Orange County hospitals have been working overtime to meet a hiring mandate.
A law that’s been on the books since Jan. 1 has required California hospitals to toughen their nurse-patient ratios from 1:6 to 1:5.
That’s helped boost the number of active registered nurses in the state as of March 31 by 3.4% to 297,897, versus a year earlier, according to the California Board of Registered Nursing.
Healthcare observers point to several factors for the rise, including nurses getting their first licenses, others renewing expired licenses, a slowdown in the number of nurses leaving the state and increased funding for schools offering nursing classes.
The state forecasts that there will be a shortfall of tens of thousands of nurses by 2010.
St. Jude Medical Center in Fullerton hired 217 registered nurses last year, said Barbara Miller, the hospital’s vice president of nursing services and chief nursing officer. The hospital’s net gain was 111 nurses after losing 106 others.
Overall, St. Jude, one of three OC hospitals owned by Orange-based St. Joseph Health System, has 663 registered nurses.
Many of St. Jude’s nurse hires are recent graduates of community colleges and four-year colleges, Miller said. Many aren’t taking the path favored by new nurses: joining traditional medical or surgical teams. Rather, some are going right into critical care positions, traditionally the domain of more experienced nurses.
Despite the rise in nurses, education programs still are struggling, Miller said.
“Schools are producing nurses, but there are not enough slots for people to get into nursing programs,” she said. “Sometimes people wait two and three years to get in.”
Nursing programs are of particular concern in California because the average age of a registered nurse is nearly 48. Thousands of nurses are expected to leave the profession through retirement in the coming decades.
County schools with nursing programs include California State University, Fullerton, and several community colleges, such as Saddleback College, Cypress College, Santa Ana College and Golden West College.
Meanwhile, the California Nurses Association has launched an aggressive campaign against Gov. Arnold Schwarzenegger’s bid to postpone the nurse ratio law until 2008. Earlier this year the nurses union successfully won a court ruling that keeps the ratios in effect, with the governor launching an appeal.
As for school funding, Schwarzenegger earlier this year proposed $90 million to boost nursing education programs. And a state Assembly committee has OK’d a bill sponsored by the nurses union that would set aside $45 million for 3,000 nursing school slots across the state.
As for the ratios, local nursing officials say they started planning for them a while ago.
“St. Jude, like many hospitals in Orange County, began preparing for ratios as far back as 2002,” Miller said.
That year was significant, she said, because it was the first time that the state Department of Health Services started detailing what the impact of the ratios would be.
At the time, St. Jude had a nursing vacancy rate based on the ratios of more than 20%, she said.
“By the end of 2004, we had managed to reduce our vacancy rate, based on the ratios, to a low of 6%,” Miller said.
Down at Hoag Memorial Hospital Presbyterian in Newport Beach, new graduates are figuring prominently in hiring, said Diane Griffiths, the hospital’s nursing employment manager.
In fact, Griffiths said that an open house the hospital held last month netted more than 40 nurse hires. Last year, Hoag hired 96 graduate nurses. Nearly all of them still are on staff.
“We started a long time ago to cultivate the nursing schools,” she said.
Hoag’s net is wide: Besides OC schools, Griffiths said the hospital taps nursing programs as far north as Antelope Valley, south as San Diego and east to the Inland Empire.
No Bonuses at Hoag
One thing Hoag hasn’t done is pay bonuses for new hires.
“We have a policy that we never will,” Griffiths said. “What we prefer to do is reward our staff who work here that can recommend a fellow nurse.”
Hoag nurses receive bonuses for referring candidates. Hoag employs nearly 1,200 registered nurses.
The state’s nursing shortage has continued to push salaries up. OC registered nurses made an average of $64,286 as of last year’s third quarter, compared to $50,810 in 1998, according to the state Employment Development Department.
“Nurses’ salaries today, I feel, are competitive, and because they are, they’ve attracted many people who choose this as a second career,” St. Jude’s Miller said.
St. Jude offers up to $5,000 annually for its staff nurses who choose to pursue bachelor’s degrees in nursing.
“Just because things have improved somewhat, I don’t believe we can say things are all right, we can relax,” Miller said. “We need to continue our focus on ensuring we will have quality nurses graduating from nursing programs.”
St. Jude has ties to California State University, Dominguez Hills. And Miller said quite a few of its nurses are pursuing master’s degrees at Cal State Fullerton.
