Mitch Fox/The Hoya Cristy Bushea is a registered nurse at Georgetown University Hospital. The hospital has developed new recruitment strategies to cope with the national shortage of nurses.

As nursing shortages hit hospitals nationwide, Georgetown University Hospital has been using various approaches to ease their own shortage of nurses. At the same time, graduates of The School of Nursing and Health Studies find themselves in a unique position, entering the working world in high demand despite the currently difficult job market.

The hospital has used a variety of strategies to keep the number of nurses at a sufficient level so that patient-care quality will not diminish. These strategies include hiring temporary help, increasing college and international recruitment and implementing innovative retention programs that include competitive salaries, according to Molly Billingsley, assistant vice president for operations support at Georgetown University Hospital. The initiatives also include a shared governance plan and increased communication between staff and administration, she said.

“There is no hospital in the country that the nursing shortage hasn’t affected. At Georgetown University Hospital, we are definitely, definitely feeling it, and we are combating the shortage by bringing in extra help – hiring more traveling nurses and nurses from different agencies,” Billingsley said. “We have never, ever been facing a situation where there is no nurse at the end of a patient’s call signal.”

A study in the Oct. 23 Journal of the American Medicine Association noted a correlation between patient-to-nurse ratios and patient mortality rates. “In hospitals with high patient-to-nurse ratios, surgical patients experience higher risk-adjusted 30-day mortality and failure-to-rescue rates, and nurses are more likely to experience burnout and job dissatisfaction,” the study reported.

Billingsley explained that some understaffed hospitals have led to exaggerations about the extent of the national shortage. “Many of the hospitals we’ve been reading about in the news, which have had the impact [of the shortage] affect the level of patient care, these hospitals have been trying to make do without bringing in extra help. These are the horror stories we’ve heard,” Billingsley said.

“The shortage of professional nurses is profound,” Dean of the School of Nursing and Health Studies Bette Keltner said. “Three factors magnify this shortage and will continue to increase demand in the near future. First, healthcare technology is becoming rapidly more sophisticated; second, biomedical knowledge is bursting at lightening speed; and third, demographic changes associated with an aging population and the capacity and will to sustain fragile life. Nurses are essential players across all three of these domains.”

The demand for nurses has prompted more students to consider pre-professional programs in nursing. “NHS applications have skyrocketed across all of our programs,” Keltner said. “Georgetown has the most selective nursing program in the country. This is driven by the fact that we admit only 100 first-year students across all of our programs. Georgetown nursing is invigorated by our innovative model of educating students for a variety of healthcare fields – essential for an industry that is highly reliant on interdisciplinary research and collaborative practice.”

The NHS has also worked to recruit top students interested in nursing or health studies. Keltner said that a career in nursing is not simply limited, however, to students in the NHS. “A new and very promising program is the Georgetown NHS direct entry/second degree program. This program is for candidates who have a recent baccalaureate degree and would like to use their first degree as a platform for a nursing career – and a good paying, fulfilling job. Young people who have degrees in natural or social sciences can accelerate in this nursing program. Qualified students take a specially designed course of studies over a period of 16 months to be eligible for nursing licensure,” she said.

To counter the shortage of staff nurses, the hospital has increasingly turned to temporary and outside help. “The hospital administration has allowed us to hire more traveling nurses. The term traveling is somewhat of a misnomer, as many of the our `traveling’ nurses have been with us for months and years, so it is simply a different way to enroll as a nurse,” Billingsley said. “While we’d rather have everyone [in our staff] wearing the blue, yellow and gray colors [of the hospital], we have not had to close any units because of the nursing shortage; in fact, we have been able to open more units.

“If anything, we have to rely on temporary help temporarily. The most obvious impact is that we would be opening more beds faster if there wasn’t a nursing shortage,” Billingsley said.

The Georgetown University Medical Center has stepped up recruitment efforts in colleges along the East Coast with scholarship and tuition reimbursement programs in addition to programs that offer full and partial scholarships specifically for graduate students in the NHS, Billingsley said.

“We have the best recruitment department that I’ve ever seen,” Billingsley said. “It’s certainly the best in the area. It is one of our strongest initiatives, and we were written up in several publications as the best nursing recruitment program in the country. We recruited 100 nurses in 100 days last year.”

Additional recruitment initiatives include a partnership between the hospital, the NHS and the local NBC affiliate to publicize the nursing shortage. “It is very innovative and the only one of its type. Other affiliates across the country are watching this program very carefully to see how successful it is in recruitment efforts.

Internationally, the hospital has an active recruitment with the Philippines, where 70 to 80 nurses are in varying stages and preparation to emigrate and work at Georgetown. About 20 nurses have already arrived at Georgetown, according to Billingsley.

“To set the record straight, there is some misconception that this program robs nurses from the countries that need them. The Philippines is one of two countries that has more nurses than it can hire. Hospitals can’t guarantee them a job in the Philippines. Some nurses work as volunteers, 40 hours a week with no pay. So we’re not robbing anyone,” Billingsley added. “And because this sends an enormous amount of money back to the Philippines, the Philippine government is largely in favor of this program.”

In addition to recruitment programs, the hospital seeks to ensure that it retains the nurses currently employed, according to Billingsley. “We can’t ignore that it is equally important to attract and recruit nurses as it is to retain them. The job market in nursing is so competitive that one can go anywhere for a job. We seek to provide an environment where our staff will be happy,” she said.

Retention programs include a shared governance program that allows nurses to set their own clinical policy, increased two-way communication between the nursing staff and the hospital administration, competitive wages and the addition of 100 nursing positions to ensure that nurses do not become overworked, Billingsley said.

“We are very aware of how important it is to maintain a presence that sets us apart from other hospitals. Our nurses have the best reputation in town,” Billingsley said. “We make sure that we give them the kind of support they need to be able to be conducive to give the best clinical care available.”

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