Broaden the nursing pool

For too many reasons to count, it's a turbulent time for the nursing profession.

The most daunting problem should be good news: Registered nurses are in demand more than any other occupation. A recent report from the state Employment Security Department cited 2,565 job openings for RNs, representing a whopping 10 percent of the total job vacancies in Washington.

Hospitals and medical centers, because they take care of the sickest patients, are the largest employers of registered nurses and every facility is scrambling to recruit more of them.

But we can't just continue to "rob Peter to pay Paul," competing with each other for the same shallow pool of candidates.

Nursing is a career for the future and hospitals must think well beyond traditional recruitment strategies. Plus, they must put far more emphasis on nurse-retention strategies and on internal staff development.

As a whole, the health-care industry must work actively to help reconfigure the profession and get rid of some outdated and unhelpful stereotypes. Society, too, needs to seriously rethink what a nurse "looks like" if we are ever going to broaden and deepen the potential talent pool.

When we were in nursing school 30 years ago, everyone pretty much mirrored us as white, female and middle class. Most nursing undergraduates wanted to work in a so-called helping profession. And they certainly weren't motivated solely by the lure of high pay. Because of their homogeneity, somewhere along the line nurses got stuck in an image rut — as did some of our professional colleagues in teaching, social work, librarianship and similar fields.

In the early 1970s, the starting wage for an RN in Seattle was around $4 per hour. Today, full-time, hospital-based registered nurses can earn up to $75,000 per year. From both a compensation and a responsibility standpoint, nursing is a much better career than it has been in past generations. Now the picture of a nurse has to catch up with the reality.

As they are currently structured and funded, nursing schools can't fill the pipeline with eager young professionals. Part of the problem is that qualified students just can't get in the doors of many nursing programs. The sad fact is that most colleges are under such tremendous budget pressure that they can't pay their professors as much as they would make as working nurses. In short, not enough faculty means not enough students.

Hospitals need to take some creative approaches to nurse education if they're ever going to narrow the nurse gap. At Swedish, we have been working with organized labor (Service Employees International Union 1199 NW, which represents RNs) and higher education (Shoreline Community College and the University of Phoenix) to develop a pilot program for students who need more schedule flexibility when pursuing an associate degree in nursing. To accommodate working people, it combines online learning with a traditional clinical practicum.

Demography is destiny and there are four major areas where nurse employers can do a better job of attracting good people:

• Age:. The average American RN is 45 years old. If we don't lower that number, in a generation we'll have nurses in walkers and wheelchairs trying to care for even older patients.

The key task is to make it "cool" again for young people to consider nursing. That involves systematic outreach to middle- and high-school students and in getting nurses portrayed widely and favorably in the popular culture.

• Race and Ethnicity: Overall, it's fair to say that, from a recruiting standpoint, health-care employers haven't connected well enough with audiences of color.

Only 13.4 percent of RNs come from minority backgrounds, while the U.S. population is more than 30 percent non-white. One of our African-American nurses put it this way: "People go where they feel most welcome."

• Gender: Nationwide, only 5.4 percent of RNs are men and, interestingly, they tend to gravitate toward the higher-stress jobs in the emergency department, operating rooms and neonatal and adult critical care. More men need to consider careers in nursing and males need to be welcomed with open arms into oncology, orthopedics, pediatrics, behavioral health and all the other high-volume units of a modern medical center.

• Career Changers: There's no question that nursing can be hard, fast-paced work. But, unlike other comparable occupations, it can offer tremendous personal satisfaction and sense of accomplishment. We'll wager, too, that no other professional gets as much fan mail as a nurse.

After 9/11 and the dot-com collapse, we saw a number of mid-career people turn to nursing because they wanted their work to be more meaningful and their lives to have greater stability. That trend has got to continue if we ever hope to have enough dedicated professionals taking care of future patients when they need it most.

Here's one step anyone can take to help to solve the RN shortage. The next time someone says to you, "What should I do with the rest of my life?" — point them toward nursing.

Pat Anderson, RN is vice president of patient care at Swedish Medical Center/First Hill. Cathe Clapp, RN is vice president of patient care at Swedish/Ballard Campus and current president of the Northwest Organization of Nurse Executives.