Medical crisis

By SCOTT NILES Courier staff writer

March 14, 2008 11:38 pm

— OTTUMWA — Health and state officials are in crisis mode.
They say Iowa could be short nearly one-third of the current number of nursing professionals in the next few years. And not doing something now to replace those nurses will almost guarantee that health care in the state will suffer.
That’s the message from Lt. Gov. Patty Judge and others following the release of a recent report by the Iowa Nursing Task Force.
“I think there are several issues that have kind of come together at the same time,” Judge said in an interview with the Courier. “The first of all the driving factors is that nurses’ wages are too low. People looking at career opportunities see that the wages are low and may make other decisions.
“People that take time to complete the program and see the wages sometimes go on to do something else where they can make more money. Part of the low wages is because the [Medicare/Medicaid] federal reimbursement rates are so low in Iowa. Ours is the lowest, in fact,” Judge said.
And the reason Iowa ranks last in the reimbursement rates is because the state is efficient.
“We do not get as much money because we have done better at administering federal [nursing] programs,” Judge said. “We have asked repeatedly for increased funding. The federal delegation needs to stay on top of this.”
But it isn’t just wages and reimbursement costs.
“One third of nurses we have now [in Iowa] are going to retire within the next decade and we are not educating enough [students] to replace that,” Judge added.
Ann Aulwes, dean of health occupations at Indian Hills Community College in Ottumwa, said they are working on that part of problem.
In fact, in recent years, IHCC has seen a large jump in the number of nursing graduates.
From 2001-02, 1,370 students graduated from the school as registered nurses. That number jumped to 2,255 students during 2006-07 school year. LPN graduates during that same time period went from 1,058 to 1,637 students.
“There were a couple of years where students who were graduating from high school were encouraged to go into other fields,” Aulwes said. “That really hurt the health care industry.”
“Nursing programs are not as large or robust as they should be because we are not able to find the instructors. Nursing is not one of the areas that can be confined to textbooks. We need clinical instructors as well. There is a good hospital and education system in Ottumwa, but we are not retaining as many students in Iowa after graduation,” Judge said.
Ironically, many IHCC nursing students are not from Iowa and when they graduate, they go back to their home states.
“We don’t just have students from Iowa that are in the nursing program, we have students from Missouri and all over, who don’t plan on staying to begin with,” said IHCC Nursing Instructor Jana Ogden.
There are Iowa students who are planning to stay put for now.
Ashley DeBoer, a second-year nursing student at IHCC, said she chose nursing because it’s something that she has always wanted to do. She also has family members who are already in the medical field.
DeBoer said the majority of her family lives in Iowa and she’s inclined to stay in the state, but ...
“I want to be in the nursing field even if it means I have to relocate,” she said.
First-year nursing student Steven DeGeest stumbled his way into nursing and said he looks at the opportunity from a job security standpoint.
DeGeest is from Newton. He came to IHCC and joined the nursing program after having worked at Maytag for 21 years. When the company was bought out by Whirlpool and subsequently closed its Newton plan, he decided to pursue a health care career.
“There’s job security in Iowa since there is a lack of nurses,” he said.
Judge said the need for nurses and other health care professionals will be great over the next five to 10 years.
“All kinds of hospitals, nursing homes and all arenas where nurses are found are going to face a shortage. That is the first line of delivery. If we don’t address this, we are going to face a shortfall all over the state,” she said.
One of the recommendations made by Judge and the task force is the development of a health workforce center to be the focal point for nurse workforce data and measures.
“I think if we can take a better look, then we can understand the need better. I think we need to make it easier for prospective nursing students by expanding the nursing program through forgivable loans and scholarships,” she said.
Task force member and State Board of Health representative Cheryll Jones, of Bloomfield, said nursing shortages are evident, especially in rural Iowa.
She said finding and retaining rural nurses is even more difficult because of low wages and burnout.
“When you have a nurse at a smaller hospital or a rural area, they have to be an expert in everything instead of one specific area,” Jones said.
And while IHCC continues to instruct students, nursing schools across the state are also facing a shortage of nursing instructors and educators.
“If we don’t have the faculty to teach, we will have to limit the number of student in the programs,” Jones said. “This further complicates the problem.”
Jones and Judge remain optimistic.
“We need to aggressively increase the number of nursing students in Iowa so we can get those ... people to teach in the classrooms and clinical settings,” Judge said.
“This problem is not something that can be overlooked,” Jones added. “The recommendations that the task force comes up with can’t just be laid on someone’s desk to collect dust. Something has to be done or it could mean the decline of health care in Iowa.”
Scott Niles can be reached at (641) 683-5360 or via e-mail at sjniles@mchsi.com.