Oregon Health Care Employers Hamstrung By Staffing Shortage, As The State Produces 3rdfewest Nurses Per Capita

© Sami Edge/oregonlive.com/TNS Daniel Bullek, coordinating professor of nursing and simulation at Clackamas Community College, works with second-year nurses during a Jan. 9 class. Oregon colleges and universities struggle to find enough qualified faculty to train nurses. Alumni Hat Oregon Gets to Work! Sami Edge / The Oregonians.

While working as an intensive care nurse in a Portland cardiology unit, Jazzy Walker suffered burnout due to COVID, which has pushed nurses out of the industry and exacerbated a widespread nursing shortage in Oregon's health care system.

She saw some of her more experienced colleagues falter under the heavy load of sicker patients, and she felt the team dynamic change as hospitals brought in nurses on short trips to fill staffing gaps.

When Walker suffered from stress that was causing panic attacks and sleepless nights, she decided to switch from nursing to science and focus on training future nurses.

After four months as a nurse at Clackamas Community College, Walker is faced with a chicken-and-egg situation that prevents Oregon colleges from meeting the needs of the healthcare industry.

Nurses cannot make as much money from teaching as they can from helping patients, and recruiting nurse educators is difficult. This teacher shortage limits the number of students who can enroll in nursing programs and prevents Oregon schools from producing enough nurses to meet the state's workforce needs. Staff shortages at both institutions mean that fewer nurse educators are available to teach students in practical clinical settings, further reducing the number and experience of graduate nurses.

© Sami Edge/oregonlive.com/TNS Clackamas sophomore Ali Oakley shares a special occasion with her classmates. Clackamas government wants to expand the nursing program to address the industry's labor shortage, but it's being held back by a shortage of nurse educators.

"It's a very ugly cycle," Walker said.

Oregon's nursing programs ranked third in the number of graduates per capita in 2020, according to Oregon Joint Longitudinal Data, which analyzes Oregon education and workforce data.

“Many of our schools have programs. It's a domain issue,” said Tracy Thompson, nursing education policy analyst for the Oregon State Board of Nursing. "There are no more teachers to support the students."

The joint panel's next report, expected in February, will recommend the state convene a task force to address the issue of nurses' salaries and implement a centralized staffing system for clinics. Nurse educators are reaching out to lawmakers to demand policy changes that can address problems in the critical public sector workforce.

"We can encourage clinical pathways, and if the state funds the salaries of nurse educators and program administrators, that would help solve both of our problems," Walker said.

LIMITED AUTHORITY

Oregon has 17 baccalaureate nursing programs, as well as six public and private baccalaureate programs and eight other community college programs for licensed practical nurses who have less than a registered nurse degree.

According to Ben Tate, director of the Oregon Longitudinal Data Collaborative, 409 students graduated from nursing programs in 2020, with 606 students earning a bachelor's degree in nursing.

But experts estimate Oregon needs 1,000 more graduates this year to meet workforce needs, according to an upcoming report summary.

Schools have enough enrollment to double. Oregon nursing schools received more than 6,000 applications in 2020, but less than a quarter were accepted, according to a draft summary.

Clackamas Community College sometimes accepts more than 300 applicants for an average of 30 openings, Walker said.

"It's very difficult to turn away so many potential nurses," she said.

Jennifer Lemons, 36, is a second-year nursing student from Clackamas and plans to become a full-time nurse this summer. She worked for several years and took the necessary courses before applying for a nursing degree, inspired by the nurses who cared for her 4-year-old son when he needed kidney surgery at Randall Children's Hospital.

Limones, who has worked as a paramedic for 15 years, was immediately accepted into the Clackamas program. He knows that it is unusual.

“There are many capable and qualified prospective nursing students who are not, and it is not because of a lack of qualifications or skills. It's not incompetence or incompetence," Lemons said. "There's very little room, and that's really disappointing.

Walker hopes to expand the existing space in Clackamas. In an ideal world, 36 locations will be offered next fall and work to open 40, possibly 60 in the long term.

But this fall, Clackamas didn't have enough teachers for the standard set. Walker said the school has cut its usual 30 spots to 18.

"Trying to advertise and get nurses to teach our students is like pulling teeth," Walker said. "They can't afford that pay cut financially, so they won't be working full time."

DO NURSES EARN LITTLE EXHIBITIONS?

Walker almost quit her job at Clackamas when the school's first offer was $30,000 less than she was making as a full-time nurse.

Without the extra round, Walker could have won $90,000. With extra spins, he won over $100,000. By comparison, full-time school teachers make between $60,000 and $80,000, according to Walker.

This is a challenge facing nursing program administrators across the state. Jenny Griffin, director of nursing at Columbia Valley Community College, reminded the new teachers that they have most summer and weekend days and can participate in patient care.

"If you look at an ad and you see I'm going to make $20,000 less (nurses say), 'I'm not even going to apply,'" Griffin said. "I don't know how we can catch it, hook it, bring it inside and say: try it, I think you will like it."

Oregon Health & Science University works to advance the nursing profession through the Oregon Nurse Training Academy. The academy aims to train 63 new faculty members and 92 new chief medical officers with a $4 million federal grant. Nurses admitted to the academy receive scholarships that cover most of their tuition.

Several lawmakers have proposed bills in the 2023 session that would provide income tax credits for rural nurses. A similar experiment in the commission died in 2019.

VARIOUS CLINICAL SITES

Nursing students need practical experience to complete their training, but a shortage of teachers and nurse practitioners means there are few teachers to guide students in clinical settings. During the COVID-19 pandemic, the shortage of outpatient facilities has increased and many medical facilities have been closed to the public.

Deb Henry, nurse education and practice specialist at Legacy Health, said the hospital system offered 2,607 clinical positions for nursing students in fiscal year 2020 and only 468 in 2021 due to epidemic-level workforce shortages.

Hospital units with few nursing positions cannot accommodate as many students, and senior staff or visiting nurses will take priority over student education, Henry said.

"We try really hard, I try really hard to accommodate these students, but there are so many variables that it's hard," Henry said.

The Oregon Board of Nursing allows schools to substitute nursing simulations (such as high-tech mannequins, case studies or actors) for up to 49 percent of a student's clinical hours, Thompson said. Some schools took advantage of this opportunity.

The Linfield School of Nursing has expanded simulation centers to meet the needs of students for clinical experiences during the pandemic. Spending time with nurses in real health care settings helps prepare students for one-on-one work with patients, but the hours can be unpredictable, said Julie Fitzwater, dean of nursing. Simulation allows teachers to create experiences that their students want to work with, e.g. B. care for a mannequin suffering from labor and postpartum hemorrhage or interact with an actor impersonating a patient in mental crisis.

"Both experiences are important for building clinical judgment and judgment," Fitzwater said.

This story was brought to you in partnership with The Oregonian/OregonLive and Report for America. Find out how you can support this important cause.

Sami Edge is pursuing a college degree at the University of Oregon. He can be reached at sedge@oregonian.com or at (503) 260-3430.

© 2023 Avans Local Media LLC. Visit www.oregonlive.com. Distributed by Tribune Content Agency, LLC.

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