North Country Nursing Crisis: Limited clinical sites limit LPH, RN training in St. Lawrence County
BY MATT LINDSEY
North Country This Week
Limited clinical training sites and low comparable pay for nursing professors are making it hard for local educational institutions to meet the demand for nurses in St. Lawrence County.Kimberly Davies, SUNY Canton director of nursing, says SUNY Canton participates with Canton-Potsdam Hospital, Massena Memorial Hospital, local nursing homes, Alice Hyde Medical Center, and others for on-site training. Despite the number of healthcare locations used by the college, SUNY Canton is only able to train a fraction of the number of students who apply for the various programs.
But clinical training sites are only part of the problem. Marcie Sullivan-Marin, nursing instructor at North Country Community College who formerly taught at SUNY Canton, says strict state guidelines are slowing the ability for educational institutions to hire more nurse instructors.
“State boards of nursing impose rigid requirements of education qualifications of possible nursing faculty and clinical instructors,” she said.
Combine this with an aging pool of college nursing instructors destined to retire, and it shortens the window in which certified educators can pass knowledge they’ve gained over their years along to the younger generation.
The American Association of Colleges of Nursing (AACN) reported a 3.7% enrollment increase in entry-level baccalaureate programs in nursing in 2018, but said the increase is “not sufficient to meet the projected demand for nursing services, including the need for more nurse faculty, researchers, and primary care providers.”
SUNY Canton offers four nursing programs. Slightly more than 700 students applied to be in the RN nursing program, and 126 were accepted, said Greg Kie of SUNY Canton Media Relations. About 400 of the applicants were not qualified for the program and the same number who were not accepted into the program were offered admission into one of SUNY Canton's other programs.
“The only way to increase possible students is you have to have human bodies for hands-on experience (clinical hours),” Davies said.
Davies was planning to speak with officials from Carthage Area Hospital following her interview with North Country This Week to see if sending nursing students there to hone their practical skills would be plausible.
In some states, such as Florida, students can earn up to half of their clinical hours through simulation labs. Labs allow students to view live medical scenarios such as heart attacks and serious sports injuries while they interact with a mannequin that mimics the needs of the patient.
SUNY Canton has this technology already and Kie said the mannequins are an “educational supplement to the program.”
However, the state nursing board does not allow simulation labs to count toward clinical hours.
“Cost isn’t an issue that prevents us from taking more students … the main issues are clinical site availability, staffing and population,” said School of Science Health and Criminal Justice Dean Kenneth Erickson.
Davies says the shortage is also partly due to specialized nursing requirements, which often need on-the-job training. She said some nurses do not have an interest in specialized fields such as mental health or emergency room.
She also said that fresh grads do not typically jump right into just any nursing position. More training is required, often on-the-job training that can take months. This deters people from applying for specialized jobs.
She said facilities have to “jump through hoops” to get new nursing students into areas such as the operating room.
She also believes the retiring baby boomers are impacting the problem.
“It’s a trickle now,” Davies said. She thinks the shortage will only get worse in the coming years when more and more baby boomers retire.
St. Lawrence-Lewis BOCES used to offer a licensed practical nursing (LPN) program that high school juniors and seniors could take and graduate ready to earn a good income.
The BOCES LPN program ended with the last class of 25 students graduating in June 2009, according to BOCES spokesperson Rebekah Grim. In August 2009 the program transitioned over to SUNY Canton and they have been offering it for the past 10 years.
The change from BOCES to SUNY Canton meant that the program would no longer be offered to high schoolers. Now, young adults need to wait until they graduate high school and finance it themselves.
The LPN program was a mix between high school students and adult students so it wasn't exactly like a traditional CTE program, Grim said.
“SUNY Canton already had the staff to support this type of program,” Grim said. “In other words, we were running a college program on SUNY Canton’s campus with staff from the college. It made more sense for SUNY Canton to run the program, which it has successfully since the transition.”
For now, BOCES does not have plans to bring their LPN program back.
“It comes down to being able to balance a budget while keeping an affordable tuition,” Grim said. “You have to have a financial aid officer to offer loans which adds another layer of expense.”
Some believed the old BOCES LPN program was free to high school students. It was not.
“Due to the agreements with SUNY Canton, there was a cost associated, although we don't have exact numbers on hand since the program closed 10 years ago,” Grim said. “For instance, for our CTE programs that offer college credit to students, there is usually some cost to families for the college credit portion (although free and reduced lunch eligible students get a reduced rate).”
There are not many BOCES across the state that offer an LPN program, she said.
“It was beginning to become cost prohibitive to keep the program running,” Grim said. “There were a lot of staffing requirements, including instructors, clinicians, and financial officers.”
Also, BOCES was paying “significant” rent to SUNY Canton for instructional space and supplies for the medical program.
However, BOCES is exploring a partnership with Jefferson-Lewis BOCES to send students to their program, since they have several openings, Grim said.
BOCES also offers healthcare-related classes to high school students including health careers, certified nursing assistant and allied health.
BOCES allied health program is for honor students. Grim said many students end up becoming nurses, and even doctors.
Through the Adult Education & Workforce Development, BOCES offers programs for certified nursing assistant, healthcare clerical support, clinical medical assistant, clerical medical assistant, phlebotomy technician, pharmacy technician, EKG technician, direct support professional, first aid, and CPR.
A variety of online classes through Ed2Go include medical terminology, medical billing and coding, and certified medical transcriptionist.
Better compensation in clinical and private-sector settings is also luring nurse faculty away from teaching, Sullivan-Marin says.
“The starting salaries for masters-prepared nursing instructors (at SUNY Canton) is only $37,000 on the academic calendar,” Sullivan-Marin said.
SUNY Canton’s Kie confirmed the nursing instructor salary, but noted that nursing instructors make less than professors. One example Kie gave was of a professor making $63,500. He said some make more and some make less than that, depending on experience and other factors.
By contrast, a registered nurse in New York can make on average $70,000 or more, according to payscale.com.