Under The Cap

March 26, 2007
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In a state where overall unemployment has danced around 7 percent for the past three years, just 2 percent of active licensed nurses were jobless and seeking work in their field last year.

That's one finding in the Michigan Center for Nurses survey for 2006. The five-year-old center, funded by a $350,000 Michigan Department of Community Health grant, produced its third annual report describing the state's 150,000-strong nursing work force.

Some 28,365 registered and licensed practical nurses who renewed their licenses in 2006 — a process they must repeat biennially — replied to the survey by mail or online.

The survey found that 86 percent of RNs and 92 percent of LPNs are actively working in a nursing or related job in Michigan. A recent review of local jobs on Web sites for hospitals, which employ the lion's share of nurses, showed dozens of openings for nurses at Grand Rapids' Big Three: Spectrum Health, Saint Mary's Health Care and Metro Health Hospital.

According to the Michigan Department of Labor & Economic Growth, the average wage for a registered nurse in the Grand Rapids-Wyoming area in 2005 was $51,580, lower than the state average of $57,190. For LPNs, the average was $36,680 locally and $37,700 statewide. That's enough to put a chicken in your pot when the alternative is twice-a-month calls to MARVIN, the state's telephone service for unemployment benefits.

Center Director Carole Stacy said more jobs will go unfilled in the next 10 years, as one-third of active nurses responding to the survey say they'll either quit or retire by then. With an average age around 46, LPNs tend to be a bit older than RNs. About 25 percent of active LPNs are at least 55 years old, while 18 percent of active RNs are 55 or older, Stacy noted. The average age for RNs is 44.5 years and for LPNs, 46.2 years.

"We need to start what we should have been planning for: for when nurses start retiring," Stacy said.

Part of the challenge is training enough nursing students. Phyllis Gendler, dean of Grand Valley State University's Kirkof College of Nursing, said the number of students in the college's three programs has doubled over the past seven years, but it's still not enough to fill job vacancies as well as staff faculties in Michigan nursing schools. Her challenge has been to create a curriculum that accommodates a shrinking faculty and upwards of 200 graduates per year. Gendler said her faculty has dwindled from 30 to 25 members since 2000.

"In my conversations with the public or other nurses, or even with people within the university, I'm not sure people are really getting it," Gendler said. "We talk about the nursing shortage. I don't think people really understand how much of a crisis is coming. It's not here yet — predictions for 2020 are far worse than we see now. We have a crisis and we have a worsening crisis. To really put resources there to deal with it is very, very important."

Another option? Make nursing more attractive to nurses who are thinking of retiring to get them to reconsider, Stacy suggested. To accommodate older nurses, the health care industry needs to "redesign the working environment," Stacy added. "Nursing is more difficult the older you get. Nursing is a strenuous position."

Some progress is being made, as the survey showed the pool of licensed nurses grew by 1,058 in 2006 over 2005.

The survey also illuminates a huge untapped market that could fill nursing vacancies: minorities, particularly Hispanics. While the U.S. Census Bureau estimates that 9.3 percent of Kent County's 584,007 residents are black and 8.9 percent are Hispanic, the survey reveals that just 7.6 percent registered nurses statewide are African-American and a mere 1.3 percent are Hispanic. Minorities are slightly more prevalent in the LPN ranks, the survey shows.

Patients deserve health care providers to whom they can relate, Stacy said.

"It does not mirror the population," she said. "We need to do better at that. If you go to a health care provider, you're more comfortable if you see people looking like you."

Gendler, who also chairs the West Michigan Nursing Advisory Council, offered several factors to explain the lack of minorities in nursing:  competition from other professions; socio-economics; quality of preparatory education; racism; and, in a which-came-first scenario, a lack of role models.

"It's kind of one of those strategic goals for all our organizations, from the American Association of Colleges of Nursing right down to two strategic goals within our college that address that," Gendler said.

Among the survey's other findings:

  • 58.9 percent of RNs work in direct care in hospitals.

  • 47 percent of LPNs work in nursing homes or other long-term care facilities.

  • Of active LPNs, 47.4 percent say their main practice area is elderly care or geriatrics.

  • Less than one-half of 1 percent of active nurses hold a doctorate degree, and 6.4 percent can claim a master's degree in nursing.
RNs (Statewide)

LPNs (Statewide)

Kent County

Total Population

White

86%

77.3%

81.9%

Black

7.6%

17.%

9.3%

American Indian/Alaska Native

1.3%

2.7%

0.3%

Asian

3%

1.4%

2.1%

Two or more races

N/A

N/A

2.1%

Hispanic (any race)

1.5%

2.1%

8.9%

Sources: U.S. Census Bureau, American Community Survey, 2005 Estimates; Michigan Center for Nursing, Survey of Nurses, 2006.    QX

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