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Florida facing a 'nursing shortage tsunami' due to increased population, more insured patients

Ashley Avis, a registered nurse at St. Anthony’s Hospital in St. Petersburg, checks on cardiac patient Steven Botvin. Florida’s nursing vacancies are increasing, a new report says.
Published Feb. 2, 2016

ST. PETERSBURG — Florida is in need of a few good nurses.

12,493, to be exact.

That's the number of vacant registered nursing positions across the state, according to a new report from the Florida Center for Nursing.

Nursing shortages have come and gone for decades. But there's reason to believe this one could be a prolonged problem. Observers are particularly troubled because the number of vacancies has increased more than 30 percent since 2013, according to the report. Compounding the problem, another 9,947 nursing positions are expected to be created in 2016.

"We're entering turbulent waters," said Dianne Morrison-Beedy, dean of the University of South Florida College of Nursing. "It's no longer like a tide coming in. It's a nursing shortage tsunami."

Hospitals in the Tampa Bay area say there are still enough nurses to provide high-quality patient care. But many are stepping up their efforts to recruit new nurses — and helping seasoned nurses move into hard-to-fill positions in critical care units and emergency rooms, where many of the vacancies are located.

"We have a monthly meeting with our recruiters and we watch the vacancies very carefully," said Pat Sizemore, the chief nurse executive at St. Anthony's Hospital in St. Petersburg. "It doesn't take but a week for things to change."

Hospitals across the country have been under pressure to hire more nurses since 2013, when the Affordable Care Act extended health insurance coverage to millions of Americans.

Population growth has made the situation more acute in Florida. The state recently overtook New York in its number of residents, and continues to grow faster than almost any other state.

"A growing population requires more care," said Mary Lou Brunell, executive director of the Florida Center for Nursing.

The population isn't just growing — it's aging. With 17 percent of residents over the age of 65, Florida is already the "oldest" state in the nation, according to a recent report from the Pepper Institute on Aging and Public Policy at Florida State University. Experts say the share of senior citizens will increase as more Baby Boomers hit retirement.

Another factor: turnover. The average turnover rate for registered nurses working at the bedside in hospitals was 18.3 percent in 2015, according to the report.

Some industry leaders blame the economic recovery.

Brunell said the number of vacancies was low during the Great Recession because nurses who would have otherwise retired or left to have children held on to their jobs.

"Now that the economy is recovering, there's a been a shift," she said. "Some of the nurses who did not intend to work full time are leaving the workforce."

Hospitals, where nearly 75 percent of the statewide vacancies are located, are doing what they can to ensure nursing shifts are covered. Some are offering more overtime to nurses who volunteer to work extra hours. Others are increasing their use of contract nurses.

Brunell also expects to see some Florida hospitals hire nurses with associate degrees instead of bachelor's degrees in an effort to quickly boost their numbers, she said.

Tampa General hasn't seen its vacancies increase, spokesman John Dunn said, adding that the hospital's "magnet" designation from the American Nurses Credentialing Center makes it attractive to registered nurses.

The vacancy rate throughout the BayCare health system, which operates more than a dozen hospitals in the Tampa Bay area, is about 5 percent, said Lisa Johnson, chief executive nurse at Morton Plant Mease Hospital. There are currently between 200 and 300 openings posted.

Johnson said BayCare is "proactive" when it comes to recruiting. Its hospitals identify employees who are interested in becoming nurses — and partner with local colleges to get them the training they need.

BayCare also runs an internship program for recent graduates and has programs to train experienced nurses in fields such as critical care, emergency medicine and obstetrics.

"We do a lot of growing our own nurses," Johnson said.

Ashley Avis is one of those nurses. She started at St. Anthony's in 2008 as a patient support technician, but earned her nursing degree through BayCare's joint program with St. Petersburg College in 2011. Three years after graduating, she embarked on a three-month training program in critical care.

Avis, 31, now works in the hospital's busy cardiac catheterization lab, where she spent a recent afternoon helping to put a stent in a patient's heart.

"Everyday is different," she said after the procedure. "I never know what the ER or the floor is going to throw us."

Morrison-Beedy, the USF nursing college dean, said she applauds the work hospitals are doing to recruit and retain top nurses. But she believes it will take more to address the shortage in the long term.

"We have to think about what primes the pump, and that is the nursing colleges," she said.

Morrison-Beedy said nursing colleges across the state don't have the capacity to keep up with the statewide demand for nurses. They are especially short when it comes to faculty members with doctoral degrees, she said.

"Long-term solutions have to focus on faculty," she said.

Willa Fuller, executive director of the Florida Nurses Association, said policy makers and hospital executives also should consider compensation. The average annual mean wage for a registered nurse in Florida was $62,720 in 2014, according to the U.S. Bureau of Labor Statistics. By comparison, it was $66,570 in Pennsylvania, $77,110 in New York and $98,400 in California.

"Most nurses don't choose nursing because of the salary," Fuller said. "But (higher salaries) could help attract nurses from other states."

A 2015 report by the personal finance website WalletHub ranked Florida the 16th-best state for nurses. The state's rating was boosted by its performance in a category called "opportunity and competition." But it was hurt by Florida's 45th-place finish in the "work environment" category.

Avis, who had initially wanted to pursue a career as a dental hygienist, said she can no longer imagine herself in another field. Sure, her job is physically demanding and the hours can be long. But she gets the privilege of caring for patients, she said.

"I feel honored … to have these lives in my hands," she said.

Contact Kathleen McGrory at kmcgrory@tampabay.com or (727) 893-8330. Follow @kmcgrory.

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