Recruiting and Retaining Nurses

Help-wanted ads are clamoring for nurses: Make a Difference! the ads shout, and Top Pay - All units, all shifts! Nursing shortages have come and gone in recent decades, but new research says the situation is getting worse - for both hospitals and the patients they serve. WNYC's Fred Mogul reports on some of the ways nursing schools and hospitals are recruiting and retaining new nurses.

Thirty freshmen from Manhattan's Washington Irving High School crowd into a nursing lab in a basement on the New York University campus. They're tour different departments and learning about different careers. IN this room, rubber practice dummies lie on hospital beds, and three nursing students stand up front.

Jablonski: I'm going to teach you how to take your pulse. Everyone know what a pulse is?

Brian Jablonski is a first-year nursing student at NYU.

Jablonski: and at the end of my four years I'll take a test, and if I pass it I'll be an RN, which is a registered Nurse. And once I'm a registered nurse, I can be an in-home nurse, like some of your grandparents might have. I can work in surgery...

Other opportunities include academic research, consulting for lawyers, developing computer systems and working on the business side of healthcare. Recruiters highlight this array of possible roles, because they believe nursing is often stereotyped. Hila Richardson is NYU's director of undergraduate nursing, and she says potential recruits often associate nursing with what they see in tenseTV dramas such as E.R. She sees it as her job to change that.

Richardson: so they don't have just one image of the hospital bedside and the pressure and tension and stress, and machines going off and making noises and people running around and so forth. And that's the advantage of getting them to think in a different frame of mind about nursing and have a different image of the full span of opportunities.

Richardson and recruiters nation-wide have been getting some image-makeover help from Johnson & Johnson. Last February, the pharmaceutical conglomerate launched a 20-million-dollar TV ad campaign. It features good-looking nurses holding patients hands, assisting surgeons and hoisting patients from dollies. They exude energy, emotion and empathy. Mixed in with all the smiles and compassionate gazes, the nurses in the Johnson & Johnson ads do show some moments of exhaustion. But while it might not be the melodrama of E.R. it's still far from the reality of many hospitals.

At Montefior Medical Center in the Bronx, 1,8-hundred nurses have been working without a contract for almost a year. Last week, hundreds of them picketed outside one of the center's main buildings, and threatened to strike if more nurses weren't hired. [POST NATSOUND] Cynthia, who would only give her first name, works with critically ill patients and says she's sometimes in charge of as many as twenty-two patients.

Cynthia: Sometimes you get so worn out, yes there are mistakes /EDIT/ errors like people giving the wrong patients the wrong medication, or things like that, but most times is not anything that will cause fatality and we have to be thankful for that.

Most times. But sometimes the worst does happen. Pulmonary nurse Nicole Barrow.

Barrow: We had a patient who was out on the floor, his blood pressure had fallen and because no doctor or nurse could get to that patient, the patient. Well, we could've done it better. --What happened? The patient did eventually pass. He probably would have passed anyway, he was a very sick man, but I think we could've done better, been a little more aggressive

Officials at Montefior wouldn't comment about work conditions or staffing levels at the medical center. But many hospital leaders are candid about how difficult it is to find and retain nurses. At St. Mary's Hospital for Children in Bayside, Queens, recruiter Peggy Donahue only has a handful of job openings at the moment, but she still finds herself constantly working the phones and cris-crossing the region to find new talent.

Donahue: We've had periods when it's been a little bit harder to recruit than others, but this really has been about the worst period. It's been expected, based on the statistics throughout the nation, that the shortage is going to increase and worsen as nurses retire because we're not seeing the same amount of volume of people going into nursing education

One recent study by the U.S. Health and Human Services Department said the country was about six-percent short of the 2 million nurses the healthcare system needs. Jack Needleman, an economist at the Harvard School of Public Health, says hospitals will need to do more than just raise salaries to alleviate this labor shortage.

Needleman: The market will make things a little better - nurses salaries will go up, because they're going to have to in order to attract nurses into the hospital. Hospital managements will have to learn to behave differently to attract and retain nurses.

Needleman co-authored a study that appeared in the New England Journal of Medicine this spring. Surveying 800 hospitals around the country, he found that fewer nurses in a given hospital means measurably longer stays for patients, and higher rates of cardiac arrest, pneumonia and other, quote, adverse outcomes. Low staffing also is cited as a major cause for low morale in the nursing workforce, where forty percent of nurses in one survey said they were dissatisfied with their work, and almost 25 percent said they planned to leave their current job within the year. Again, Jack Needleman.

Needleman: We really do need to focus on treating nurses as professionals. I think for the public there is an understanding that nursing is a physically demanding job, and it's an emotionally demanding job. What I often think the public doesn't understand is that nursing is intellectually demanding job and part of what we need to do in terms of changing the nursing systems in hospitals is to recognize and acknowledge the professionalism that nurses bring to the bedside and to their work.

Many hospitals say their hands are tied, because HMOs, insurers and the government don't pay them enough to hire as many nurses as they'd like. But other facilities find ways to make work conditions good enough to attract and retain nurses. Peggy Donahue, of St. Mary's Hospital for Children, says her hospital has been trying to do that.

Donahue: We basically have tried to be very flexible with our nurses. We've implemented something we call flex-time, which is a four-day work-week. We promote from within whenever possible, the majority of our supervisory staff have all started working in the field with us so the career ladder we try to establish helps to retain our nurses. We really try to provide ongoing education and support to the nurses.

Within a few years, the ninth-graders of Washington Irving High School will have to make decisions about jobs and future schooling. Programs like the one at NYU hope to plant seeds to make them think about nursing. But it might take more than a 15-minute presentation or a 30-second ad on TV to persuade Precious Coleman and Stephanie Mitchell to become nurses.

Coleman/Mitchell: I would possibly consider it, I'm more focused on my performing art degree and what not I wouldn't do it, because I wouldn't like to see people suffering and dying, and I would think it's my fault, if I don't' save their lives, I'd be, like, It's my fault, it's my fault,' so before that happens, I would rather not do it yeah, yeah

Both girls say they want to be actresses rather than care-givers. But Precious, at least, isn't preparing her Oscar speech just yet. You've got to have a backup plan, she says. For WNYC, I'm Fred Mogul.