Executives expect no relief for state's shortage of nurses

The nursing shortage in central Arkansas was among the leading topics at a roundtable discussion Wednesday featuring three top executives in the health care industry, a significant segment of the region's economy.

An audience of about 200 people attended the Power Up Little Rock breakfast, a quarterly topical series hosted by the Little Rock Regional Chamber of Commerce at the Robinson Center.

Cam Patterson, chancellor of the University of Arkansas for Medical Sciences, the state's only research hospital, said about 2,000 nurses receive their licenses every year, which "is not nearly enough to keep up."

Health care providers in central Arkansas alone list more than 1,000 openings for nursing positions, he said.

Marcy Doderer, president and chief executive officer of Arkansas Children's Hospital, which has a health care network that treats 700,000 children annually, said the pipeline for future nurses is shrinking because fewer people are having children.

"For the first time in the history of mankind, we are not replacing ourselves as people," she said. "The pipeline is smaller, period. Understanding that there are fewer and fewer children that are going to get through high school and choose their career is a really challenging piece for us."

The nurses whom hospitals do hire require additional investment in training, in part because nursing education isn't as regimented as, say, becoming a physician, Patterson said.

"There are multiple ways to become a practicing nurse," he said. "The standards are highly variable."

About 25 percent of the labor force at UAMS are nurses. They require up to three months before they are operating independently, Patterson said. "That's an enormous investment."

Children's Hospital has a residency program for nurses that takes 18 to 22 weeks because many nurse training programs focus on adult care.

The residency program has reduced turnover among the first- and second-year nurses to less than 2 percent, Doderer said.

"Our nursing turnover really maxes in the three- to five-year tenure of an employee," she said. "We do really well in the first three years -- we say we're a great training ground for nurses -- and then they want to move. They're very mobile."

Other factors make it difficult to keep nurses on staff.

Nursing takes place in a "stressful environment" with "high expectations," Patterson said. "Burnout is substantial."

The shortage in central Arkansas is part of a national trend, a trend nurses use to their advantage.

"They can take contract jobs anywhere in the country," Doderer said. "It's one of the few jobs where you can go to school for two years, work three days a week and make $60,000 a year."

Troy Wells, president and chief executive officer of Baptist Health, which is the largest health system in the state, said that while health care costs are relatively low in Arkansas, it hurts the state's ability to attract and retain nurses and other health care professionals.

"The good news is Arkansas is a great place to get health care in terms of cost," he said. "We are one of the lowest places in the nation in terms of cost. A lot of that's a great thing. Everybody thinks it's expensive still so it's a relative issue.

But previous wage growth for nurses and other health care professionals was based on the local economy, which is no longer the case, he said.

"It was the central Arkansas economy, where you're competing for people going into nursing versus manufacturing," Wells said. "Over time, that has changed."

It's no longer regional demand but national, he said. "It's so lucrative and the mobility is such that people can go all over."

Compounding the state's difficulties, Wells said, is the low reimbursement payment rates health care providers receive from Medicare, the federal health insurance program for the elderly.

"Our wage rate was set decades ago when it was a very poor state with low wages because our overall economy wasn't good relative to the rest of the country," he said.

That hurts the state's ability to keep and attract health care professionals, including nurses, Wells said.

"We're competing nationally for physicians," he said. "We're competing regionally and nationally for nurses, people who are in very high demand with big-time shortages for these personnel. Yet our pay is the lowest rate in the nation from Medicare and, in turn, commercial payment rates.

"This very difficult situation now -- the better job we do keeping health care costs down, we are penalized by the Medicare program. We are paid less."

Business on 04/25/2019