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Nursing, anyone?

In desperation, many local hospitals are making the training practically free.

© St. Petersburg Times
published November 24, 2002

Facing a shortage of nurses, six hospitals in Pasco and Hernando took dramatic action. In 2000, they offered a free nursing education at Pasco-Hernando Community College to up to 150 students who would, in return, commit to work at one of their facilities after graduation.

Only 24 people initially enrolled.

"When you're turning down more than $3,000 in fees and books, even if you've got the money to pay for the course work, that doesn't make a lot of sense to me," said PHCC president Bob Judson.

But it speaks volumes about why there are not enough nurses to meet demand. For many nurses, the quality of professional life is low; they work odd hours; many complain of getting little respect; they're frequently overworked because of chronic understaffing; they have to deal with blood, body fluids and the pressure of having someone's health in their hands.

"It seems like a lot of students would rather pay to go to school and choose where to go," said Nita Kasan, chief nursing officer at Regional Medical Center Bayonet Point.

Take nursing student Gisela Dalnoky.After a career in social work and a 15-year retirement, she decided to become a nurse. But she wants to make sure she lands at a place where she can get good on-the-job-training.

"I want to choose, so I'm paying my own way," said Dalnoky, 59, a mother of three from Port Richey now attending PHCC. "I don't want to have to go out there and not give good care. I'm going to go somewhere where I can give the nursing that everybody deserves."

Because of people like Dalnoky, the joint effort of the hospitals and PHCC to produce more nurses to work locally is an odd mix of success and disappointment.

PHCC's classes are jam packed well into the future. The hospitals have recruited additional students since the program began, but many students still would rather keep their job options open, even if it means sacrificing a free ride. They know that there are lots of nursing jobs outside of hospitals. About 21 percent of all licensed nurses are not employed in nursing, according to the Florida Hospital Association.

"It used to be that all the nurses worked in hospitals," said Cathy Allman,a former nurse who now works for the FHA. "That's just not true anymore. There's home care, long term care, skilled nursing facilities. Attorneys that do medical malpractice are hiring nurses to consult with. If you're creating a computer software program for a hospital, it's great to have a nurse on staff."

* * *

The PHCC partnership with the hospitals went well beyond the scholarships.

Six hospitals in Pasco and Hernando each initially gave PHCC $52,000. That funding allowed the college to start weekend and evening nursing courses, hire five new staff members and buy a human care simulator, a mannequin-like device that can simulate any human ailment.

The participating hospitals were: Oak Hill, Brooksville/Spring Hill Regional, East Pasco Medical Center, Regional Medical Center Bayonet Point, Community and North Bay hospitals.

The program followed a major investment in health and science education by the community college.

PHCC spent about $11.3-million to build a new science and health care building on the West Campus, renovate its Brooksville nursing classrooms and upgrade its equipment all around.

Health and Sciences are "certainly a major major job market in these two counties," Judson said. "And they're good paying jobs, which fulfills that high wage high skill category" that the state is trying to promote.

Judson has continued to search for ways to ensure that the nurses who are trained locally go to work at local hospitals.

"That's what the program is really about," said Judson.

Facing a cut in state funding earlier this year, he approached the hospitals to help expand the nursing program once more.

Each of the hospitals -- except Oak Hill and Community -- have agreed to give PHCC an additional $50,000 to fund a class to begin in January 2003 and to provide their nurses as clinical instructors. Each of the hospitals was invited to provide up to 12 sponsorships for students in the new class.

The college is now contacting the students who are signed up to start nursing classes in the fall of 2003 and the fall of 2004 and giving them the option to start in January.

The only condition: If they want to start school sooner, they have to take the scholarships.

So far, the hospitals and the college say they have gotten a warm response from students to the expanded program.

"I'm very very pleased with the response from students here that we have," he said.

Officials from Oak Hill and Community said that at this point they have opted not to give PHCC funding a second time because they have their own in-house tuition reimbursement programs.

* * *

The nursing shortage has plagued hospitals all over the nation. Studies link the shortage to higher rates of hospital deaths, rising patient complaints, a reduction in hospital beds and overcrowded emergency rooms. It's costing hospitals big dollars to pay for overtime and to hire expensive contract nurses for temporary work.

And for Florida, with its huge elderly population, the situation is even more critical: 12.5 percent of all nursing positions are vacant, 1.5 percent above the national average. It's even higher on Florida's west coast, at 17 percent. Hospitals in Pasco and Hernando report vacancy rates ranging from 10 to 30 percent.

Since the average age of nurses is 47, the shortage is expected to get worse as those nurses retire.

In response, a rush of funding has emerged for nurse recruitment.

In July, Congress approved legislation that provides scholarships and loan repayment programs for nurses and funding for graduate-level nursing education.

HCA-The Healthcare Co., which owns Oak Hill, Community and Regional Medical Center Bayonet Point, has long offered tuition reimbursement for employees.

As the economy faltered after the Sept. 11 attacks, the HCA and the Department of Labor started paying to retrain people in health care careers who had been laid off from other jobs.

Hospitals still try to lure nurses with sign-on bonuses and higher salaries. But increasingly they realize that they must mend the conditions that caused the nursing shortage in the first place.

"You can recruit all you want," said Oak Hill nurse recruiter Donna Poppo. "But if you don't have programs in place aimed at retention, it just becomes a round robin."

Oak Hill is one of many area hospitals that is trying to give nurses more say in hospital policy. Oak Hill offers referral bonuses and expanded continuing education opportunities, and it began peer interviews of job candidates.

Next fall, Bayonet Point plans to hold a middle school job fair, hoping to get kids interested in nursing before they get to high school.

North Bay lets nurses pattern their schedules around the school year. It also gives nurses raises as they get continuing education.

All those efforts have made a big impression on Leo Jacoby, 47.

At a job fair last year, he fended off a crowd of recruiters attempting to woo him with everything from signing bonuses to free M&Ms.

He ultimately took a scholarship from North Bay and committed to work there for a year after graduation because he thought people there were genuinely concerned about his professional development.

"When I was talking to North Bay, it just all seemed very real," said Jacoby, a father of three from New Port Richey. "It wasn't just a sales job."

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