Health systems cut nursing shortage

Recruiters offer education aid, bonuses as incentives

Sofia Kosmetatos / The Detroit News

Grace Yasay moved to Metro Detroit from the Philippines a year ago for a job at Henry Ford Hospital.

It was a career move that took her from a small military hospital to a fast-paced inner-city institution that treats some of Metro Detroit's sickest.

For Henry Ford Health System, hiring the 32-year-old nurse and others like her from countries across the world is one of a series of steps that has helped the system fill its nursing ranks.

Across Metro Detroit, health systems have turned the spotlight on retaining and attracting nurses, an effort begun amid huge vacancies several years ago and projections that the nursing crunch will only worsen as aging Americans seek more medical care and older nurses retire. In Michigan the shortfall of nurses is expected to reach 18,000 by 2015.

But efforts under way at local hospitals and health systems are helping to close the gap between the number of nurses hospitals need and the number available for them to hire.

"With everything that Henry Ford Health System has been doing...I believe by early this spring we will have all of our positions filled," said Veronica (Ronnie) Hall, senior vice president of clinical operations and chief nursing executive for the system.

There are work force shortages for other health care workers including respiratory therapists, but nursing is where the need is most acute. Solutions among Metro Detroit hospitals vary. They range from forging partnerships with schools to increasing the number of nurses in training to work-life improvements to help retain nurses, including those on the verge of retirement.

Retaining nursing staff

Henry Ford has focused on creating an inclusive work environment that offers nurses more say in policy decisions and flexibility in scheduling.

The result: The nursing vacancy rate has declined from 10 percent to 3 percent over the past three years.

Key to the health system's efforts is a program implemented last fall that forgives up to $8,000 in loans for new college grads or employees who want to go back to school for their bachelors' degrees, in exchange for a three-year work commitment.

Henry Ford also partnered with Henry Ford Community College to help fund accelerated undergraduate nursing degrees, in partnership with the state, in exchange for two-year work commitments. The first class of 55 graduated in September and included dozens of Henry Ford employees from other health careers who went back to school to become nurses.

Angela Belken, 22, plans to take advantage of loan forgiveness to get her bachelor's degree.

"You don't find that in a lot of places," said Belken, a registered nurse from Belleville. She came to Henry Ford Hospital on a nursing school rotation in May, and has started working full time after graduating from Henry Ford Community College in August.

Recruiters go abroad

Henry Ford also looks abroad for foreign nurses to help fill the ranks. Canadian nurses have long worked in the system's flagship hospital in Detroit, where they make up 20 percent of the nursing staff. About 6 percent of nurses at Henry Ford relocate from countries other than Canada -- mainly the Philippines and India -- and the health system also is branching out to the United Kingdom.

For Yasay, the move to Michigan was a natural one. Many Filipinos move to the United States for nursing jobs, and she found a sizable community near her home in Warren. Support is just as important at work, however, where co-workers behave like a family.

"They really appreciate what I'm doing for my patients," Yasay said.

Like its competitors, Henry Ford seeks to attract nurses while they're still in school. The system partners with colleges and universities to offer clinical rotations that are required for graduation, and internships after graduation.

The combination of steps is a huge investment for Henry Ford, both of time and finances. It has spent $1.2 million on the accelerated nursing degree program with HFCC, for example.

But Henry Ford will reap rewards for its combination of investments in a steady work force for years to come, said Michigan's Chief Nursing Executive, Jeanette Klemczak. "That will engender them a huge loyalty and retention of nurses."

Referral bonus is attractive

To attract nurses to Oakwood Healthcare, the system hosts open houses and theme dinners throughout Metro Detroit to meet nurses. The system has forged clinical partnerships with schools, some as a sole sponsor, to train students. Oakwood mentors new employees for 18 months, and offers tuition reimbursement up to 70 percent for employees who want to complete their bachelor's degree, in exchange for a three-year commitment.

The Dearborn-based system also rewards employees who refer nurses to the system. For a full time nurse referral, an employee gets $1,500 -- the highest referral bonus of the 13 types of jobs considered critical to fill.

And, a patient care initiative launched this year aims to improve bedside care and the relationships with patients.

"That's really what it's all about," said Diane DiFiore, manager of nurse recruitment for Oakwood Healthcare Inc. "Working collaboratively with patients."

The system dropped its vacancy rate to 10 percent from 14 percent several years ago.

Cutting the turnover rate

At St. John Health, a nursing recruitment and retention initiative launched last year has helped reduce the registered nurse vacancy rate to 5.5 percent from 9.5 percent a year ago, said Mary Naber, senior vice president of work life services. The efforts cut the turnover rate too, from 15.6 percent to 11.6 percent.

"This is a very important issue for us," Naber said.

Like Henry Ford, St. John also looked abroad for new employees, for the first time last year, and hired 48 foreign nurses.

To help nurses spend more time at the bedside, the health system launched a pilot program to centralize equipment storage last year at St. John Hospital and Medical Center.

You can reach Sofia Kosmetatos at (313) 222-2401 or skosmetatos@detnews.com.