Across the country and locally, too many of America’s nurses have felt overworked, neglected and ready to take back their lives. Many have dropped out of the profession, and that has put even more pressure on those who are left.
A November 2022 survey conducted by the N.C. Nurses Association tells the story.
In a survey of 315 respondents, 79.1% of the association’s members said their workplace suffered from a “severe” or “moderate” shortage of nurses. Nearly 60% said that shortage had forced them to work longer hours or take different assignments. Nearly 50% said they have witnessed violence on the job, with more than a quarter saying they were the victim.
And on a scale of 1 to 10, with 10 being ready to leave the profession, just over 50% said they felt they were halfway to burnout.
Should nurses turn their back on a noble calling? Or should they stick it out and hope for the best?
Suprena Hickman (shown in the middle with students
), a registered nurse and owner of Sankofa Training & Wellness Institute, worked at New Hanover Regional Medical Center after coming to Wilmington 20 years ago. She opened her certified nurse assistant training program in The Murchison Building in December and calls CNA a “must” for anyone planning on entering nursing school. Her focus is on increasing diversity among the local nursing workforce.
Hickman’s hopes come at a time of restlessness in the profession, sparked by fatigue and a felt lack of appreciation “because now, after the pandemic, nurses are realizing ‘Hey, we got options, we can do other things.’ And they’re starting businesses; they’re leaving the field,” Hickman said.
According to research conducted by the N.C. Board of Nursing and The Cecil G. Sheps Center for Health Services Research at the University of North Carolina at Chapel Hill, hospitals, medical practices, assisted living centers and other in-state facilities face a shortfall of 12,500 registered nurses by 2033.
“Most regions of the state are projected to face RN (Registered Nurse) shortages except for the Southeast region; all regions will face LPN (Licensed Practical Nurse) shortages,” the research paper warned.
Registered nurses, who have more advanced training, can engage in broader and more complex kinds of patient care than licensed practical nurses, who engage in more basic care and generally are supervised by an RN or a doctor. Certified nurse associates often consider their position a steppingstone to further education and advancement.
But already, a shortage of nurses has led to longer wait times in emergency rooms and delays in elective surgeries, along with the possibility of reduced quality of care, especially as the demand for medical services by aging baby boomers grows.
STOPPING THE BLEEDING
With realization that the nursing shortage will take years to overcome, an increasing number of leaders in the public and private sectors have reached out to one another to collaborate more closely or create partnerships to stop the exodus of much-needed talent and to attract fresh faces to the field.
In Southeastern North Carolina, Novant Health New Hanover Regional Medical Center and Cape Fear Community College have each launched an ambitious program to help train, place and retain new or advancing nurses.
Just a year ago, Novant Health NHRMC was in danger of losing Medicare funding after regulators cited deficiencies in the level of nursing services, emergency services, quality assessment and performance improvement, according to Becker’s Hospital Review. Novant put forth a plan of corrective action, and the Centers for Medicare & Medicaid Services found the hospital to be in compliance.
While hospital officials cobbled together their plan of action, they also went live with a new, yearlong residency program designed to recruit and retain quality nursing staff. That program, months in the making, attracted 117 participants.
“This program is valuable because it provides an opportunity to nurture all new graduate nurses as they complete rotations throughout the hospital to gain clinical skills and help identify where they would like to work,” said Amy Akers, the hospital’s chief nurse executive, adding that “in some cases, nurses were able to pick their final home after two rotations, and in other cases, nurses continue to complete a third or fourth rotation. … We’ve seen very high retention rates for our nurse residents.”
Akers said the hospital has heard from both local and out-of-state candidates who are interested in the next residency class, “so we’re very optimistic this will continue to be a strong nursing recruitment and retention tool.”
Novant Health NHRMC has now “substantially closed the gap” in staffing by utilizing both permanent and more costly traveler nurses and has “seen improvement in staffing levels over the last six months,” Akers said in late May. Hospital officials declined to provide specific numbers.
Other recruitment programs at Novant Health NHRMC include partnerships with colleges and high schools to drum up interest in the profession as well as providing upfront scholarship money for nursing trainees, including support for CNA students at Sankofa Training.
At Cape Fear Community College, where about 130 students enroll in nursing programs in the fall and about 60 in the spring, officials have announced a goal of recruiting 200 new nursing students per year going forward.
That goal may be made easier thanks to a total of $1 million in scholarship money donated by individual and corporate donors. The money is earmarked for students who demonstrate financial need and will provide an additional 52 nursing scholarships on campus, bringing the number of recipients to about 130 per year.
“By providing financial support, we are enabling students to pursue a career in nursing and helping to address the critical shortage of health care professionals in the region,” said CFCC President Jim Morton in an April 28 press release.
But there is an even more significant development looming.
Last fall, New Hanover County’s Board of Commissioners approved the use of nearly $12 million to purchase the five-story former Bank of America building at 319 N. Third St. in downtown Wilmington. When the deal closed in April, the county ended up paying about $11.4 million for the property.
A lease agreement for CFCC space in the building will cost the college just $1 annually.
From now through fiscal year 2027, renovations are slated to take place to convert current office space into classrooms, additional laboratories and a simulation section to support the college’s growth plans.
Mary Ellen Naylor (shown left
), CFCC’s dean of health sciences, said the nursing and allied health programs were already “bursting at the seams” at Union Station and the L Building on the downtown campus when the college started zeroing in on enrollment growth several years ago.
Naylor said that in addition to a projected $14.8 million needed for renovations, 12 more full-time and 15 more part-time faculty members will be hired.
“Our goal is to have some initial space ready for classes in January of 2024,” Naylor said, while citing Novant Health in particular as a major supporter of the college’s ambitious plans.
“So it is certainly the financial assistance from Novant in supporting our students with scholarships. It is Novant identifying employees that they have, that can come into our programs and then go back to Novant. It is providing clinical sites and for students to get those clinical experiences that they need. It’s job placement,” Naylor explained.
“As the students graduate, over 90% of our students, our graduates, stay here in our local community,” she emphasized.
As for the University of North Carolina Wilmington, the number of new nurses obtaining a bachelor’s degree dropped from 271 in fall 2021 to a low of 200 in summer 2022, but bounced back to 263 last fall as the pandemic began to recede.
Back at Sankofa, Hickman is continuing her classes to qualify students as CNAs. Initial training can be accomplished in 19 days over six weeks, followed by a state board examination that can be taken online and a live demonstration before a proctor of five skills out of 23 taught.
Novant Health is covering tuition for the students on condition that they earn their certification and accept employment with them.
In addition to training future nurses, Hickman serves as a health and wellness coach to a wide range of clients, from blue-collar workers to executives. Many of those clients, including nurses, are on “the brink of breaking,” said Hickman, who has personally experienced burnout and works with each client to peel away the layers of individual, family and professional issues that beset them, putting them on the road to positive plans that can guide them throughout their lives.
“The fact is, shortages of specialized clinical workers, including nurses, is a nationwide challenge we will have to contend with for the foreseeable future,” said CFCC’s Naylor.
With fresh funding, more robust training, some new facilities and accelerated hiring – and maybe with a little help from a coach or counselor at times – it looks like the current prescription for troubled times in health care just might be what the doctor ordered.