Gilbert’s hospitals grapple with nursing shortage

Nursing data
(Sources: Arizona Commerce Authority, University of St. Augustine for Health Sciences/Community Impact Newspaper)

(Sources: Arizona Commerce Authority, University of St. Augustine for Health Sciences/Community Impact Newspaper)

Image description
(Source: American Nurses Credentialing Center/Community Impact Newspaper)
Image description
(Source: Arizona Commerce Authority/Community Impact Newspaper)
Image description
(Source: U.S. Bureau of Labor Statistics/Community Impact Newspaper/Community Impact Newspaper)
The hospital systems serving Gilbert—as with Arizona and the remainder of the nation—say they are battling the effects of a nursing shortage exacerbated by the global COVID-19 pandemic.

But the reasons behind the shortage are more deeply rooted than the pandemic, and the effects could last for years, experts and data suggest.

By 2022, the American Nursing Association reports more registered nurse jobs will be available than any other profession at more than 100,000 per year. With more than 500,000 RNs anticipated to retire by 2022, the U.S. Bureau of Labor Statistics projects a need for 1.1 million new RNs for expansion and replacement of those retirees.

In addition to the older workforce and retirement, experts cite high burnout among nurses, who are overtaxed not just from the pandemic but from an increasingly aging, sicker population as well as short staffing leading to longer hours and more patients under each nurse’s care.

Rhonda Thompson, chief nursing officer and senior vice president for patient care at Phoenix Children’s Hospital, said by email that years ago the American Nurses Association had predicted this nursing shortage, which has been exacerbated by the pandemic.

“This is not a short-term challenge,” she said. “Many health care organizations are working diligently to be creative with staffing models.”

A supply of new nurses is problematic, too, the experts said. With few nurses available to teach nursing students or to mentor young nurses, schools can only take so many candidates.

The town of Gilbert moved to help the situation by launching its higher education initiative, which resulted in the University of Arizona starting a nursing program in the town’s University Building in 2019.

Health systems in town

Hospital systems in Gilbert said they are facing staffing shortages amid ongoing expansions. Officials with Banner Health, which runs two hospitals and other facilities in Gilbert, reported 1,000 core nursing positions open, while Phoenix Children’s Hospital has reported 200. PCH is partnering with Dignity Health on the Women and Children’s Pavilion expansion at Mercy Gilbert Medical Center set to open in 2022.

Dignity Chief Medical Officer Keith Frey declined to give a number of nursing openings as recruiting remains fluid but said in an email it is recruiting a number of positions across the division, including nurses. Construction is also underway on the Dignity Health East Valley Rehabilitation Hospital, slated to open in 2023.

Frey and Thompson said they do not anticipate the shortage creating a problem with their expansion plans in Gilbert. Thompson said the pavilion will be staffed in phases per department.

“As we continue to recruit for these open positions, travel nurses, respiratory therapists and other clinicians are being utilized to help fill these roles and allow us maximum flexibility as our patient census fluctuates,” Frey said. “We continue to closely monitor and adjust staffing levels to ensure we are providing safe and effective care to our patients.”

Travel nurses—nurses who travel to work in temporary positions, mostly in hospitals—have been an important part of the health care picture through the pandemic, hospital officials said. Banner, for example, is using 2,500 travel nurses through the system when it typically uses 600-800 during the winter.

Thompson said PCH also has had to be creative to meet staffing needs.

“We supplement staffing plans with travel nurses or temporary staff, and we have creative staffing models to meet the needs of our patients and their families,” she said.

Effect on nurses, patients

Each official said patient safety remains the top priority.

“We work proactively on a daily basis to be ready with a staffed bed for anyone who needs us,” Thompson said. “There may be times when we are working with providers in the community to triage the sickest patients. All that said, safety always comes first.”

But all the hospital officials acknowledge the current environment is difficult on health care professionals, including nurses.

“Our efforts to support teamwork and well-being are showing promise, as the Dignity Health in Arizona employee satisfaction scores this year lead the organization,” Frey said.

Denise Link is an emeritus faculty member at Arizona State University’s Edson College of Nursing and Health Innovation. Link said she has researched the nursing shortage and believes it is contributing to high burnout among nurses.

Link said hospital patients today have a higher acuity of illness than in previous decades when patients were admitted before procedures and also did recovery time in hospitals. The aging population in America also contributes to that higher acuity.

In 2029, the last of the baby boomer generation will reach retirement age, resulting in a 73% increase in Americans 65 years of age and older—41 million in 2011 compared to 71 million in 2029, according to U.S. census data.

Additionally, Link said the shortage has affected staffing ratios of patients to nurses, which means nurses are having to pay closer attention to more patients who are sicker.

“It’s not a good situation for the nurses, and it’s not a good situation for the patients, either,” she said. “Fatigue can factor into your response time, your critical thinking and judgment.”

Future nurses

Link noted the median age of nurses is 50 years old, meaning retirements are looming, contributing to need.

According to the National Center for Biotechnology Information, approximately 1 million registered nurses are older than 50, meaning one-third of the workforce could be at retirement age in the next 10-15 years.

Currently, NCBI data shows the national average for turnover rates is 8.8% to 37%, depending on geographic location and nursing specialty.

To retain existing work force, Naomi Cramer, executive vice president and chief human resources officer at Banner Health, said Banner has increased starting base pay for new nurses with raises for more than 9,000 existing Banner registered nurses.

The retirements and turnover also underscore the need for new nurses coming into the field, but Link said it is a challenge because there is also a shortage of nursing faculty and people going into academia.

“It’s hard to expand the programs because there’s a certain amount of hands-on experience that people that are in the program, the pre-licensure people, need,” she said. “And there’s only so many students that a facility can absorb. Those students have to be closely monitored because now they’re students, but yet caring for people that are acutely ill. The hospitals have to put sort of a tighter reign on how many students can be supervised by a single faculty member.”

Thompson said PCH works closely with academic partners, and a number of its nurses work as faculty adjuncts.

“One of our tactics has been working closely with our academic partners to ensure that they can admit the number of applicants that is appropriate, and that those applicants can be educated and transitioned to practice as soon as possible,” she said.

Gilbert has its higher education initiative, led by Economic Development Deputy Director Jennifer Graves, which supports the town’s University Building and its tenants: Park University and the University of Arizona.

The original tenant, St. Xavier, had a strength in online nursing and subsequently had the building’s third floor built out to support nursing education. After St. Xavier left, the town received interest in becoming tenants from a number of schools with nursing programs, ultimately leading to UA putting a nursing program in the town in 2019, Graves said. The UA program has a capacity of 216 students. About 70 students have graduated the program since it opened.

Economic Development Director Dan Henderson said the town recognized early that nursing would be a regional need that could be addressed in Gilbert’s higher education initiative and was purposeful in finding a partner school.

“We were looking at gaps in the state that were needed,” he said. “Clearly nursing was one of those gaps in the state and Phoenix metro region.”
By Tom Blodgett

Editor, Gilbert

Raised in Arizona, Tom Blodgett has spent more than 30 years in journalism in Arizona and joined Community Impact Newspaper in July 2018 to launch the Gilbert edition. He is a graduate of Arizona State University, where he served as an instructional professional in the Walter Cronkite School of Journalism and Mass Communication from 2005-19 and remains editorial adviser to The State Press, the university's independent student media outlet.


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