Final
High Vacancy Rates and High Turnover in Nursing
HEALTH CARE TASK FORCE
Votes:
Action Taken:
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01:13 PM
-- The Causes and Cost of High Vacancy Rates and High Turnover in Nursing
Becky Romero, Jule Monnens, and Bernie Patterson, all registered nurses in Colorado, discussed the myths of the nursing shortage. They distributed a handout of their testimony (Attachment R). Ms. Romero stated there is a 12 percent vacancy rate in nursing that accounts for 3,600 vacancies. She explained that there are currently 51,000 RNs licensed in Colorado but only 30,000 work in hospitals which leaves 21,000 already qualified nurses who choose not to work in acute care hospitals. Ms. Romero stated that the retention of nurses is the problem, not a lack of qualified nurses. Senator Keller asked if nursing homes were included in the nurse's definition of hospitals to which Ms. Romero responded no, they are only speaking to acute care.
Jule Monnens discussed the inadequacy of nursing education programs. She stated she teaches at Denver Community College and that she took a $20,000 a year pay cut to do so. Ms. Monnens went through the factors that have been found to successfully attract and retain nurses. She stated nurses need: 1) adequate staffing levels in order to ensure a reasonable caseload; 2) competitive wages; 3) respect and empowerment; 4) residency programs and relationships with nursing schools to ensure an ongoing supply of nurse trainees and graduates; and 5) opportunities for continuing education and advancement. Senator Keller commented that she has heard from many in the health care profession that competitive wages are not the issue and that the biggest issue is lack of staff. Ms. Monnens clarified that bedside nurse's wages and nursing faculty wages are inadequate.
Bernie Patterson addressed the costs associated with the retention of nurses and turnovers. She stated that there needs to be more attention on retention rather than recruitment. Ms. Patterson explained that the staffing shortfalls are due to lack of retention not lack of staff. Senator Tochtrop asked if JCAHO, the Joint Commission on Accreditation of Healthcare Organizations, has any staffing ratio requirements. Ms. Patterson responded that they do not, and that no one from JCAHO has ever asked her how safe the staff are. She added that it is no surprise when JCAHO comes, therefore the hospital has time to prepare and increase the number of staff on duty while the inspection is occurring, but once JCAHO leaves, staffing returns to the normal levels. Senator Tochtrop agreed with Ms. Patterson's statements about JCAHO and spoke of her own experiences as a nurse in an acute care hospital inspected by JCAHO.
Senator Tochtrop asked the nurses how they expect to gain empowerment and respect without organizing. She stated that the nurses must unite in strength together. Ms. Monnens replied that they were there because of the Colorado Nurse Alliance, a branch of the Service Employees International Union (SEIU), stating they have organized nurses around these issues and membership is growing. Senator Tochtrop asked Ms. Patterson about her experiences at St. Anthony Central to organize over the past 25 years. Ms. Patterson explained that the nurses at St. Anthony Central had attempted to organize with SEIU three times over the 25 years she was a nurse at the hospital, and each time the nurses were fought by the hospital organization. She stated that in order for the nurses to organize themselves they need legal advice and help because they are fighting major entities like Centura and Exempla.
Representative Todd asked the nurses to elaborate on why staff nurses are sent home due to hired travel nurses. Ms. Patterson explained that the travel nurses receive guaranteed hours so when there is no work to do staff nurses are sent home whereas the travel nurses get to stay because their hours are contracted. Representative Todd asked about the difference in pay between staff nurses and travel nurses. Ms. Patterson stated that travel nurses are paid the same or a little bit more then they are. Senator Tochtrop asked if staff nurses are contracted with guaranteed hours. Ms. Romero stated she could never use her vacation time because she had to use it to make up for the lost wages from being sent home early.
Representative Butcher stated that she sees the issues as: no guaranteed hours and too many RNs while not enough LPNs, nurse aides, and orderlies. Representative Butcher explained that the RNs have to do the work of the LPNs on top of their work because there are so many RNs and not enough LPNs. Ms. Patterson agreed and stated that LPNs and nurse aides are needed and are not utilized enough. In response to a question from Representative Butcher, Ms. Patterson explained that if a nurse jumps from an Associates to a Bachelor's Degree they receive no more money unless they go into management.