Hospital Responds Nursing The Journal Star asked the Administration to address the issue of the present nursing situation at GMH. The followning is their response Nursing as a profession is undergoing change at a very rapid rate. As health care technology has moved forward in the last several years, the nursing profession has had to change to meet the demands and needs. The average age of the nurse just several years ago was 44. Now the average age of the clinical nurse is around 46. Previously, the average age of a nursing instructor was early 50's. The average for nursing instructors now is mid to late fifties. Nurses are beginning to retire from both clinical and instructor positions leaving gaping holes in the nursing profession. The requirements are also changing. Nursing instructors must now have a minimum education of a Bachelors Degree in Nursing and be working toward their Masters or Doctoral Degree in Nursing to be able to teach nurses. The aging workforce, added to an ever increasing demand for nurses in the healthcare profession or other related fields, has put great tension on the workforce. Hospitals and nursing homes everywhere are struggling to hire enough nurses to keep up with the demands for increased services and technological advances. The Gordon Memorial Hospital and Gordon Countryside Care are proud of their nursing staff which provides high quality patient care. This group of individuals should be commended for the loyalty they have shown to both the hospital and the community. The professional staff is well prepared and is continuously updated through training courses such as Advanced Cardiac Life Support, Advanced Trauma Life Support, Pediatric Advanced Life Support and Neonatal Resuscitation. However, GMH, like many other hospitals, does not have enough nurses and is actively recruiting RN's. Many hospitals have turned to foreign graduate RN's from the Philippines, Canada, Mexico and even Australia to fill the ever increasing needs. One outstanding foreign graduate nurse had been recruited for GMH; however her work visa will not allow her to work in this country until late 2008. Recruitment of nurses continues at the hospital. Many recruitment tools are being explored such as scholarships and loan repayment to attract nurses to our facility. The dollar amount per hour for RN's is steadily increasing which reflects the increasing demand and competition for RN's. Hospitals in the cities are paying top dollar and adding incentives such as paying re-location expenses, large shift differentials, sign-on bonuses, school loan repayment and other enticements to get a nurse's attention. Some nurses are going from job to job after a couple years because the sign- couple years because the signon bonus is so lucrative. The agency or traveler nurse is used by almost every healthcare system as a way to meet the ongoing shortages occurring from day to day in hospitals. One can find traveler nurses in critical care units, emergency rooms, obstetrics, and the general medical-surgical units to name a few. Before a health care system hires a traveler, the nurse goes through an extensive screening process and also a personal interview by phone. The human resource packet which is reviewed by the hospital nurse administrator includes immunization record, work record, recommendations from other hospitals where the traveler has worked, drug screen information, an in depth skills assessment , license status, background checks, and other information which is located in the nurses general profile. Only after all of these areas are reviewed and the nurse has in depth interview with the potential hiring facility will a candidate be considered for placement. GMH also requires a current CPR and Advanced Cardiac Life Support certification. Traveler contracts may range from one or two days to several weeks. The contract remains in place only as long as it takes to cover the needed shifts. Although the Nursing Home industry has issued guidelines for nurse-patient ratios, the acute care/hospital industry is more individualized. Acute care facilities evaluate the staffing needs daily as the patient load can vary so much each day. Patient loads can change from two to ten in a 24 hour time period. This variance makes a set number of staff each day impossible to determine. However, there are a minimum number of nurses per shift per day to handle the day to day needs. If the census increases and it is determined that the acuity or difficulty of the patient care is more intense than the scheduled component of nurses can safely manage, the Director of Nursing along with the Administrator and the nurses on the floor determine who and how many staff members to call in order to meet the needs of each shift. Our Nursing staff must also cover our 24 hour Emergency Room. If a multi car wreck or other large emergency occurs, the hospital has call guidelines to manage extreme emergencies or disasters. Our hospital, as well as other hospitals in the Panhandle, has been actively preparing in accordance with the Panhandle Public Health District guidelines, for these rare but very important situations. The disaster preparation is ongoing and grants have been used to purchase specific disaster supplies. Long past are the days when nurses just work at the bedside. RN's now must be trained in stastical analysis, leadership, and people management skills. They write policies and procedures, manage and troubleshoot extremely high tech monitors and patient care systems, and keep up with rapidly changing medications, procedures, and technology. Some RN's are leaving the field of nursing because the on-call schedules, the 12 hour shifts and the expectations which are many, varied, and overwhelming. It is projected by the year 2010; Nebraska alone will be short hundreds of RN's. Recruitment of quality RN's able to meet the day-to-day demands of health care will remain an ongoing challenge for all healthcare systems GMH is committed to meeting this challenge. Hiring positive, competent, can-do members for the healthcare team is a priority.