By JOSEPH KELLARD
As most bedside nurses nationwide are expected to retire by 2010, because many are baby boomers age 47 and older, South Nassau Communities Hospital in Oceanside will continue looking abroad to hire nurses, particularly India and the Philippines, to address the subsequent shortage.
Even North Shore-Long Island Jewish Health System, a Manhasset-based network of 15 area hospitals that has resisted recruiting foreigners for its 10,500 nursing positions, may change its hiring policy five years from now. So said Sue Shelvin, North Shore-LIJ's assistant vice president of talent acquisition, who otherwise believes the present nursing shortage is due primarily to a shortfall in people who teach nurses. " ... [T]here are plenty of people who want to go into nursing careers," Shelvin said. "I think sometimes the problem is you don't have enough faculty."
Echoing Shelvin's comments is Dr. Bernadette Curry, dean of nursing at Molloy College in Rockville Centre, the nation's fourth largest nursing school, who added that comparative salaries keep many people from becoming educators. "It is not uncommon that the nursing student who graduates goes out into a position that pays significantly more than the professors who taught them," Curry said.
Cheryl Peterson, senior policy analyst at American Nurses Association (ANA), a nationwide professional trade association that represents 155,000 registered nurses out of Maryland, said there is much policy making in graduate medical education for physicians, but that the same level of focus on nursing is lacking.
"The only time you hear about nursing education is when there is a shortage," Peterson said.
Curry, who began her nursing career 40 years ago, noted that many people who do teach are former nurses themselves, exacerbating the already dwindling pool of bedside nurses. This change of careers reflects a trend in which ‹as many female baby boomers became nurses or teachers ‹women today are entering more diverse fields, from medicine to law and business, and nurses are leaving hospitals to take their knowledge and skills elsewhere.
"Law firms, insurance companies, home health care want nurses," said Yvette Mooney, South Nassau's senior vice president for patient care services. "Lawyers who do medical malpractice, for example, have nurses review cases as experts on, say, what degree of faults could there be, documentation, appropriateness of care."
Curry also believes the nursing shortage has a lot to do with the increased responsibilities in the field from decades past, when nurses simply followed doctors' orders.
"Nursing is really a scholarly profession that requires an extremely formidable base of knowledge," she said. " ...We are as legally and ethically [responsible] for what we do as the physician ... Because of the demands, there are some people who come into the profession and after a few years say, maybe it is more of a challenge than I anticipated."
Yet, despite the nursing shortfall, South Nassau is able to maintain a full-time nursing staff, and as part of its long-rang plan to keep substantial vacancies at bay, the hospital rents houses and apartments to provide for nurses, including a new $5 million, 22-unit staff apartment complex it built on Merrick Road. The hospital seeks to fill the units with nurses, particularly from India and the Philippines.
Some question why American-born nurses won't be moving into the complex. Mooney said that when South Nassau talked with the staff, domestic nurses were unwilling to take an apartment because of its minimum one-year lease.
"According to the demand, they could be moving out after that year, because we need to bring other people in," Mooney said. "That's the part that the American nurses would not be interested in."
Others question the ethics of recruiting nurses from developing nations, and the shortage they experience from the mass exodus of nurses. Over the last six years, for example, more than 50,000 Filipino nurses have left home to work abroad, while the nation's nursing schools have produced about 33,000 in that time.
Organizations such as Physicians for Human Rights, a physician advocacy group, oppose this migration of nurses from poorer nations to the U.S. because of the potentially worse conditions this may visit upon their home lands. The ANA, too, opposes international recruitment on the grounds that the U.S. is creating the greater shortage of nurses in other nations, Peterson said. "[The ANA] wants to keep the pressure on hospitals and health systems to do the right thing about creating excellent work environments for nurses and paying them appropriate wages," she added.
When asked why North Shore-LIJ won't recruit foreign nurses, Shelvin, too, said that, ethically, the system doesn't want to take nurses from under-served areas. But Mooney argues that both India and the Philippines are not nations with "severe" shortages of nurses, and that South Nassau picks them because they produce many "excellent nurses," she said. "So we don't feel that this is an ethical dilemma.²
Peterson said the Philippines and India basically educate nurses with the full intention that they will be employed in other nations, and will send money back home. In the Philippines and India, a nurse's average annual salary is $2,000, while at South Nassau the base salary is $58,500. The comparatively substantial salaries in America have allowed foreign-born nurses to send billions of dollars home to their families, and because of this some government agencies, such as in the Philippines, encourage their nurses to work in America.
"What's happened is that in the Philippines, they can't keep up with the demand from the developed countries in particular," Peterson said, "because we aren't doing what we need to do to retain enough of our own nurses."
Curry believes there are circumstances beyond economics in which both nations, the nurse's adopted and native lands, can benefit from his or her move abroad. "For instance," she said, "nurses who come here can work for some time and then return home and provide different ways of dealing with health care that may be beneficial to their original population."
Curry noted how some of Molloy's nursing graduates go on to work in foreign lands, including two recent grads who are working in India and France. "We do take a global perspective," she said, "and try to understand the needs of all."
Ultimately, Peterson cites inconsistent workforce planning as the root cause of most problems with nursing shortages. In the mid-1990s, she said, schools for nursing were closed because most people in the field projected an oversupply was imminent.
"We need workforce planning to guide how many schools we need, what type of practitioner do we need and where should they be deployed," Peterson said. "If we could do that type of planning, we may not have to be so reliant on other countries."
Comments about this story? JKellard@liherald.com or (516) 569-4000 ext. 287.
