New Nurses Filling the Ranks

Patients in Northwest Arkansas will get the nurses they need, but many nurses might be new to the job, hospital administrators say.

The need for nurses is increasing because of an aging population and the federal Affordable Care Act of 2009. In Northwest Arkansas, though, the demand is not simply the numbers.

Everyone is looking for experienced nurses, but people need to get that experience somewhere,” said Claudia Williams, chief nursing officer for Washington Regional Medical Center.

Sue Tedford, executive director of the Arkansas State Board of Nursing, said the market has changed over the past 10 years.

“We’re hearing that new graduates are finding it more difficult to find a job,” Tedford said.

The recent recession kept many nurses from retiring, adding to overall numbers, she said.

Jobs are out there, but new nurses may need to be patient, said Pegge Bell, director of nursing at the Eleanor Mann School of Nursing at the University of Arkansas.

“Are they all going to get their first choice? No,” she said. “But they will get a job, and with a couple years of experience they open up more options.”

Nursing opportunities also are increasing in areas outside patient care. One example is an industrywide move to electronic medical records, said Lepaine Sharp-McHenry, assistant director at the Eleanor Mann School of Nursing.

Local educators are expanding nursing programs to meet the need.

The University of Arkansas opened the Epley Center for Health Professionals in January 2012, which allowed it to double enrollment to 200 students a year.

NorthWest Arkansas Community College opened the Center for Health Professions in January, which added a nursing simulation lab.

Northwest Technical Institute began a certified nursing assistant program in August.

“The local schools are doing a very good job of training nurses, and it’s allowing us to be very selective,” said Carol Gore, chief nursing officer for Northwest Medical Center-Springdale.

The Numbers

Arkansas has 35,025 licensed registered nurses, and 15,272 licensed practical nurses, Tedford said.

A registered nurse graduates either from a four-year nursing program with a bachelor of science degree or a two-year program with an associate’s degree.

A licensed nurse graduates from a one-year practical nursing program.

Both levels require nurses to pass nationally standardized exams.

Registered nurses have more responsibilities and are able to address more issues than licensed nurses. A registered nurse can make independent decisions while a licensed practical nurse is always under the supervision of a registered nurse or doctor.

There were 1,957 registered nurses living in Washington County and 1,819 in Benton County on June 30, the end of the Arkansas State Board of Nursing’s fiscal year, according to its annual report.

More than one-third of the state’s registered nurses work in hospitals and 15 percent work in clinics or offices.

There were fewer licensed practical nurses living in the two counties with 615 in Washington County and 517 in Benton County.

Almost one-fourth of the state’s licensed practical nurses work in nursing homes.

Washington Regional employs about 800 nurses systemwide, with only registered nurses working at the hospital.

Northwest Health System employs 614 registered and 57 licensed nurses at its three hospitals and 42 clinics. All but 14 of the system’s licensed practical nurses work in clinics.

Mercy Northwest Arkansas has 325 registered nurses working at Mercy Medical Center in Rogers and 50 licensed and 75 registered nurses at its clinics.

Tedford said an increasing number of acute care facilities are using fewer licensed nurses and more registered ones, skewing the numbers. She said this is a trend she has seen in the past and expects it will change.

“It hits the budget too hard. It’s very costly,” she said.

Increased Education

Deena Clevenger said she always wanted to be a nurse and sees how an advanced degree will help her career. She received her bachelor’s degree in nursing from the University of Arkansas in 2006. She will earn her master of science in nursing May 11.

“I decided to go back to broaden my opportunities,” she said. She is completing her master’s degree through the university’s online program and is doing her clinical work at Washington Regional and the Veterans Health Care System of the Ozarks in Fayetteville, both places she has worked.

She worked at Washington Regional right after college in the cardiology unit and was a charge nurse and training supervisor for nursing students and new employees. She began working at the Veteran’s Hospital in January 2010 in the cardiac unit.

Clevenger worked full time throughout her master’s program. The first two years of the program, she took classes part time, but she said the third year required her to put in full-time hours at school and at work.

“The trick is to have a great support system around you and have an employer that will work with you,” she said.

The Department of Veterans Affairs hospital allowed her to work weekends so she could fulfill her clinic hours and other educational requirements during the week.

“You have to be self-motivated, set realistic goals and be willing to make sacrifices,” she said of the schooling.

The University of Arkansas offers a bachelor’s in nursing degree, and Bell said she hopes to see 80 percent of the registered nurses complete the degree program. Only about one-third of the state’s registered nurses have a bachelor’s degree.

The university admits 100 nursing students to its program every semester for a school enrollment of 200. Sharp-McHenry said there were 256 applicants for the 100 open spots for the fall 2013 semester.

Jillian Springer is in her second year of nursing school at the university, but she is already looking ahead.

“You have to get your master’s to get the job you want,” she said.

NorthWest Arkansas Community College had 110 students enrolled in registered nurse programs in 2011, according to the Arkansas State Board of Nursing. Numbers at the community college spiked at 191 in 2009.

Keith Peterson, director of instruction at Northwest Technical Institute, said the school admits 55 students each year to its 18-month licensed practical nursing program. More than 200 people apply each year for those spots, he said.

Enrollment in the licensed program ranges between 100 and 110 at a time and accounts for almost 30 percent of the school’s total enrollment, Peterson said.

“We have a 100 percent placement rate, and a majority of the students work in long-term care facilities,” he said.

The school’s new certified nursing assistant program lasts six weeks and averages about six students each class, he said. The school would like to see 25 to 40 people go through the program each year.

Classes meet in the evenings to accommodate working students, Peterson said, and will be held in the summer.

“One thing we are certain of is the demand for nurses is here,” he said. “This area pumps out a lot of very qualified nurses.”

Training Facilities

The new nursing facilities at the University of Arkansas and NorthWest Arkansas Community College brought new opportunities for hands-on training.

Both schools have nursing simulation labs that use interactive mannequins that can be programed to give students different scenarios.

Students must react to the mannequin’s response to treatment, and the sessions are recorded and reviewed.

“Being recorded is great because you can see if you do something or say something that is awkward,” said Lauren Delph, a second-semester nursing student at the University of Arkansas.

Bell said the simulation rooms give students a real-life feel of being in critical situations without real patients.

“We’ve definitely made our mistakes here, but it’s better than doing it in the real world,” Delph said.

The community college’s new 83,000-square-foot Center for Health Professions let the Health Professions school grow to 1,700 students. Enrollment was capped at 1,350 students.

In addition to the nursing programs, the building houses the respiratory therapy, physical therapy assistant, paramedic, emergency medical technician and fire science programs.

Peterson said Northwest Technical would like to expand its nursing program. School officials last October unveiled plans for a 31,000-square-foot, $5.8 million building to house its allied health programs.

School officials are working on money, and Peterson said he’s hoping the state’s Legislature will award the money to get the project going.

“We want to be able to take everyone who applies, but we are tapped out of space,” he said.

Looking Ahead

More nurses in the market lets health care providers be more selective in hiring, said James Bass, director of cardiology services at Washington Regional Medical Center.

He said the hospital hires about 30 nursing graduates twice a year in May and December. Bass said he spent four hours a day for eight days interviewing six to seven candidates.

Bass has been a registered nurse for 40 years and said things are changing rapidly. Patients are sicker and spending less time in the hospital.

“We are doing a better job and being more progressive,” he said.

The better education a nurse gets, the better prepared they will be on the job, Bass said.

“Nurses with a bachelor’s degree start their jobs with better thinking skills,” he said.

Gore started at Northwest Medical Center-Springdale last May and said a challenge she sees is finding good nurses and keeping them in the competitive Northwest Arkansas market.

She said she hired between 45 and 50 newly graduated nurses in the past 10 months and likes to have a good mix of new and experienced nurses.

“New grads with the right attitude and training can be really good nurses,” she said. “The challenge is finding a good balance.”

Charlotte Rankin, executive director at Mercy Health System, also said training is key for new hires. Mercy has a program helping new nurses bridge that gap by having them work alongside experienced nurses.

“It creates a support system for them so when they do begin to go out on their own they have that confidence,” she said.