No nurses, no teachers, many more patients

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Colorado is about to face the “perfect storm” in its nursing industry: an aging population that requires more care, an older-than-average work force and a lack of teachers to train new nurses.

Those factors will lead to a critical nursing shortage around the state, said Pam Haynes, executive director of Colorado Health Institute, which surveyed the state’s nurses and discovered troubling trends.

Nearly one third of Colorado’s registered nurses are 55 or older, almost twice the percentage of the state’s overall work force. One in 12 RNs is 65 or older, also twice the percentage of the overall work force.

“This means that many of these nurses are nearing retirement age, at a time when the population is aging,” Haynes said. “Combined with the fact we just don’t have enough teaching faculty, this is going to lead to serious problems in the very near future. We have to find a way to train nurses, to get enough people to teach these programs.”

The survey did find some innovative teaching programs throughout the state.

Mesa State College in Grand Junction allows nurses to enter the work force at a basic level and then return for more education. Federal grants are available that will forgive up to 85 percent of student loans — as long as the nurses agree to work at a health care facility that has an acute nursing shortage.

There is some good news: the overall pass rate of Colorado graduates taking the national licensing exam during 2008 was higher than the national average of 70 percent in nearly all the nursing programs.

However, the survey found that the average age of nursing faculty in bachelor’s and graduate degree programs was 51.5, and the projected rate of retirement exceeded the projected rate of replacement.

“Nursing is one of the few professions in which new graduates are not directed to pursue graduate education immediately, but rather are encouraged to obtain clinical experience before considering a faculty position,” Haynes said.

She said many nurses — responding both to the economic conditions and to the rising shortage — were delaying retirement or returning to work. Some nurses who were only working part-time are now taking full time positions.

And the problem in Colorado is being repeated around the nation. Studies show that half the nation’s 32,000 nursing faculty expects to retire within the next 10 years, and a 21 percent expect to retire within the next five years.

Other findings from the survey include:

During 2006, 35 percent of all budgeted, full-time nursing faculty positions were reported as vacant.

RNs of Hispanic ethnicity were the most underrepresented racial group, when compared to the general population. Only 1.7 percent of nurses identified themselves as Hispanic, while 14.1 percent of the state’s population is Hispanic.

Most of the nurses working in Colorado were employed as RNs, representing the highest percentage in the work force since 1980.

During 2006, the Bureau of Labor Statistics says that 21 percent of RNs worked part time, while 7 percent were working in more than one position.

Half of RNs indicated they are the primary wage earner in their family, with 57 percent earning $50,000 or more each year. Overall, RNs working in rural settings earn less than their urban counterparts — 59 percent of nurses work in urban areas earn at least $50,000, compared to 47 percent of rural RNs.

A number of RNs reported working extra jobs, but not always to supplement their income. About 12 percent of RNs in urban areas and 20 percent in rural areas indicate they have another paying job.

About 8 percent of Colorado RNs are advanced practice nurses, a level that requires a master’s degree. Of those, only 6 percent were primary care nurse practitioners. APNs earn at least $75,000 a year.

Nationwide, there were about 2.5 million licensed registered nurses in the United States — the largest single health care professional occupation.

Profile of Colorado RNs during 2008

92.8 percent were female

61.8 percent were 45 years or older

92.7 percent were white

86.2 percent lived in an urban area

83.3 percent were employed as an RN requiring an active license

57.5 percent were earning $50,000 or more annually

17.9 years was the average number of years working as an RN

Amy Gillentine covers health care for the Colorado Springs Business Journal.