UK Healthcare Uses Education Incentives to Address Critical Shortage of Nurses

LEXINGTON, Ky. (Nov. 14, 2017) — It has been said that nurses are the most trusted professionals in healthcare. In addition to providing treatment, they are nurturers, educators, and champions for the sick and injured. And Kentucky doesn't have enough of them.

A shortage of registered nurses, whether they are in hospital or clinical setting, is a multifaceted dilemma. The aging "baby boomer" population places a strain on healthcare resources, and the expansion of the Affordable Care Act means that more people are seeking treatment. The high number of Kentuckians with diabetes, cancer, heart disease and strokes also increases the demand for trained nurses.

"We have some serious health issues in our state," said Colleen Swartz, Chief Nurse Executive and Chief Administrative Officer of UK Healthcare. "It's no longer, 'I have a fractured hip', it's 'I have a fractured hip and I'm a diabetic and I have congestive heart failure. That has created care that is very complex."

To address both the shortage and the complex health issues with which nurses must contend, UK Healthcare and the College of Nursing have instituted education incentives designed to attract new nurses and provide current UK nurses with opportunities for professional development. These incentives include tuition assistance, loan-repayment programs and continuing education programs. One such program is Nursing Professional Advancement, which rewards nurses with pay differentials added to their base pay for participating in development opportunities. The nurse residency program for new graduate nurses is a one-year educational and support program that provides regular contact with experts and mentors to help with the transition from student to professional.

"We try to provide students with the best learning environment we possibly can," said Swartz.

The UK College of Nursing awards over 300 undergraduate and graduate degrees each year. The PhD program is ranked among the top eight programs in the US by the National Research Council, and the Doctor of Nursing Practice (DNP) was the first of its kind the US. Online continuing education programs are available, as well as a number of graduate certificates geared toward preparing advanced practice registered nurses for national certification eligibility and licensure in a new or additional specialty area.

"The registered nurse of today is not the registered nurse of a decade ago," said Swartz. "There is an increase in demand on their performances and their understanding of complexities."

While other healthcare centers offer monetary incentives, such as sign-on bonuses for new hires, UK focuses on recruiting nurses looking to expand their skill set or to advance their careers.

"Incentives are different things to different people", said Nora Warshawsky, associate professor in the College of Nursing. "People graduating with student debt will be drawn to the sign-on bonuses, whereas those who are looking ahead at their career trajectories might gravitate to hospitals with educational opportunities."

The hospital's reputation is a factor as well. UK Healthcare was named the best hospital in Kentucky by US News and World Report, and has achieved top 50 rankings in cancer treatment, neurology, geriatrics and diabetes and endocrinology. "[Another benefit] is the culture of the environment such as hospitals with magnet status that treat employees with respect," said Janie Heath, Dean of the College of Nursing. "We recognize and promote their outstanding efforts to meet the mission of care delivery excellence."

Ensuring that nurses have administrative support as well as a professional and encouraging workplace can be the most effective incentive. "The work environment is instrumental in retaining nurses," said Warshawsky. "Supporting nurse managers is critical to the patient care experience. They are the chief retention officers. Nurses who are treated with respect are nurses who are likely to stay."

While the number of registered nurses and advanced practice registered nurses has grown, it has not been enough to offset the number of nurses retiring each year. 2,200 nurses retired in 2016, up from 1,793 in 2014. It is estimated that 3-4,000 registered nurses are not currently working, such as young mothers and those who have returned to school full time. Nearly 800 registered nurses in Kentucky have left the healthcare field entirely. Nursing programs all over the country must deny admission to qualified applicants due to limitations of classroom space and a shortage of faculty. Combined with increased demands on healthcare caused by an aging populace and the expansion of the Affordable Care Act, nurses experience increased patient loads, stress and job dissatisfaction. Inadequate nurse staffing levels are linked to higher rates of patient falls, medication errors, and even death. Medicare and Medicaid  can deny payments for preventable hospital-acquired illnesses and injuries, and private insurance companies are expected to follow suit.

"A shortage can be crippling," said Swartz. "You do all you can to fill the demand and to ensure the care environment is safe."