North Country This Week

As elsewhere in the nation, St. Lawrence County hospitals and nursing homes are struggling to find qualified nurses, from licensed practical nurses to advanced positions that require specialized training.

“Nurses with specialized training, such as emergency department nursing or critical care nursing, are typically more challenging to recruit,” said Jan Carroll, chief of nursing for St. Lawrence Health System. SLHS operates Canton-Potsdam and Gouverneur hospitals and recently took over management of Massena Memorial Hospital.

At Highland Nursing Home, 182 Highland Rd. in Massena, “not enough people are applying for the positions,” said Janet Partlow Green, who was until recently the director of nursing there for 39 years.

Four out of the 20 positions were vacant at the time of her interview.

But it is not just a local problem.

“I doubt there is any hospital in New York State that isn’t short-staffed,” said Carl Ginsburg, New York State Nurses’ Association communications director. NYSNA is a union that represents a number of RNs from throughout St. Lawrence County.

Short-staffing can lead to high mortality and infection rates as well as avoidable patient readmissions, which in turn lead to higher healthcare costs, Ginsburg said.

“Nurses tell me there is no time to educate people and inform them of their condition and steps they need to take to allow for complete healing,” he added.

Carroll says every hospital struggles with finding qualified nurses and some specialty nurse vacancies take longer to source and hire than others.

“To ensure safe patient care, hospitals often hire temporary agency or ‘travel’ nurses to care for patients while they recruit,” she said.

“Hospitals are also employing newer tactics to recruit, such as using social media outlets” to fill vacancies in. both in the hospital and the ambulatory setting, Carroll said.

Green said a decade ago the nursing home had fewer issues filling positions. Many of the employees they hired had taken a nursing program at St. Lawrence-Lewis County BOCES and then passed their state boards.

Students could often begin making a decent wage almost straight out of high school, she said.

But BOCES discontinued the LPN program in 2009 and since then, Green says there has been a “significant decrease in applications for LPNs.”

She believes nursing students are now encouraged to get into the RN program, which she says is fine, but it also depletes the LPN employee pool.

An LPN can administer medications, but does not create a diagnosis or make decisions without consulting an RN or doctor. Instead, an LPN helps with patient care, and follows through on decisions and care plans that have been implemented by other medical staff.

Green says nursing home nurses “learn as you go” and deal with multiple illnesses daily which differs from acute care in hospitals.

Unfortunately for nursing homes, they often offer less pay than hospitals or private medical offices. Other factors working against nursing homes are heavy workloads due to being understaffed and a potentially negative public image of working in a nursing home facility.

In hospitals as well as elsewhere, Ginsburg said the shortage is causing nurses to “burn out.”

“Older nurses are leaving before they can mentor and develop younger nurses,” he said.

The average cost to replace an RN ranges up to $88,000, according to the Journal of Nursing Administration.

The American Association of Colleges of Nursing says the number of people enrolled in entry-level baccalaureate nursing programs is “not sufficient to meet the projected demand for nursing services, including the need for more nurse faculty, researchers, and primary care providers.”

According to the National Council of State Boards of Nursing and The Forum of State Nursing Workforce Centers, 50.9% of the RN workforce is age 50 or older. More than 1 million RNs will reach retirement age within the next 10 to 15 years, according to the Health Resources and Services Administration.

But an increasing number of older people will fuel the need for more nurses, and other medical positions.

The U.S. Census Bureau projects that by 2050 the number of U.S. residents age 65 and over will be 83.7 million, almost double the estimated 43.1 million in 2012.

Next week North Country This Week will look at how local educational institutions are addressing the need for more nurses.