Health Care

Shortage of nurses: A once stable industry for jobs is seeing large employment gaps

By Kathie Harris, posted 2 years ago

It’s been nearly a decade since a national nursing shortage was announced, and the Fayetteville region isn’t immune to the impact. According to a University of St. Augustine data study, the U.S. will need 1.2 million nurses by 2030 to fill the gap. 

 

In 2020, North Carolina had 120,600 registered nurses employed statewide. For every 1,000 residents, there are fewer than 12 practicing nurses. According to the North Carolina Board of Nursing, Cumberland County has 3,363 RNs and 1,018 licensed practicing nurses serving its 335,500 residents. 

 

The factors behind the shortage are varied. The aging baby boomer generation is creating more demand. Many nurses belong to this generation themselves, so retirement numbers are up. 

 

Another factor is the lack of nursing faculty to teach future nurses. Thousands of qualified nursing applicants are turned away every semester because schools don’t have enough teaching nurses or clinical spaces. One reason for this is the industry-wide low pay rates for nursing faculty compared to practicing nurses. 

 

On top of all these issues, the COVID-19 pandemic overwhelmed the medical community. Nurse burnout has resulted in many leaving the profession entirely. 

 

Nursing shortages historically lead to longer wait times and are a detriment to patient safety. The Fayetteville region is experiencing an impact across all aspects of the spectrum. 

 

HOSPITALS RECRUITING TALENT

 

Cape Fear Regional employs 2,012 LPNs and RNs across its six major hospitals in the region. The healthcare system is short 450 nurses. 

 

In response, Cape Fear’s human resources team has prioritized nurse recruitment, says Debbie Marshburn, a registered nurse and chief nursing executive at Cape Fear. The system has contracted with several agencies to bring in travel nurses and international nursing staff, some of whom have become permanent hires. 

 

“We are also focusing on growing the local pool of talented nurses by working with local colleges and universities to help them graduate more nurses,” says Marshburn. 

 

Marshburn says the nursing staff is stretched thin, which increases dissatisfaction. 

 

“A shortage of available nurses can also lead to temporary or long-term closures of the number of available inpatient beds,” says Marshburn. “When you don’t have the staff to manage those beds, you can’t keep the beds open.” 

 

Even local ambulatory surgical centers are feeling the pinch. The increasing use of ASCs in performing outpatient surgeries in lieu of hospitals makes them a popular choice. ASCs are struggling to operate with fewer nursing staff. Fayetteville Ambulatory Center employs 42 nurses but needs 12 more to be at full strength. 

 

FirstHealth, headquartered in Pinehurst, operates four hospitals in the mid-Carolinas region. It employs 1,630 RNs, LPNs, nurse anesthetists and nurse practitioners. It currently has 150 open RN positions. 

 

To mitigate the shortage, FirstHealth has implemented a multiphased approach to attract and retain nursing talent, says Jacklynn Lesniak, a doctor of nursing practice and chief nursing officer for FirstHealth of the Carolinas. 

 

The effort involves recruitment bonuses of up to $25,000 for some positions, flexible scheduling, and a floating system for full-time positions. FirstHealth has also implemented a nurse extern program to allow nursing students to gain handson experience working alongside experienced registered nurses. 

 

“Professional registered nurses are the cornerstone of our workforce, and we are working every day to attract and retain clinically excellent registered nurses at FirstHealth,” says Lesniak. “Our shared governance practice environment provides a strong foundation to work collaboratively with our nursing team to develop innovative strategies and to ensure our nurses' voices are heard. We are extremely grateful and proud of our nursing staff and how tirelessly they have worked to provide exceptional care to our community despite the challenges of nursing shortages and the ongoing impacts of COVID-19.”

 

SCHOOLS SUPPORTING STUDENTS 

 

A fundamental issue causing the nursing shortage is the need for more faculty to teach future nurses. A recent American Association of Colleges of Nursing found that more than 80,000 qualified nursing candidates were turned away from nursing colleges because of a lack of faculty to teach and clinical spaces for training. 

 

Shannon Matthews, a doctor of nursing practice and nursing department director at Methodist University, says its nursing faculty shortages match national trends. The average age of a teaching nurse is older than 50, so they are often lost to retirement. 

 

Methodist currently has seven faculty on staff and recently received a grant that left one position vacant. In the last three years, there’s been some turnover, says Matthews. At least two nurses left to go back to practice, where the pay is greater. 

 

Matthews says they are more or less fully staffed at the moment. 

 

To support faculty retention and student recruitment, Methodist is participating in the Golden LEAF community economic grant program along with other area nursing schools and high schools. The partnerships help increase the nursing workforce pipeline with projects like workshops, simulation experiences, and information sessions. 

 

Methodist is working with Cape Fear Valley Health System to enhance clinical experiences and shorten residency periods for nurses transitioning from the classroom to practicing. Methodist also has dedicated education units for clinical education, so students can understand their expectations once they get into the field. 

 

The school is also expanding its clinical spaces through partnerships with the Fayetteville VA Medical Center and other medical facilities in the area. 

 

In the Spring, Methodist is launching a new Bachelor of Science in Nursing program to help fill the requirements of higher educated nurses in the industry. It’s also in the final stages of creating a fully online masters program, which will include 12 credit hours of a nursing assistant program that can be done separately. 

 

Matthews says the highly competitive nursing market means nurse graduates receive multiple job offers, generally months before they even graduate. Medical facilities that want to attract nurses should consider what benefits they’re offering. 

 

“They really want to work in a facility that’s got an extensive orientation process, that gives them that time to develop work practices, that have mentors and role models in the facility,” says Matthews. “Some others that students have mentioned were enticing include relocation assistance, tuition and loan reimbursement, childcare, and scheduling options.” 

 

DRIVING CHANGE AT THE STATE LEVEL

 At the state level, the North Carolina Nurses Association has been lobbying for better pay for nursing faculty in hopes of filling the gap. They’re getting close to realizing their efforts as the NC General Assembly prepares to pass the budget, which will include pay increases for frontline workers. The bill would increase pay for nursing faculty, though the amount is currently being negotiated. The NCNA lobbied for a 20% increase. 

 

“They have to take a 20% pay cut to go from clinical practice to academia, and we have to consider the cost of living loss and the value they bring in supporting the nurses of the future, “says Meka Douthit, a doctor of nursing practice and president of the NCNA. “We’re glad we’re gaining some momentum on that.” 

Ico insights

INSIGHTS

SPONSORS' CONTENT

In The Current Issue

Publisher's Note: What a magnificent month of March!

What an impactful month March is! We get to honor the women in our lives throughout the month of March, and more specifically on March 8 for International Women’s Day. We also get to celebrate the beginning of new life in spring which coincidentally


Finding learning solutions: Fayetteville learning expert Kathryn Cox shares her dedication to education serving as the new VP of learning solutions

It is a season of growth for Linchpin Solutions, Inc. as they welcome in their new Vice President of Learning Solutions, Kathryn Cox. Cox has been developing training and education programs for customers for over 30 years, building up her impressive


Optimal Bio for optimal health: Cary based optimal bio is continuing to grow and expand practice locations under the leadership of “She.E.O.” Tylar Brannon

Based in Cary, NC, Optimal Bio currently has four established locationsacross North Carolina, including one in Southern Pines, NC. PHOTOS TAKEN BY SARAH MORREL PHOTOGRAPHYTylar Brannon, the chief executive officer of Bioidentical Hormone Replacement