Nebraska still grappling with nursing shortage

State Sen. Mike Gloor asked the question: How is the nursing shortage being talked about now different from the ones in the past five decades, the ones the state always seemed to soldier through?

It’s different, said Juliann Sebastian, because of the large number of aging Nebraskans and the changes in technology and treatment keeping them alive longer.

And those past shortages — while they seemed to lessen — never really disappeared, said Sebastian, dean of the University of Nebraska Medical Center College of Nursing. They kept redeveloping and compounding, she said.

A Tuesday hearing before the Legislature’s Health and Human Services and Appropriations committees was part of an interim study (LR285) on what to do about the nursing shortage, which threatens to worsen over the decade.

There are ways the state can help to alleviate the shortage, said Lincoln Sen. Danielle Conrad, who sponsored the study.

Solutions include recruiting and retaining nursing professors, addressing infrastructure needs, improving access in rural and underserved areas and addressing health care reform issues.

Sebastian said 73 of Nebraska’s 93 counties have fewer nurses than the national standard.

More need to be trained, but 402 qualified applicants to Nebraska nursing programs were turned away in 2010-11, mainly because of a lack of qualified educators.

In the next nine years, the shortage will reach 5,581, according to projections by the Nebraska Center for Nursing.

Sebastian said researchers have found the ratio of nurses to patients is related to quality of care, patient mortality, hospital infections and falls, and the ability to save a hospitalized patient’s life when he or she experiences a complication.

The Institute of Medicine recommends increasing the proportion of baccalaureate trained nurses to 80 percent by 2020 and doubling the number of nurses with doctorates.

Only half of Nebraska registered nurses have four-year baccalaureate degrees; 5.3 percent have master’s or doctorates.

The UNMC College of Nursing program in Lincoln is vital in terms of the nursing shortage, Sebastian said.

But the program has turned down 60 percent of qualified applicants over the past several years, and needs to be expanded, she said.

Now, it is in leased spaced downtown, without the adequate number of technologically wired conference and seminar rooms and office space, according to the Nebraska Center for Nursing.

Classrooms are full, and research is limited by space.

UNMC is proposing to build a new 45,525-square foot, $16.4 million facility on the University of Nebraska-Lincoln East Campus that would accommodate a 23 percent increase in the number of students who could study there by 2020.

University officials are hoping the Legislature can appropriate some money for that project.

Another possible solution is development of post-graduate residency programs for RNs and nurse practitioners. Those would be like physician residency programs and would help them adapt to the realities of busy, complex clinical practices.

Bruce Rieker, with the Nebraska Hospital Association, said the shortage goes beyond nursing to other hospital health care workers. But nursing is the largest occupation.

Employment of registered nurses is expected to increase 24 percent by 2018, approximately 5,100 jobs across the state, he said.

The recession has brought temporary relief from the shortage, he said, as nurses who were close to retirement postponed it for a few years. Nurses also have come out of retirement or switched to full-time employment.

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