Critical: the nursing shortage
By Michelle Knight knight@theacorn.com

An unsafe work environment in hospitals may be contributing to a shortage of nurses, said an industry expert at an April 4 nursing symposium at St. John's Regional Medical Center.

A group of 120 hospital administrators, educators, and student and experienced nurses listened as Rick Martin, chief nursing officer and senior vice president of clinical operations at Hoag Memorial Hospital Presbyterian in Newport Beach, said the situation will only get worse unless hospitals change their policies and nursing programs accept more students.

"Our brightest and best are not going to wait two years to get into college," Martin said, referring to the waiting list for many nursing schools throughout the state.

Schools without the capacity to accept more nursing students are another contributing factor to the county's nursing shortage, according to a study presented at a nursing summit in April 2007, which was hosted by California State University Channel Islands and the nonprofit Ventura County Community Foundation.

The foundation was one of 10 nationwide and the only one in California to participate in a national initiative to develop and test solutions to the nursing shortage.

Ventura County has 372 nurses for every 100,000 residents, almost half the state's average of 622 nurses per 100,000, the study found. The national average is 787 nurses per 100,000 residents

With forecasts of older county residents outpacing the growth of other demographic groups and a significant number of nurses nearing retirement age, the need for skilled nurses is more pronounced in Ventura County, the study said.

The foundation and university brought together last year nursing and healthcare leaders for the Ventura Nursing Legacy Project, which produced the study and determined key factors contributing to the county's nursing shortage.

The study cited 14 issues that inhibit a strong supply of nurses, including nursing programs that lack sufficient teaching faculty, students' need for child care, lack of workplace mentoring programs and work-related injuries.

Martin said hospitals need policies that protect the health of nurses. Home Depot restricts its employees from lifting more than 50 pounds without assistance, but many hospitals have no such policy for nurses, who may be expected to single-handedly push a 600-pound bed occupied by a 200-pound patient down a hall, he said.

Martin urged nurses to have a more aggressive response when the Legislature threatens to change the nursing profession without their input. Nurses typically don't speak out, he said, and as a result salaries have stagnated, nursing schools have reduced or capped enrollment, and procedures traditionally performed by nurses, such as the finger prick for blood tests, are increasingly being performed by people with less rigorous medical training.

Martin also called on nursing schools to update curriculum that's five years old or older and to ensure it realistically addresses job demands and patient needs.

Hospitals must act now and not wait for the state to solve the nursing shortage, Martin said. Medical facilities must ensure their environments are safe for nurses and that supportive policies are in place.

One of the philosophies Hoag Memorial administrators subscribe to is no one comes to work intending to harm patients; therefore, nurses are not punished for errors or near misses, Martin said. If a nurse does make a mistake, Hoag administrators may recommend more education for the individual, he said.

Policies like this make Hoag Memorial an attractive place for nurses to work, Martin said. Hoag has an industry low 10 percent turnover rate for nurses and earned Magnet status three years ago from the American Nurses Credentialing Center. Magnet status indicates highquality nursing staff and hospital procedures, according to the credentialing agency.

"These things make a difference," said Barbara Thorpe, CSUCI professor of nursing and director of the Ventura Nursing Legacy Project. Thorpe said Ventura County is producing 69 percent more nurses than it did four years ago, but the bad news is there are only three nursing programs in the county, limiting the supply.

Moorpark College admits 88 students a year into its nursing program. State funding provides for 66 of those students. The state pays for 48 students to go through the nursing program at Ventura College. Grant money was provided for 48 additional students this spring and 12 more this fall.

CSUCI launched its nursing program last year, admitting 66 students, 33 more than state funding provides for. This year only four additional students were admitted into the program.

Fluctuations occur because the three programs are dependent on grant money from local hospitals and a state hospital association to accommodate the additional students.

Thorpe said 313 students applied for CSUCI's 37 openings this year.

The next step for the Legacy Project is to create campaigns to educate the public and encourage corporate and private foundations to fund strategies aimed at alleviating the county's nursing shortage, Thorpe said.