There are more registered nurses working in Illinois than ever before.
But ironically the shortage of nurses has soared statewide to 15 percent from 10 percent in 1986.
Five years ago, when there were 110,309 licensed registered nurses in Illinois and the shortage was just beginning, health-care experts said there was a 10 percent shortage of RNs across the board in hospitals, nursing homes, home health care, clinics, health maintenance organizations, community and public health centers and other health-care facilities.
Alarm at the shortfall and dire predictions of more to come immediately set into motion model recruiting programs statewide by health-care employers, associations and nursing schools.
The programs did a good job of promoting the profession, and today there are 117,528 registered nurses in Illinois. But nevertheless, the vacancy rate of registered nurses in full-time, budgeted positions has risen by 5 percentage points.
”The problem isn`t so much a decrease in the number of nurses but an increase in demand,” said Pamela Towne, associate administrator of the Illinois Nurses Association. The union represents 7,450 registered nurses;
1,200 of them work for the state.
”Supply has not kept up with demand because the health-care field has expanded,” said Towne. ”Americans are aging, and patients in hospitals-where 65 percent of all Illinois nurses work-are much sicker and require a more intense level of care. Fifteen years ago, the average nurse-to-patient ratio was 50 RNs to 100 patients. Today, it`s 98 RNs to 100 patients. Hospitals have become one giant intensive care center.”
Chicago`s inner city and rural areas in the southern part of the state such as Mt. Vernon, Carbondale and Olney have the most severe shortage of nurses in all health-care facilities. But statewide, hospitals generally need more nurses in critical care, trauma, high-risk labor and delivery, oncology, and medical surgical units.
There also are statewide shortages of nurse anesthetists and geriatric nurses. And nursing homes also need more RNs.
”There are no pockets in Illinois of severe demand versus severe oversupply,” said Towne. ”The shortage is across the board. The suburbs are feeling it as much as anyone else.”
Some optimism can be found in the state`s 250 hospitals, where the vacancy rate of nurses dropped to 7.8 percent in 1989 from 9.5 in 1988, the latest available data, according to Mary Schulz Haras of the Illinois Hospital Association in Naperville.
The lowest hospital vacancy rates for nurses, Haras says, are in East St. Louis and in Clinton, St. Clair, Madison and Monroe Counties, which report only a 1.3 percent shortage.
”But three areas are higher than the state average,” she said. Springfield has a shortage of 11.7 percent; the Chicago metropolitan area, 9.4 percent; and, Kendall, Will, Kankakee and Grundy Counties, 8.7 percent.
Haras says admissions to nursing schools were up 20 percent from 1988 to 1989, and general enrollment was up 5 percent.
Julie Weldon, health careers manager of the Metropolitan Healthcare Council, reports that among her organization`s 100 member hospitals in Cook, Kane, Du Page, Lake, McHenry, Will and Kankakee Counties, vacancies have risen to 12.5 percent from 10 percent in 1990.
”More nurses are working, but the demand is higher,” said Weldon.
”There are close to 3,000 openings right now in the Chicago metropolitan area, and according to all the labor statistics, the need for nurses will continue to increase. Ours go up each year.”
Hospitals, she says, are ”doing more to look at how to free nurses up from unnecessary nursing duties.” To attract nurses, she says, salaries
”have jumped about 11 to 12 percent a year in the past five years.”
Salaries now start out at $27,000 to $29,000 and can range up to $65,000, compared with salaries in the low $20,000s with a cap of $30,000 five years ago.
Weldon says nursing is more attractive because of new flexibility in shift scheduling, health care and cafeteria benefits, tuition reimbursement and child care programs. ”But the fact remains we just need more nurses out there to fill positions,” she adds.
The vacancy rate at Memorial Hospital of Carbondale, a 150-bed hospital with 150 RNs in Southern Illinois, is close to 10 percent. Starting salary is $10.53 an hour, augmented by a program of cash incentives, night bonuses of $4,000 and the option of 12-hour shifts. Nurses are active in committees that determine policies and procedures.
”There`s always been a certain amount of shortages of nurses in Southern Illlinois, so this isn`t a new problem for us,” says Catherine E. Neuman, a registered nurse and director of nursing at Memorial. ”Our shortages tend to be in specialties where you need more experienced nurses, such as critical care, emergency, operating room and intensive care.”
The shortage ”has helped us to be creative with existing staff and to look at different ways of delivering health care,” says Neuman, who has a three-year diploma in nursing, a bachelor`s degree in vocational education, another bachelor`s in nursing and a master`s degree in nursing.
”I enjoy being a nurse,” adds the director, who`s been a registered nurse for 34 years, the last 20 at Memorial. ”If I had my life to live over, I`d be a nurse again, and that`s the highest recommendation I can make.”
As the need for health care continues to mushroom in Illinois, so will the need for registered nurses. Another way of looking at the critical shortage and accommodations being made to attract and retain nurses is that employment opportunities have never been better.
Health-care institutions are beginning to realize that those with the best to offer registered nurses will have the least vacancies.
Last July, the University of Chicago Hospitals, which has 600 beds, had
”serious” shortages of registered nurses. ”Today, all slots are filled, except in adult hematology and oncology, where we have vacancies of less than 10 percent,” says Diane J. Ward, director of surgical nursing.
”Even surgical intensive care, which had a 70 percent vacancy rate, now is fully staffed with 120 registered nurses,” she adds. ”We have 1,200 RNs on staff, and generally, every job is filled. There`s even a waiting list.”
What made the dramatic turnabout, says Ward, was the introduction of a recruiting and retainment program that nurses helped formulate. ”We now have a career path to management,” says Ward, a registered nurse.
Just as important, the hospital has negotiated a salary schedule with the Illinois Nurses Association that Ward says makes RNs at the University of Chicago the highest paid in the state: Starting nurses with bachelor`s degrees working 40 hours a week now average $31,000 a year, compared with $26,000 last year. Those with five years experience now average $38,000; those who work nights might earn $45,600.
An attraction of the plan is that nurses who work more than 24 hours a week are paid an additional 20 percent for the extra hours; if they work more than 40 hours, they get another 50 percent bonus based on the average wage for the previous 40 hours.
There`s also a 15 percent premium for evening-shift workers and a 20 percent for night shift. Weekend workers get an additional $2 an hour.
Since last July, 300 nurses have been hired, says Ward-and the turnover rate, which previously was 50 percent, is now 1 percent.
”I was recruited by the University of Chicago Hospitals last July,”
says Annette Evans-Sheppard, registered nurse in neurosurgery at the University of Chicago Hospitals. ”I`d worked for Cook County Hospital for eight years, for a health maintenance organization and for a private nurses`
registry. . . .”
At Cook County, Evans-Sheppard earned $28,000 and had a high patient load. Today, she earns $40,000 and has responsibility for three to four patients at a time. ”Another reason I like my current position is that I work only four days a week, with two eight-hour shifts and two 12-hour shifts,”
says the nurse, who has an associate degree in nursing and is attending Chicago State University to get her bachelor`s of science degree. The hospital gives her 100 percent tuition reimbursement.
The staff nurse is in charge of patients in the brain research unit.
”I`m doing the same work I did before, but with more dignity and pleasure,” she says. ”I love my job. I love being a nurse. I love having hands-on contact with patients and helping them in every way. I like seeing a person come through serious surgery and leave healthy. I used to be burned out in my other jobs, but not now.”
