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Colorado faces a staggering shortage that’s only getting “scarier” 

Not enough nurses

click to enlarge Colorado’s registered nurses average $72,570 in pay. - COURTESY UCHEALTH
  • Courtesy UCHealth
  • Colorado’s registered nurses average $72,570 in pay.
Colorado is getting older.

Between 2010 and 2015, the state’s 65-and-over population grew 29 percent — more than three times as fast as the total population, according to the Colorado State Demography Office. That surge, the third-largest in the nation, comes as a large group of baby boomers who moved to Colorado back in the 1970s ages.

It’s not great timing for the health care industry, because Colorado’s nursing population is aging, too. Already, 35 percent of licensed registered nurses (RNs) are over 55, data from the Center for Nursing Excellence shows. And it’s sometimes hard for nurses to continue in the same roles as they get older.

“You’re on your feet, it’s physically demanding,” says Lt. Gov. Donna Lynne, who worked in health care administration for years before entering politics. “There’s overtime, it’s sometimes mandatory. It’s a draining kind of profession, as rewarding as it is.”

Colorado’s aging population is just one factor contributing to the state’s critical nursing shortage, the topic of a conference July 18 hosted by Lynne, the Colorado Commission on Higher Education and other stakeholders in the health care industry. It addressed the lopsided supply and demand for RNs: There’s an average of 2,912 annual openings, but only 2,558 degrees were granted in 2016, according to the 2017 Talent Pipeline Report. Hospitals such as University of Colorado Health are looking to recruit nurses from other states, but still have trouble filling positions. It’s preferable, says Lynne, to “produce them ourselves as opposed to going outside the state.”

It gets scarier. By 2025, according to the U.S. Department of Health and Human Services, Colorado’s demand could exceed supply by 12,900 positions.

In the Colorado Springs metro area alone, there were 938 open positions with “nurse” or “nursing” in the job title on July 18, according to data supplied by the Pikes Peak Workforce Center. A good portion of those are openings at Children’s Hospital Colorado, which announced July 16 that it’s recruiting the first of 200 team members it plans to hire at its new facility in Colorado Springs. And all of the clinical nursing positions available at the Children’s Hospital require at least a four-year degree.

Part of the reason it’s getting harder to find qualified nurses is that companies are creating more stringent requirements. While traditionally, more health care facilities were willing to hire RNs without a four-year degree, that landscape is shifting. The Institute of Medicine is now recommending that the proportion of nurses with a baccalaureate degree should reach 80 percent by 2020 (from 50 percent in 2010).

UCHealth is one organization taking innovative steps in pursuit of that goal. This fall, UCHealth Memorial Hospital is starting a program in which some RNs employed at its facilities can earn bachelor’s degrees paid for almost entirely by the organization, says Jeff Johnson, the hospital’s vice president of human resources.

Having a BSN is important, Johnson says, because “what we expect from nursing staff is getting more complex, and so that extra training is very helpful.”

Pikes Peak Community College currently has a two-year RN program that graduates around 100 students a year. RegisteredNursing.org ranked it best in the state. While students may have landed jobs with that education in the past, many are now having to return to school at a four-year institution, says spokesperson Warren Epstein.
Soon, that could change. House Bill 1086, which passed in March despite objections from Gov. John Hickenlooper, will allow Colorado’s community colleges to also grant bachelor’s degrees in nursing.

PPCC’s BSN program, which Epstein says is one or two years from launch, will allow registered nurses who’ve already trained in a clinical setting and passed the NCLEX exam to complete BSN requirements online through the community college. A handful of other two-year institutions around the state are preparing to launch their own, similar programs.

It’s clear that Colorado’s two- and four-year schools need to prepare more nurses for the workforce. House Bill 1086 will help, by making it easier for some applicants to meet employers’ requirements. But educational experts say there are other challenges facing institutions that keep them from graduating enough students to meet demand.

Nationally, 40 percent of qualified applicants are turned away because nursing schools don’t have enough slots open, says Karren Kowalski, a conference panelist and the president and CEO of the Colorado Center for Nursing Excellence.

The two biggest factors contributing to that problem are clinical placement and faculty shortage, says Colorado Nurses Foundation President Dr. Sara Jarrett, another panelist.

Epstein says Pikes Peak Community College has, due to a lack of clinical placements in Colorado Springs, even started placing students in mental health facilities in Pueblo for clinicals.

Adding the BSN program could make that aspect of nursing education even more problematic, but Epstein says the process of finding clinical placements comes down to “community partner-building.”

“It’s not like everybody [health care facilities] doesn’t understand the need,” Epstein says. “But it’s not always easy for them to create clinical positions if they have their own organizations to run.”

But faculty shortage could be an even bigger challenge. Schools often have trouble finding the nursing faculty they need because a nurse providing patient care usually must take a massive pay cut to become an educator.

“I took a $30,000 pay cut to go teach seven years ago,” says Paula Kirchner, a panelist and the dean of nursing at Pueblo Community College. “You have to love what you do.”

The annual mean wage for a registered nurse in Colorado was $72,570 in May 2017, according to the Bureau of Labor Statistics. For nurse practitioners, who need a master’s degree at minimum, the mean salary was $110,440.

That’s part of the reason nursing is a popular profession. Kirchner says that for just one of Pueblo Community College’s campuses, there were 324 applicants this year, and she only had spots for 48.

Lynne says she hopes the conference will be a first step toward opening a dialogue among the health care, education and economic sectors, and perhaps even go further.

“For me, it’s not just talking about the nursing shortage,” she says. “It’s really talking about where are we going with respect to the professions to support the needs of the people who live in Colorado.”

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