It’s been all over the news for years, but as time marches on and experienced nurses retire, the estimates become more dire. How will this affect central Illinois? Andrea Parker, an RN with more than 20 years of experience in both public nursing and hospital settings, is currently the public health administrator for the Peoria City/County Health Department and the Marshall County Health Department. She shared her insights about where the problems lie, what can be done about them, and why nursing is a great career choice.
Parker said the Illinois Department of Public Health projected that by 2020, Illinois could face a shortage of more than 21,000 nurses as a result of the aging Baby Boomer workforce. Meanwhile, central Illinois institutions are doing their best to train new nurses. “We have several opportunities for someone to go to nursing school. Both Methodist and OSF Saint Francis have converted into four-year Bachelor degree programs. Bradley University, Illinois Central College, Illinois Wesleyan University, and Illinois State University all have programs.”
But getting into one of these programs isn’t always easy. “This area’s grade point minimum for entrance is 2.5. Many people think nursing is an easy curriculum, but it isn’t,” Parker said. “And although the programs admit a certain number of nursing students each semester, retention is also an issue. Once in the program, students are exposed to the art and science of taking care of real people—the need to touch and assess all body parts, orifices, etc. This is where one has to decide, do I really want to become a nurse? Do I have what it takes? Some students will self-select out of the program, and some will be eliminated due to poor grades and performance.”
She said another issue is providing enough high-quality nursing instructors. “There are many nurses who don’t seek advanced degrees, especially at the doctorate level. This results in a limited number of faculty positions, which affects the number of students a program can accommodate. Many nurses have said that for the stress and cost associated with getting an advanced degree, they’ll see no pay increase for such an enormous commitment and accomplishment. And if you’ve ever researched the pay for nurses, you’ll know the highest paying positions are in the hospitals, especially for the new grad.”
In what seems like good news, Parker said local schools of nursing really don’t have a waiting list, and local hospitals aren’t offering the large sign-on bonuses they have in the recent past. But instead of signaling a healthy nursing supply, it could be interpreted as resignation. “As a society, we’re using the ‘do more with less’ model; I know that doesn’t sit well with some, but with the economy as it is, this motto isn’t a new one.”
Her two-decade exposure to medical and nursing students could hold some answers as to why the schools of nursing are full but we’re still experiencing a shortage. “Many medical students come to Peoria for the great learning opportunities, with no intentions of remaining in this community once they’ve completed their programs. I was told by a medical resident once that the Peoria medical community pays such large stipends that they attract fine students from all over the country who don’t want to work, play, and live in the Peoria community. Like the medical residents, many nursing students aren’t from here and don’t plan to remain once they’ve graduated. They return to their Chicago and neighboring communities, as well as other communities throughout the state.”
Parker said many of the hospital-based programs seem to attract more local students than the academic institutions, and they usually make arrangements so those students have employment upon graduation at the affiliated institution. “However, another factor I see with my own staff is those who are interested in seeking a nursing career are challenged with how to attend school and work a full-time job. Much of the coursework for the programs are daytime classes, which are difficult to fit into a work schedule. With the many programs in this community, clinical sites are another issue. Not only are the schools’ capacity of students limited by their number of faculty, but the clinical sites in the community require someone with similar education and credentials to oversee and educate nursing students.”
She said in addition to the sheer number of nurses needed, there’s also the issue of creating a workforce that resembles the populations being served. “It’s been documented that by the 2010, our country will see an increase in our Hispanic, Asian, and biracial populations. Therefore, schools should be planning the recruitment, retention, and training of minority workers. Mentoring programs are necessary. For students who didn’t fare as well as their non-minority classmates in math and science and weren’t guided and supported, their grade point average will prevent them from being accepted into the nursing programs. And even once accepted into a program, some will require positive reinforcement, encouragement, mentoring, and academic support to complete the program successfully. Also, some non-minority folks will need cultural and diversity training and education. It will be, and currently is, a learning curve for all of us.”
Parker is up to the challenge, however. She grew up surrounded by relatives who were nurses and believes something innate guided her into the field of nursing. “At an early age, I remember playing with my Barbies and baby dolls. Somehow, they always seemed to require health care assistance.”
She graduated from the Methodist Medical Center School of Nursing with a diploma in nursing and started working as a registered nurse. The following year, she enrolled in the Bradley RN Completion Program. “At that time, the tuition reimbursement from Methodist was 100 percent, with books being reimbursable at 50 percent. I was fortunate; I was in the last class that benefited from this arrangement between Methodist and Bradley. Once I completed the BSN program, I immediately enrolled into the Masters program at the University of Illinois College of Nursing in Peoria.”
Initially, Parker was in a medical-surgical track curriculum but later transferred into the community health nursing curriculum, which she thoroughly enjoyed. “It was during that period that I began to understand theories of nursing and what I believed about the nursing role. I was exposed to a theorist named Madeline Leineger, whose nursing theory was based on ‘cultural care’ of all patients, and this is the theorist upon which I based my graduate work.”
As a public health worker, she knows there are far more opportunities for nurses than just hospitals—including schools and home health care. “Most of us correlate nursing and a hospital setting. I did too until I got the exposure of providing nursing care outside of the hospital. It was through my experience as a home health nurse that I realized my role as nurse was much more fulfilling on the outside of a hospital. The hospital setting is sterile, clean, mostly controlled, and you have other nurses to help you. But when you’re out there caring for people on their turf, it’s much different. You become more of an advocate for your patients. You see how people live; what priorities guide their life; and why and how they practice their health care, support their families, etc. I believe that as health care costs continue to rise, we’ll see less care take place in a true hospital setting; people won’t be able to pay for it.”
Recruiting for these public health positions is extremely difficult, Parker said, especially in this community. “One issue is pay. Our public health nurse pay scale can’t compete with the hospital nursing pay scale. But it isn’t all about the money; public health often takes on the more challenging clients such as young mothers on medical assistance who may live in neighborhoods where safety is an issue. Some don’t find disease prevention attractive. Again, the hospital setting offers, and is perceived as, a safer work environment. Many nurses in this community don’t understanding the duties of a public health nurse; therefore, their interest is limited. When nurses interview and hire into the health department, we often hear, ‘I had no idea of all the roles and opportunities for nurses here.’ I believe we’re a well-kept secret for nurses. Even after I started working here, I thought to myself, ‘What took me so long to get here?’”
Although she doesn’t currently work as a clinical nurse, Parker said her nurse training drives most of what she does. “I have the ability not only to assess one patient, but now as the public health official for Peoria and Marshall counties, I assess the entire community—the population—and see where public health can make a difference. I feel blessed that the career path I selected has provided me with training and experiences that have enabled me to be better prepared for what I do every day.”
To help address the projected nursing shortage, Illinois Gov. Rod Blagojevich proposed a plan that Parker hopes will, indeed, aid the cause. According to Parker, part of his plan includes:
• The development of a center for nursing, creating a strategic plan within the department of financial and professional regulation that will maintain a database to monitor nursing supply and demand, as well as develop nursing retention and recruitment initiatives.
• Nursing educator scholarships in the amount of $1.3 million towards nursing education to make it more affordable and attractive. One faculty member can add 10 nurses to the workforce.
• Increasing grants to nursing schools to address faculty salaries, allowing for more evening and weekend nursing education to accommodate more students.
• Changing existing nursing scholarship programs, allowing for current scholarships to include merit, in addition to financial need, to be considered.
• Student loan repayment for nurse educators, allowing current nurse educators or those in Masters and Ph.D. programs to have a $5,000 student loan forgiveness for up to four years. For every year of student loan forgiveness, a nurse must work one year as a nurse educator in Illinois.
“The governor has stated it will take approximately $3 million to $5 million a year for the next 14 years to eliminate the nursing shortage. I’m not sure where the dollars will come from to accomplish this plan, but I’m pleased to see his attention to the nursing shortage and his willingness to develop a plan to address it,” she said.
Parker admitted there are some aspects of the field that may seem unattractive to potential nurses. “Often, nurses feel unappreciated—for the long hours, hard work, and dedication they provide to their patients. The pay isn’t always commensurate with the level of work—or so it’s felt. Nurses work around the clock, and that sometimes requires sacrifices of their families. Some people may fear the nursing profession because, ultimately, your nursing care may be the difference between life or death.”
However, the challenges are far outweighed by the rewards, she said. “Among the best aspects of nursing: you can work anywhere in the world. Pick the arena that most interests you, and go for it. Also, you have a real opportunity to save a life, change a life, and help somebody. It’s an extremely rewarding career.” TPW