Health Care Quarterly:

Staffing clinicians during a massive shortage

According to an American Journal of Medical Quality study published in 2011, Nevada ranked as the third worst state in the U.S. when it came to a nursing shortage forecast to the year 2030. And when it comes to physicians, Nevada is ranked No. 47 in the U.S. when it comes to active physicians in the state. Even with increasing education opportunities for clinicians popping up in Nevada, the aging, experienced workforce retiring continues to be an issue.

And Nevada is not alone, especially when it comes to the nursing shortage. Dignity Health’s experience in three states — California, Arizona and Nevada — shows that each state has a similar challenge. Each market has a lot of new graduates, but what about the need for those nurses that need additional training and expertise for nursing positions like the intensive care unit, operating rooms, emergency room and trauma?

The same goes for physicians. Even with the current number of medical schools this state has, Nevada simply does not produce, and then keep, enough of its homegrown talent. That will continue to change with the addition of UNLV’s School of Medicine and increased graduate medical education (GME) dollars funded by the state, both during last legislative session and in upcoming sessions. St. Rose is still in the process of determining what its GME footprint will look like in the coming years and other hospitals are also in the process of building their programs.

With these new potential residency and fellowship programs being cultivated in the state, something similar needs to happen for nursing. St. Rose currently has a RN residency programs for new graduates who wish to move into more experienced units of nursing, along with preceptorships so that new graduates can shadow their mentors in a real-time setting, but this program is very small and needs to be a larger endeavor with other hospital systems and educators included.

And even though nurses in the state are paid very well amongst others in the U.S., it’s difficult to recruit nurses from out-of-state for a number of reasons — slow licensure processes, a perception that southern Nevada is not family-friendly, a low-rated public school system — and for physicians, they can also expect low Medicaid reimbursement rates.

These issues continue to be discussed, and even fixed, in the legislative process, but with a quickly aging population and more and more of our older clinicians retiring, more needs to be done.

At Dignity Health-St. Rose Dominican, we aren’t just seeking clinical staff with a degree, or even experience. Our Hello humankindness movement and mission, vision and values shape everything we do every day for our patients, and hiring staff that fit into that dynamic can be challenging. Beyond the usual ways of recruiting — online job boards, social media, aggregators, job fairs and open houses — we also put a large emphasis on our culture and behavioral interviewing during the hiring process.

Linda Gerstenberger is the vice president of human resources for Dignity Health-St. Rose Dominican.

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