to the nursing shortage.
    Some of them:
    - Providing an array of programs for nurses to get their degrees and to offer those programs in a variety of formats.
    - Forming academic and clinical partnerships to bolster the number of sites for students to conduct their practicums.
    “While schools of nursing would love to admit more students, not only is there a shortage of faculty to teach but also clinical placements for their training,” Bernaix said.
    - Hospitals are examining their tuition reimbursement policies to encourage nurses to go back and further their degree.
    - Schools like SIUE are offering accelerated programs to assist nurses with two-year degrees to further their education.
    Many schools also offer an Accelerated Bachelor Degree program, allowing students who have majored in another science degree to obtain an additional baccalaureate degree in nursing within 15 months.
    At SIUE, they offer an accelerated, 100 percent online RN to BS program, for those who are already registered nurses and are coming back for their baccalaureate degree.
    “We’ve revised it so that it can be achieved within 12 months’ time,” Bernaix said. “It addresses all the critical content that a practicing registered nurse would face. We’ve seen a 500 percent increase in that program in just over a year’s time.”
    Bonuses to lure nurses are still a factor though not as prevalent as they once were, depending on the region of the country and the type of industry.
    Health-care delivery in general has changed and the demand for nurses is greater than ever. Obamacare will drive that even higher.
    “You now have the Affordable Care Act and millions more people will have access to health-care services,” Bernaix said. “That’s why we’re in even more need of registered nurses.”
    Nursing is listed as one of the top industries for job growth in coming years — by some counts almost a million more nurses will be needed by 2022.
    “As more baby boomers approach retirement, it is essential that our health-care industry has the ability to quantify the forthcoming need for additional health-care professionals and other health-care services,” said Bryan Schneider, Department of Financial and Professional Regulation secretary. “The RN Workforce Survey is certainly a tool that will assist and guide workforce planners as they seek to determine what types of RN will be in greatest demand, as well as the types of specialties and skills required of future models of care.”
    Additionally, the data collected indicates a decrease in cultural diversity of the RN workforce in the younger cohorts, which coincides with the decreased number of graduates of associate degree programs (ages 25 and under). Gender diversity is also on the decline, as only 7 percent of those (25 years and younger) self-reported as being male.
    Bernaix said SIUE is addressing this cultural diversity decline through their federally funded program entitled SNAP (Student Nurse Achievement Program) SNAP is a successful, ongoing initiative that addresses the critical need to increase the numbers of diverse professional nurses in the workforce by recruiting and retaining students from racially, ethnically and culturally diverse backgrounds.
    That demographic, along with knowing the relative numbers of RNs in each age group, as well as educational preparation is vital to long-term planning, said Dr. Maureen Shekleton, Illinois Center for Nursing Advisory Board chairperson.
    “With this data, we can begin to address questions, such as what is the current RN supply and will it be adequate to meet the health-care needs of Illinois citizens,” Shekleton said.
    The 2014 Illinois Registered Nurse  Workforce survey was completed under the leadership of the Illinois Center for Nursing’s Advisory board of directors. The survey was the first such Illinois study tied to individual on-line licensure renewal.
    For the complete report, visit: http://nursing.illinois.gov/ResearchData.asp