Nurses

Respiratory Care students examine a set of pig lungs during a lab with Zachary Spimpson, director of clinical education, on Oct. 6 at BCTC in Lexington.

The coronavirus pandemic has further revealed what those in health care already knew: There are not enough employees.

While nursing programs generally have no trouble finding students in Kentucky, some worry that it won’t be enough to address the nursing shortage, especially as aging nurses begin to retire. For nursing and health care programs at colleges in Kentucky, this means preparing students to enter a field with workforce shortages and can include leadership training, as well as talking about mental health and self-care before students graduate, professors said.

“This is not new,” University of Kentucky College of Nursing Dean Janie Heath said of the nursing shortage. “It’s just different. For over two decades, we’ve had a nursing shortage and a nursing faculty shortage.”

At the end of August, more than half of Kentucky’s acute care hospitals were reporting critical staff shortages in trying to deal with the COVID-19 pandemic. That grew to 65% of hospitals by the beginning of September. The Kentucky National Guard was deployed to several hospitals in the state, including the University of Kentucky hospital system.

While the nursing shortage is not new, the pandemic has raised concerns as more health care professionals close to retirement are exiting the field.

“I do think that COVID has probably tempted those planning to retire to go ahead and possibly retire now, if they’re able to,” said Brooke Bentley, chair of the School of Nursing at Eastern Kentucky University. “One concern that our students need to be aware of is that they may not have quite the amount of the more experienced nurses on their unit when they graduate.”

In a September interview, Dr. Mark Newman, executive vice president of health affairs at UK HealthCare, said he feels addressing the health care workforce shortage is the biggest issue that needs to be addressed in Kentucky, and across the country. Newman added that the number of staff members “has not stayed in line with the growth in demand for our services.”

UK HealthCare has included the need to address the workforce shortage in its strategic plan, which outlines priorities over the next five years. According to information presented at the September board meeting, there were over 2,600 vacancies in UK HealthCare during fiscal year 2020. The number of vacancies is expected to grow to over 3,400 in fiscal year 2022, as UK HealthCare expands its workforce.

Heath said a big need is the ability to expand the nursing faculty. UK has not had issues with recruiting students, she said, but in order to recruit even more students, there needs to be a larger faculty. Because of state regulations about how many students can be in a clinical group at one time, there is also a need for more faculty in that area.

“You hear a lot about the nursing shortage,” Heath said. “What we don’t hear enough about is the nursing faculty shortage. The pressure is on to generate more nurses in the workforce, and in order for us to do that in higher education, we have to have more faculty to do that.”

According to the Kentucky Board of Nursing, there are 16 approved baccalaureate nursing programs in Kentucky.

More faculty would mean more students could be accepted and eventually could enter the workforce, Heath said. For the nursing program at UK, “the interest is still there” from students, she said.

Respiratory therapists in high demand

Respiratory therapists have been in high demand during the pandemic, as the virus affects the respiratory system of patients.

Lisa Wright, enterprise director of respiratory services at UK HealthCare, said there are not enough current respiratory therapy students to replace those who will be retiring in the near future.

Another issue is that employees who were previously willing to drive into Lexington to work for UK HealthCare now have the option to work closer to home at smaller hospitals as people retire and more positions open up, Wright said.

“The market is really wide open right now with lots of choices for people,” Wright said. “In the past, we hired almost 100% of our graduating student employees, but now we’re competing, even though they’ve been here, we’re competing with offers that are either closer to home or even here in town for them.”

In recent years, UK has expanded its recruiting outside of the immediate region, and recruited employees from Bellarmine University and Jefferson Community and Technical College in Louisville, Wright said.

Job offers mean options for students

The shortage among nurses and respiratory therapists means students have a high likelihood of getting a job offer after they graduate and pass their board exams. It also means they have more options, and can pick where they would like to work, Wright said.

Bluegrass Community and Technical College offers a two-year respiratory therapist degree. Students who have previous medical experience or a previous degree are good candidates for the program, said Zach Simpson, director of clinical education at BCTC.

Students from the respiratory therapy program are almost guaranteed a job after graduation because demand is so high, Simpson said. That also gives them the flexibility to choose where they want to work, whether that’s in Lexington or returning to their hometown.

“We’ve had a lot of people retire, we’ve had a lot of people get terminally ill, sick and have to not continue working,” Simpson said. “There’s been a lot of reasons but there’s now a personnel issue and they’re offering ridiculous incentives to work overtime and things like that.”

Cody McNeil, a respiratory therapy student at BCTC, is currently a nursing care technician at UK Hospital. He has been working on the COVID floor, and has seen how respiratory therapists can help, he said.

“COVID is especially affecting the respiratory system, and us as therapists can go in and help bring them back to life or just make their daily well being better as well,” McNeil said. “I just think it’s going to be so rewarding going forward.”

Even with the nationwide shortages in health care, McNeil said he doesn’t have concerns about entering this field, but sees the potential for the field to grow.

Nursing students at Eastern Kentucky University have no issue finding jobs after graduation, either. Students do their clinical rotations at area hospitals, and more often than not, will have a job offer when they graduate, Bentley said.

One effect of the nursing shortage is that young nurses may move into leadership roles earlier in their careers, which is something EKU tries to address with students. Nursing students take a leadership course, and also practice being a charge nurse during one of their projects.

At multiple schools in Kentucky, professors also try to address concerns about burnout and mental health, especially as nurses are working through the pandemic.

“It can be very easy, going into nursing at this time during the pandemic, that you could become burnt out (or experience) what we call compassion fatigue,” Bentley said. “Family members aren’t allowed to visit as much so you’re now not only the nurse, but you’re also the family member to many of these patients. So self-care is emphasized.”

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