DECATUR -- In a 20-mile radius of Macon County there are 1,059 openings for registered nurses.
How will all those positions get filled? That’s a question health care providers in this area and all over the country are trying to figure out. Macon County alone can’t provide its own nursing workforce: There are just 54 RNs in Macon County looking for work.
“How scary is that?” said Laurie Brown, regional director of operations for Christian Homes Inc., which includes Hickory Point Christian Village.
Denise Smith, director of people services for HSHS St. Mary’s Hospital, said the nursing shortage could potentially get worse.
“The demand is going to be there; it’s only going to increase,” Smith said. “You’re seeing growth in preventative care, but you’re also seeing more obesity and diabetes, health problems that are going to require attention. The baby boomers are also living longer, and there’s more access to care under the Affordable Care Act.
“All that is adding up to a lot of opportunities for nurses right now.”
Smith said the U.S. Bureau of Labor has indicated there will be a 16 percent increase in the number of registered nurses by 2024. Demand is also high for certified nurses assistants (CNAs) and licensed practical nurses (LPNs).
St. Mary's recently held a nursing recruitment fair and is planning more. Linda Fahey, Decatur Memorial Hospital chief nursing officer, said her hospital has recruited 45 nurses since January, but may need to average 50 a year to keep up with annual attrition rate.
Fahey said the majority of the nurses DMH hires are new graduates from Millikin University and Richland Community College, though some are also from the University of Illinois and Illinois State University. But even with two colleges with nursing programs and an adult education program from the public school system for CNAs, Decatur is feeling the squeeze.
Fahey said even if the number of nursing students increased, there's still the problem of would-be nurses on waiting lists to get into nursing programs because of the cost involved in running one.
“Training a nurse is expensive -- it takes one faculty member per eight students,” Fahey said. “The requirements for teachers are an advanced practice or doctorate degree, but that faculty isn’t readily available. Schools are having trouble expanding because it’s expensive and there’s a faculty shortage.
“But we’re trying to combat this. We, along with St. Mary’s, have dialogues with both Richland and Millikin trying to come up with ideas and increase the number of students they enroll.”
With the number of jobs rising and the numbers entering the workforce remaining stagnant, medical facilities are looking for ways to make sure they can recruit nurses. Benefit packages are at the top of the list.
According to the U.S. Bureau of Labor Statistics' 2016-17 Occupational Outlook Handbook, the median salary for an LPN is $42,490 and for an RN it’s $66,640. Sign-on bonuses are also becoming common.
Nurses also have more opportunities, particularly with the rise of nurse practitioners and nurse anesthetists. But that's only added to the shortage.
“That’s one thing that’s wonderful for my profession: Nurses are going back to school and filling the gap for primary care in our community,” Fahey said. “But that's actually made it even more difficult to find RNs."
The biggest shortages are on medical units and emergency rooms. Fahey said especially with an aging pool of nurses -- the average age of an RN at DMH is 45 -- it's become more difficult to staff night shifts and weekends.
"Especially with more positions available out there that are daytime Monday through Friday, those bedside nurses in inpatient environments are hard to find," Fahey said. “Those positions are hard, physical work with hours that aren’t as attractive as you grow in your profession. We recently celebrated a nurse who had worked on our medical until for over 40 years -- that’s rare.”
The problem, Fahey said, is it’s those positions where the best nurses are needed.
“You have to always be thinking, setting priorities and paying attention to a lot of different things,” Fahey said. “Our sickest patients are in critical care and the ER -- we need some experts in that area, too. But you have to really love it to do that.”
Those are the kinds of nurses Brown is looking for. But she said she worries that, with the rapid increase in positions and money being paid to nurses, finding ones who truly love the profession will be more difficult.
“Not everyone is meant to be a nurse,” Brown said. “You want people who have the compassion, the heart; the gift. You want people who are doing it who aren’t just about the dollar.”
But finding nurses isn't the only concern. Even when area medical facilities identify a qualified nurse, many of those coming out of Millikin who aren’t from the area choose to return to their hometowns.
“I love Decatur; I’ve lived here my whole life,” Brown said. “But Decatur has a lot stacked against it. It’s hard to get people here. It’s another reason we need to look at how we can get people here and create jobs for people who have nurses in their family.”
While recruiting and creating more nurses remains a priority, Smith and Fahey said working smarter also can help relieve the shortage.
“We want to make sure nurses’ workflows utilize them to the top of their license,” Smith said.
Fahey said the goal is to streamline nurses’ jobs and make sure other services such as housekeeping, dietary, nurse’s aids and phlebotomists are filling the roles patients often mistakenly ask nurses to do, such as fetching water and snacks, taking blood and cleaning.
“We want nurses to be nursing, not doing other things,” Fahey said.
Brown said solving the nursing shortage won’t be easy, and Decatur’s medical community will need to pool its resources to accomplish it.
"We need to come together and figure out what to do about this, because what we’re doing isn’t enough,” Brown said. “I don’t think there’s anyone out there providing poor care because they don’t have enough staff. I think we’re all just figuring out how we’re going to survive it. We’re managing it.
“But there are going to be people leave and people are going to retire. With the pool we have now … it’s not enough. We have to find a way to get more nursing students and then pull them in.”