Vermont’s hospital workforce is suffering from one cancer in two forms: age.
“We’re losing health care providers to retirement, and we have an aging population that requires care,” said Devon Greene, vice president of Government Relations at the Vermont Association of Hospitals and Health Systems. “We absolutely cannot sacrifice our quality of care.”
According to a Vermont Talent Pipeline Management survey from 2018, an estimated 3,900 new nurses would be needed throughout the state by 2020 due to attrition and retirement.
As a result, medical facilities are having to shell out more cash when hands are needed and nurses are scarce, and traveling nurse agencies are the only place for hospitals to turn.
But experts said the graduation rate of nursing students is still too slow, especially for medical facilities that require 80% of their nursing staff to have a bachelor’s of science degree in nursing to maintain their magnet hospital status.
Like Rutland Regional Medical Center, where they might have 30 traveling nurses at any point in time, when they would hire permanent nurses to fill 20 or 25 of those positions, if they could find them.
But many of the new nurses gravitate toward the mobility of travel nursing and the opportunity to work in varied locations.
“For certain, we are sensing there’s a (diminished number) of available nurses out there,” said Brian Kerns, vice president of the Human Resources Department at RRMC. “Contract nurses do tend to cost, on average, twice as much as a permanent nurse.”
Dr. Angela Smith, chairwoman of Castleton University’s Nursing Program, said if a base rate for permanent nurses started out at an approximate $47 per hour, as an example, an agency contracting out traveling nurses could cost the hospital over $100 per hour due to increases in contracting fees, housing and placement.
“It’s not (necessarily) that the nurse is making more money,” said Matt Choate, chief nursing officer at Central Vermont Medical Center. “Traveling help is more expensive because you’re paying the company in the middle.”
To combat the competitive availability of traveling nurses — some of whom only spend several weeks at one location — hospitals are coming up with new programs to speed up and sweeten the educational deal for prospective nurses.
At RRMC, all new nurses who are signed on to a two-year contracted commitment with the hospital receive a $5,000 sign-on bonus in addition to help with relocation costs for those who have to move to the area.
A 12-week licensed nursing assistant course is offered up the road at Stafford Technical School for approximately $1,500, and a subsequent course ranging from two to three years is available through Castleton University, Kerns said.
“We will help support the student through the course,” Kerns said. “In many cases, we will pay for them to get their (bachelors of science in nursing.)”
There is also a nurse residency program at the hospital in addition to the regular orientation program, a year-long mentoring and professional development program for new nurses, said Peg Bolgioni, communications specialist and marketing & public relations for RRMC, and they regularly collaborate with nursing programs at Norwich University, Colby Sawyer College, Adirondack College and Castleton University, the latter of which provides RRMC with most of their nurses.
At CVMC, where Communications Specialist Hjonas Hanson said there is an 8% nursing vacancy, 27 traveling nurses currently make up the hospital and skilled nursing facility, filling both temporary vacancies and open staff positions.
“There’s been talk over many years that we have a looming nursing shortage, and its definitely catching up to us in Vermont,” Choate said.
To combat the nursing shortage, this week they initiated a pilot program to test 18 of their current LNA staff, a full class: an 11-month in-house training at CVMC to earn an LNA’s licensed practical nursing certification, along with classes through Community College of Vermont and Vermont Technical College.
“One of the barriers (to continuing their training) is they can’t leave their current job, because then you have no income, and you can’t necessarily take that course,” Choate said. “We will hire you Day One as an LNA.”
After eight weeks in their paid training program — for which students only need a high school diploma, GED or be a 17-year old in school — the new LNA’s may be able to apply for the LPN program with part-time pay.
“We’re asking them to take on the financial aid to complete the nursing program, while supporting them with supplemental pay,” Choate said. “Once they stay, if they finish, we will forgive their loan over the next three year (contract).”
The only rung of the ladder they are missing is their LPN to RN program which is still in the works, but would have a similar contractual agreement, loan forgiveness and earnings plan, Choate said.
“We feel like we have to grow our own,” Choate said.
Back down in Rutland, though RRMC is enjoying their status as a magnet hospital — a status that Bolgioni said is making their nursing program more popular with RNs, those with BSNs, and a permanent destination for travel nurses looking to settle in — the hospital is considering partnering with firms in the United Kingdom and the Philippines to bring other nursing staff to the city.
“There are hospitals who have brought in health care providers from other countries and its worked really well for them,” Greene said. “The issue is there’s a lot of barriers at the federal level.”