Monday, October 4, 2010

Nursing shortage may rest on wage discrepancies

with 1/2 col. photo

By ANNE KAZMIERCZAK Register Reporter

In her 17 years at Neosho County Community College, Director of Nursing Pam Covault has seen many changes.
More and more students — and potential faculty — are lured away by the possibility of higher salaries in urban centers.
“The reality is, the urban areas pay more,” Covault said.
Larger schools can pay faculty more, just as urban areas offer a higher salary to nurses on the floor, Covault said. In fact, the elephant in the room driving the nursing shortage may be the lack of qualified teaching staff.
Statewide, nursing programs are having a hard time recruiting teachers, a Kansas Helath Institute report said.
It all comes down to money.
“You have to love to teach, because the reality is, you are going to take a cut in pay to teach,” Covault said.
According to the Kansas Department of Labor, licensed practical nurses in rural Kansas (including Southeast Kansas) earn about $15.75 an hour. In metro areas, that wage jumps another $2 per hour. RNs earn a lot more. In rural areas, they can expect $22.45 an hour. In urban areas, that’s bumped up to $25. In Kansas City, they average $27.98 per hour.
Though she couldn’t give exact salary figures, teachers make much less, Covault said, making it hard to fill those roles.
“The reality is, the nurse that is working on the floor is making more than educators,” Covault said.
Luckily for students, and the state in general, both Covault and Assistant Nursing Director Beverly Rousch both love to teach. Covault has been with the program since 1991, Rousch since 1988. Neither plans to leave.
At NCCC, Covault said, “We are sitting better than we have been the last couple years, but ideally we need masters-prepared nurses” as teachers. Current provisions by state and national accrediting bodies allow nurses with a bachelor’s degree to teach, but the situation is not optimal, Covault said.
The advanced degree entails more experience, equalling more knowledge, Covault said.
“To teach the associates of nursing program, nurses must have a master’s of science in nursing,” Covault said.
Because MSNs can earn so much more on the floor, though, few are interested in teaching. Plus, Covault said, many masters-prepared nurses are now opting to become nurse practioners.
“They work under a doctor’s prescriptive authority,” she said, but can be the primary provider for some patients.
“The advance practice laws have changed across the nation in the past few years,” explained Deb Grazda, Chief Nursing Officer at Allen County Hospital.
“They have expanded the roles and those nurses with a higher education are allowed to do more.” Such nurses earn even more than RNs.
The lack of new nursing instructors puts a strain on those nurses already in academia, Covalut said.
“Most of us are covering full loads. Full time nursing faculty are full time in the classroom and clinical. The average instructor wil lecture and be in the hospital with students and have office time.”
It amounts to about two full days at each task, Covault said. “We’re stretched.”
NCCC has 17 FTE faculty plus additional clinical adjuncts, Covault said.
“Those clinical adjuncts are generally working nurses. They work on the floor three days and teach two days,” she said. 
“Regulations say we can’t have more than 10 students per clinical instructor,” Covault said. A recent instructor illness at the Chanute campus left the college shifting staff to cover classes, Covault said. Still, NCCC’s program is successful.
Both the Chanute and Ottawa programs take 48 students each year as LPN candidates, plus 48 LPNs looking to get their RN liscensure. An additional 20 RN students sign up for online studies, Rousch said.
“Our students have to take their LPNs boards at the end of their first year,” she said. Unlike some prgrams that the KHI said are fighting to retain the state-required 75 percent LPN pass rate, “We have had a 100 percent pass rate on the LPN level for the last 18 years,” Rousch said, and “We had a 93 percent pass level at the RN level last year.”
She credits the stability of the program and the maturity of the students.
“We now require that students have their CNA before they apply into the nursing program.”
At Allen County Hospital, Grazda is concerned about the decline in other parts of the state. While the KHI said that students struggle most with writing and math, Grazda pointed out that “Communication has been identified as a huge patient issue. There have been a number of studies that show that ICU survival was impacted by doctor/nurse communication.” If students lack such skills, quality of care can be impacted, she said.
ACH is a critical access hospital, Grazda said. It is connected to a larger web of hospitals through its management under the Hospital Corporation of America. “It gives us a lot of access to large metropolitan facilities both in Wichita and Kansas City,” Grazda said. “We have access to hospitals that can do any kind of care, and that’s a big asset to nurses.”
“HCA constantly provides us with up to date data, information and training,” she said.
“It’s extremely important to retain nurses once they’ve gained knowledge of our processes,” Grazda said. “It’s our number one priority.”
That sentiment is universal, Covault said.
“Many of our students are already employed in health care” when they begin at NCCC, she said. “They may be a CNA at a hospital already, and the hospital tries to hold on to them.” Most of those students remain job-attached, Covault said, and return to their hospitals as RNs after their schooling. It’s a win-win situation.
“NCCC has had to do far less career placement, and the hospitals get a trained RN.”
Neosho County Community College’s nursing program can be reached through its web site at www.neosho.edu. The nursing link is on the left.

01/28/09

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