As a reflection of an industry-wide problem confronting the health
care field, Texas hospitals have been experiencing acute shortages
among nurses and allied health professionals. The University Health
System (UHS) in San Antonio was no exception. UHS is a 604-bed,
acute care hospital, and the primary teaching facility for The
University of Texas Health Science Center, as well as neighborhood
and outpatient clinics. The system has
4,500 employees.
UHS alone was experiencing a vacancy rate among registered nurses
of 22 percent in 2001, threatening patient care and requiring the
UHS emergency center to close its doors to some trauma events.
Across the city, hospitals were reporting 800 RN vacancies. Among
the problems causing the gap: significant numbers of today's nurses
are approaching retirement; qualified applicants to nursing and
allied health instructional programs are in short supply; and,
experienced adult workers who might be interested in a career
switch to nursing face job and family pressures that make it
impossible to attend college full-time. Compounding these problems
was a shortage of faculty members to train nurses. With many
faculty retiring, new nurses were not taking their places because
they could earn more in staff nursing positions.
No magic bullet
Realizing there was no single magic bullet to address the shortage
of nurses, UHS joined in a wide-ranging partnership with other
health care facilities, educational institutions and government
workforce development entities to convene a healthcare summit in
2001. Among the outcomes of the summit: UHS forged partnerships
with three local schools of nursing to certify UHS nursing staff as
adjunct faculty members and to create "extension campuses" at the
hospital.
UHS also adopted what the system's administrative director, Jacque
Burandt, called a "grow your own" strategy to provide nursing
instruction to workers in non-nursing jobs. Through the Certified
Nursing Assistant (CNA) program, UHS enabled environmental service
and food service workers, as well as other incumbent employees, to
obtain clinical experience and mentoring as nursing aides as a
first step toward obtaining nursing scholarships and careers.
"In the past, there has been a huge hole in the pipeline of new
nurses because people could not get the clinical experience they
needed without leaving their jobs and going to the community
college to start their training," says Burandt. With funding from
state and local workforce development initiatives, the CNA program
offered workers the flexibility and the support they needed to
bridge the gap.
Vacancy rate drops
Through its partnerships with local nursing schools to add faculty
and create extension campuses at the hospital, UHS was able to
create and fill more than 70 new nursing student slots, an increase
of 25 percent. In addition, more than 25 UHS staff had completed
the CNA program as of early 2006. At UHS, the success of these and
other efforts could be seen in a huge reduction in the vacancy rate
for RNs to just 2 or 3 percent.
"We're making it more convenient for people to get the instruction
they need," says Burandt. She adds that a key factor in UHS's
success has been a stepped approach to instruction, with each new
step leading to a certification and enhanced job prospects.