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IN SEARCH OF MICHIGAN'S NEXT NURSES

WHY THE STATE NEEDS MORE NURSES, AND WHAT IT MEANS FOR YOUR HEALTH

By Claire Charlton

Michigan, like the rest of the country, needs nurses. No matter the health of the economy, registered nurses continue to be in high demand. The National Institutes of Health's Bureau of Health Professions projects 120,000 job openings per year for registered nurses until 2014, with a widening gap between demand and supply continuing well beyond 2020.

"There is a tremendous demand right now. If you want to be a nurse, you can write your own ticket, make huge amounts of money and do humongous numbers of things," says Barbara Redman, Ph.D., dean of the college of nursing at Wayne State University.

With the country's aging population and ever more ways to access health care, Michigan's nursing workforce is spread thin and expected to get even thinner, says registered nurse Carole Stacy, director of the Michigan Center for Nursing.

The average age of a nurse in Michigan is 47, and one-third of Michigan's 140,000 practicing nurses, about 46,000, will leave the profession in five to 10 years. Each year, Michigan's 56 nursing programs graduate just 3,000 nurses, says Stacy.

The real crisis: training

The answer seems simple: Train more nurses. Yet according to the American Association of Colleges of Nursing (AACN), nearly 43,000 qualified applicants were turned away from schools in 2006 because of insufficient numbers of faculty, clinical sites and classroom space. Add to that the average nursing educator's age of 55 and the fact that more than 50% of Michigan nursing faculty are currently eligible to retire, and the situation becomes even more complex.

"The largest issue facing the nursing shortage now is the faculty shortage," says Suzanne Mellon, Ph.D., dean of the college of health professions and the McAuley School of Nursing at the University of Detroit Mercy. "You can't bring in unlimited numbers of students without the adequate faculty to teach them."

According to AACN surveys, the salaries of nursing professors have fallen well below those of practicing nurses, although the fact that many in academe work under a nine-month contract must also be taken into account. The University of Detroit McAuley School of Nursing reports that entry-level nursing graduates earn an average starting salary of $40,000. Emergency room nurses with master's degrees average $80,000 per year, according to the AACN, while nurse professors with master's degrees average $60,000 per year. These disparities could discourage qualified nurses from considering jobs training more nurses.

Persistence pays off

The paths to nursing are as diverse as the many roles nurses take. Nursing students can attend community college, where it takes about two years to achieve an associate's degree in nursing. Many Michigan universities offer bachelor's, master's and doctoral nursing programs, which take four years or longer to complete. Wayne State University and the University of Detroit Mercy offer accelerated second degree programs for those who hold a bachelor's degree in another subject. Students can receive a bachelor of science in nursing in as little as one to two years.

With so few nursing school openings, competition is fierce. A high grade point average in prerequisite courses is a strong predictor of success in nursing school, and will help pave your way to getting accepted, says Redman. Demonstration of community involvement plus a clear commitment communicated through goal statements or interviews also will help.

"All universities are expensive, but the nursing program is very hard and you have to be prepared to give up work and be fully committed, fully focused on your program," she says.

Those lucky enough to be accepted into nursing programs learn that whatever their skills, there is a place for them in the profession. Although nurses are needed across the spectrum of health care, the areas of surgery, mental health and public health currently have the most need for qualified nurses, Redman says.

Finding solutions

In metro Detroit, nursing jobs are plentiful enough to create competition among employers. Oakwood Healthcare System has discovered the value of collaboration with educational facilities in increasing the chances of recruiting quality nurse graduates.

"[Oakwood] proactively partners with Oakland University and Michigan State University to offer accelerated nursing programs while simultaneously addressing faculty shortages many schools are facing by providing our own nursing staff as clinical instructors," says Diane DiFiore, R.N., director of nurse recruitment and retention at Oakwood Healthcare System.

Nursing is a career that requires considerable personal commitment, both in education and on the job, but the return on investment can be huge, says Redman.

"You are immediately sought out for a job, and can work up to very high figures," she says. "You can work everywhere, internationally and in any place in the U.S. We need people to get into these [nursing] jobs and grow jobs for Michigan."

4 WAYS THE NURSING SHORTAGE MIGHT AFFECT YOU

A 2002 national poll found that a majority of Americans trust, respect and admire nurses. But should the average person be concerned about a shortage? Here are four ways it could affect you.

1. Quality of care. According to a 2005 survey in Nursing Economics, more than 75% of registered nurses believe the nursing shortage negatively impacts patient care because it increases stress on nursing staff and causes burnout. Too few nurses, too little time with patients and fatigue among professionals contribute to an increase in consumer dissatisfaction in health care, according to a 2004 survey.

2. Patient safety. A 2005 study reported that 93% of hospital RNs said they didn't have enough time to maintain individual patient safety, detect complications early or collaborate with team members. Another study found that 53% of physicians and 65% of the public cited the shortage as a leading cause of medical errors.

3. Medical outcomes. Thousands of patients' lives could be saved by more bedside nurses, according to a 2002 study published in the Journal of the American Medical Association. A higher proportion and greater number of hours of nursing care provided by RNs was associated with better outcomes for hospitalized patients, according to another study.

4. Fewer caregivers for an aging population. Baby boomers will be aging at the same time the nursing shortage is expected to substantially increase. The ratio of potential caregivers to the elderly population will decrease 40% between 2010 and 2030, according to a 2001 study by the University of Illinois.