Eastern Iowa hospitals take steps to ease nursing shortage

Health care providers in Eastern Iowa are pulling out all the stops to recruit and retain nursing staff amid an ongoing nursing shortage in the United States — a challenge that has been accelerated by the COVID-19 pandemic.

Nursing leaders at University of Iowa Health Care, UnityPoint Health-St. Luke’s Hospital and Mercy Medical Center discussed the steps they’re taking to address the nursing shortage.

“The pandemic has brought a great need for more nursing staff,” said Carmen Kleinsmith, senior vice president and chief nursing officer at UnityPoint Health-St. Luke’s Hospital. “Nursing staffing challenges are pretty prevalent across the country right now. A lot of things are contributing to that. It’s something we’ve been looking at over the last several years.”

The need for nurses is outpacing the number of nursing program graduates, according to the American Association of Colleges of Nursing, in part because America’s aging population will require more nurses and because many experienced nurses are approaching retirement.

In Iowa, more than 58 percent of health care facilities reported a shortage of qualified applicants for nursing positions according to a 2020 workforce demand survey by Iowa Workforce Development and the Iowa Board of Nursing.

Since the onset of the pandemic, many nurses opted to become traveling nurses, allowing them to work for different health care providers for several weeks or months at a time at a much higher rate of pay. “That’s really appealing to young folks with student loans to pay off,” said Kleinsmith. “There are pros and cons to that type of work setting. My hunch is that it’s temporary and not a way of life.”

Supporting the nurses of today

From salary increases and retention bonuses to unique education programs, area health care providers are taking an “all of the above” strategy to bolster their nursing ranks.

“I mean, what aren’t we doing?” said Nancy Hill-Davis, senior vice president and chief talent officer at Mercy Medical Center. “Wage increases, retention bonuses, elevated sign-on bonuses, referral bonuses. We’ve also focused on caregiver wellness and addressing the needs of our staff. They’ve really suffered the effects of the past two years”

University of Iowa Hospitals and Clinics held two open house-style hiring events for nurses on April 12 and 19 where candidates were able to meet with managers, interview for jobs and tour UIHC facilities. Qualified candidates could receive same-day offers and a sign-on bonus of up to $10,000.

In addition to increasing financial compensation for new and existing nursing staff, local providers are looking at ways to address burnout and keep staff engaged and happy in their work environment.

“We talk a lot about stabilizing the work force and bringing more people in, but I don’t ever want to minimize that we have tenured people here and we need to make sure we’re taking care of them, too,” Kleinsmith said. “Retention is just as important as recruitment. If I could balance those two out, that would be utopia.”

One concept St. Luke’s is working on is having some well-tenured nurses work virtually, either by video chatting with patients or providing support to newer staff. That would allow staff who may no longer be able to handle the physical demands of hospital work to continue serving patients, Kleinsmith said.

“Compensation is very important to anyone, but the work environment is equally important,” said Kim Hunter, interim CEO and chief nursing officer at UIHC, the state’s largest employer of nurses.

UIHC nurses are able to work in many different settings, including hospitals, clinics and ambulatory care. “We’re able to offer a variety of opportunities as a nurse grows in their career. They might want to be challenged in a different way, or work in a setting that may fit their life better,” Hunter said. “You can spend your whole career here and do a variety of different things.”

It’s important for nurses to have a voice in how patients are cared for, Hunter said. An advantage at UIHC is that nurses are able to serve in shared governance roles, she said.

In addition, UIHC has been designated a Magnet hospital — one that is recognized by the American Nurses Credentialing Center as having high standards of nursing excellence — since 2004. St. Luke’s has been designated a Magnet hospital since 2009.

Mercy’s role as a health care provider in Cedar Rapids started with the Sisters of Mercy. The hospital still leans strongly on its mission as it seeks to recruit new employees and retain those who remain committed to Mercy’s vision and values.

“One thing that we’re doing with our current team members is really reengaging them with their purpose and the mission of Mercy,” said Mary Brobst, senior vice president of patient care services and chief nursing officer at Mercy. “We know a lot of people who chose to stay [during the pandemic] had a strong connection to that purpose.”

Kleinsmith said St. Luke’s is soliciting feedback from staff and making sure they have opportunities to learn and grow professionally. “Ultimately, where do you want to be able to grow your career and work with a team that is aspirational and innovative and wanting to do the best for the community? I want to say that that’s here.”

One unique program at St. Luke’s is its “generate” innovation lab, which opened in November of 2019, Kleinsmith said. Through a partnership with Boston-based MakerHealth, the lab is equipped with a 3D printer, a laser cutter, and a variety of other tools that allow staff to build prototype devices to help improve patient care. “If you have ideas of what you want to do about something in your work that slows you down, you just go down to the lab and they’ll work on your idea,” Kleinsmith said. The innovation lab, the only program of its kind in the Midwest, was founded by Rose Hedges, a registered nurse who now manages the lab.

“To be in an environment where you feel supported, like you’re growing your career, feel you can do your best work and provide great-quality outcomes for patients — that’s something we pride ourselves on,” said Kleinsmith.

Training the nurses of tomorrow

Meeting the growing demand for nurses in Iowa and across the country will require more nursing program graduates. To that end, health care providers and nursing schools in the Corridor are developing programs to help train and support the next generation of nurses.

In the spring of 2023, the UI College of Nursing will launch a Master of Science in Nursing: Entry into Practice program that offers an accelerated path to a nursing career for people without an undergraduate nursing degree. The program can be completed in less than two years and prepares students to immediately enter the nursing workforce.

“At UIHC, we’re very excited about the program,” said Hunter. “We work closely with the College of Nursing and provide clinical experiences to colleges and universities across the state. As an academic medical center, one of our missions is to teach people so a variety of people stay in the state and take care of Iowans.”

A partnership between Mount Mercy University and Mercy Medical Center — the MercyReady Nursing Education Assistance Program — was unveiled in March. That program is open to sophomores, juniors and seniors at Mount Mercy. In addition to financial aid, participants will earn a salary while working at least 20 hours per month as a phlebotomist or patient care technician I.

“We’re thrilled about offering the program,” said Brobst. “We’ve had a lot of great conversations with students who are interested in continuing their education and getting assistance from Mercy and potentially continuing their careers with us.”

“We are holding twice-weekly interview sessions for MercyReady candidates, trying to make same-day offers available,” Hill-Davis said. “We’ve also engaged with the Marion Economic Development Corporation and have a cohort of eight students that are completing the Kirkwood Certified Nurse Assistant program and will join us this summer to work.”

In addition, leaders in other clinical areas, such as phlebotomy and surgical tech, will meet with local high school students to introduce their fields, which often aren’t as well-known, said Hill-Davis. Those professionals work alongside nurses and can help lighten their load by handling responsibilities that don’t require a nursing license, she said.

In early April, St. Luke’s Hospital and Mount Mercy University announced a partnership to offer financial aid and sign-on bonuses to students who work at least 18 months as a registered nurse within the hospital. The Senior Promise Program, which is open to students who will graduate in 2022 or 2023, covers the student’s remaining out-of-pocket tuition and fees for their final two semesters of study. The hospital has also announced a similar partnership to support nursing students at Kirkwood Community College.

Ultimately, health care leaders said that by supporting nurses they empower them to provide the best possible care to patients.