Fixing state's nurse shortage (Part II) (Brattleboro Reformer)

By Nicole Orne, Reformer Staff

BRATTLEBORO -- The effects of a nationwide nursing shortage may be felt less in Vermont, but that still has local hosipitals and organizations working on solutions to avert any shortcomings.

Nursing programs in colleges are experiencing the shortage when it comes to instructors, at times meaning interested students can't enroll in nursing classes.

According to Mary Urquhart, vice president of patient care services at Brattleboro Memorial Hospital, the best defense against the shortage is a strong workforce development plan focusing on both recruitment of new nurses and retention of staff.

"The state of Vermont has a very good one," she said. "There's very good awareness in the state to work on this problem and not be blind to it."

The state also offers a nursing educational loan repayment program for nurses working in Vermont or at a hospital up to 10 miles from the state border.

"It's very good in terms of keeping nurses in the state," Urquhart said.

The state also offers a consortium for nurses to get their bachelor's degree through courses on television. BMH joined this program last fall.

"It's been very good, from my point of view. One of the things that actually helps nurses stay in nursing is to seek out education. It improves their knowledge and it improves their self-esteem," Urquhart said.

The hospital, along with Windham Regional Career Center and Southern Vermont Area Health Education Centers, also now offers a free course for high school students interested in nursing at Brattleboro Union High School.

This preparation is important, she said, since the shortage began in the late 1990s and has not peaked yet.

BMH has an organization set up to look at both recruitment and retention.

Michael Kelliher, vice president of human resources at BMH, said the hospital updated the way it advertised vacancies to combat the shortage in clinical staff.

"What tends to work even 10 years ago, it's not going to work now. It's different generations, different ways of looking for jobs," he said.

Now, jobs are posted online on general job search sites as well as job sites specific to clinical professions. While the shortage means more work filling positions, the Internet has made this work go much faster, he said.

It is also important for a hospital to put out an image of itself, Kelliher said. "We've established an employment brand. Why does someone want to work at BMH? In the past it was just sort of trying to live off the reputation. Now it's more of 'What can you do for me now?' type of thought process with a lot of applicants. We try to build upon our mission to be the best community hospital."

Being a community hospital can often draw in new graduates eager to start at a hospital with a lot of personal contact between nurses and patients, as well as more seasoned nurses hoping to get away from the fast pace of larger hospitals, Kelliher said.

"For a lot of folks, this is very, very important. They can reach out to the community, they can relate to them, talk to them," he said.

"It's something an organization has to strive for," Urquhart said. "One of the best ways to achieve this is to involve the nurses. The one we do here is a joint staffing committee, made up of members of nursing management and staffers and we look at a number of different things. We want to come up with some projects to instill innovation in the way we do scheduling."

Offering mid-shift hours and mothers' hours can help to keep nurses happy, she said. "I think one of the things about it is we're working together, looking at the best way to recruit and retain and keep satisfaction high."

It is also important to make sure stress on nurses does not affect patients.

"At the bedside, you don't see a lot of change. Or you shouldn't. Any organization has to look very carefully if the shortage is effecting bedside care," Urquhart said. "The group of nurses that you have, they know what it takes to provide patient care. If there's vacancies, they pull together, work extra time. They share it. We'll also bring in traveling nurses. You're not seeing it at the bedside."

The committee holds regular staff meetings to provide nurses a chance to vent their frustrations. "We talk, I get information from them. It doesn't sound like a lot, but it's a lot. They get the opportunity to talk about their concerns and issues," she said.

These efforts and the high demand for nurses make this a great time to be a nurse, she said. "People are always sick 24/7. There's always going to be night and weekend duties, but what we've found is people have found their niches."

Retention efforts can help to keep nurses in the field and, ideally, at that same hospital. Urquhart said some of this effort is a matter of competition between hospitals. "It's something every hospital has to do, but what we need to do is really concentrate on what our staff needs and not compare us to anyone else. What are our disatisfiers? How do we make them better?"