Nursing has never been an easy job, but with staffing shortages and patients piling up, the gig is getting tougher across the country.
Navicent Health in the small community Macon, Georgia, is the second-largest hospital in the state. Located just an hour outside of Atlanta, the hospital has more than 600 acute-care beds and 1,900 nurses. But attracting and retaining qualified staff has proven difficult, leaving Navicent with a shortage of over 150 nurses at a time when the aging population is creating myriad headwinds for the industry.
"The biggest challenge here is just the workload," chief nursing officer Tracey Blalock said. "It can sometimes be a little overwhelming. Caring for five or six patients can get very difficult if they're acutely ill."
The nursing shortage goes well beyond Macon, and the challenge is layered — patients are living longer than ever before, requiring more care than in the past. More nurses are also aging out of the workforce, leaving a skills gap as they wind down their careers. Recruiting new talent is more challenging in rural areas and smaller facilities, which offer lower pay and a less vibrant social scene.
"We are seeing growing shortages in different states and geographic reasons. It's a real distribution issue that is only getting worse," said Pamela Cipriano, president of the American Nurses Association. "When we talk to nurse executives and staff around the country, we hear they have difficulty recruiting, and nurses are short-staffed."
Meanwhile, the outlook for registered nurses is set to grow by some 16 percent through 2024, adding nearly half a million jobs, according to Bureau of Labor Statistics. Salaries within the industry can vary widely, according to the American Nurses Association, from $45,000 a year on the low end to $150,000 annually, depending on the degree of education, specialty and location.
Travel nursing plays another factor as it's become increasingly popular, and Blalock has seen many nurses at her facility follow that path. "They can go anywhere in the United States and make $10 to $15 more an hour than they were here," Blalock said, noting that the average salary is $62,000 annually at Navicent.
The hospital aims to motivate employees and recruits with a nurse externship program for students and a residency program with advanced training for nurse graduates. There's also tuition reimbursement and a program to help cover payments, book fees and more.
The aging population presents unique challenges
The aging population contributes to the nursing shortage beyond just patient care and nursing staff retirements. Nurse educators are also aging out of the field.
About 150,000 registered nurses graduate from nursing programs across the country each year, but Cipriano says schools don't have faculty to teach all the qualified applicants in their programs.
"Our schools are telling us that they are turning away over 68,000 qualified applicants a year," Cipriano said. "The average faculty member is older than the average clinically practicing nurse, and so they are approaching retirement age faster."
It's an issue the University of Maryland School of Nursing faces, as its enrollments grow. It has some 1,900 students across this year, up from about 1,700 in 2010.
"We've been very purposeful in terms of admitting more entry-level nursing students," said Jane Kirschling, the dean, adding that the state is projected to have a shortage of some 10,000 nurses in the years to come. "We feel a personal responsibility for making sure Maryland has enough registered nurses and professional nurses to meet care needs of our residents."
One of those students in 26-year-old Jasmine Noronha, who is advancing her degree as a nurse practitioner. The Bowie, Maryland, native wants to work in a rural facility on Maryland's Eastern Shore once she graduates because she believes that's where she'll be able to make the greatest difference.
"I really enjoy the patients there. A lot of them haven't sought care in a couple of years, because they don't know how important it is for their diet and nutrition to see a doctor," Noronha said.
Despite long days and headwinds within the field, Noronha remains eager.
"At the end of the day when I go home, I may have had a hard day and not sat down, and not eaten lunch," she said. "But I can look back on my day, and say 'I made a difference.'"