By Jeni Miller
It is no secret nursing shortages are causing considerable anxiety and trouble for hospitals and health systems nationwide. As expected, shortages can negatively affect patient outcomes.
According to the American Association of Colleges of Nursing, “A shortage of nurses prepared at the baccalaureate level is affecting healthcare quality and patient outcomes. [A] study published in Sept. 24, 2003 ... identified a clear link between higher levels of nursing education and better patient outcomes. This extensive study found that surgical patients have a ‘substantial survival advantage’ if treated in hospitals with higher proportions of nurses educated at the baccalaureate or higher degree level. In hospitals, a 10% increase in the proportion of nurses holding BSN degrees decreased the risk of patient death and failure to rescue by 5%.”1
When the COVID-19 pandemic hit in 2020, it would take more incentive to entice future healthcare workers to enter nursing programs. Fast forward to 2022, and some hospitals are even covering full tuition for nursing students to potentially combat the shortage and provide undisrupted healthcare services to their patients. One such hospital is Mercy Medical Center in Cedar Rapids, IA. In June, the hospital announced its second partnership with a local college to cover the tuition of two-year and four-year nursing students.
The first partnership, between Mercy Medical Center and Mount Mercy University, “will help Mount Mercy students complete their nursing degrees with little to no debt while gaining valuable, on-the-job experience as they prepare to enter the nursing workforce,” according to representatives. “The MercyReady Nursing Education Assistance Program is designed with four goals in mind: 1) provide financial assistance as students complete their Mount Mercy nursing degree; 2) provide a part-time job as a patient care tech II at Mercy Medical Center (Mercy) while students are still in school; 3) provide a full-time registered nurse position at Mercy upon graduation; 4) appeal to individuals considering a career in healthcare.”1
The second partnership is a program called Mercy’s Earn & Learn, designed to “provide financial assistance to cover a student’s unmet needs while completing a BSN degree at Coe College. The assistance may be applied to tuition, housing, transportation, fees, and food.”3 In addition to the financial assistance, which is expected to cover full tuition, students also will be provided with a part-time job “as a patient care tech, phlebotomist, or paramedic at Mercy while they’re still in school, as well as a full-time position at Mercy upon graduation.”
Nursing shortages also affect case management. Hospitals across the country might want to consider these partnerships in their localities to bring a consistent flow of nursing talent to their case management departments.
The Why
Mary Brobst, BSN, MSN, senior vice president and chief nursing officer of patient care services for Mercy Medical Center, agrees hospitals should take these kinds of steps to address shortages.
“The nursing shortage has been on the forefront for decades,” Brobst says. “I’ve been a nurse for more than 30 years, and I knew that this was predicted to get worse by 2020-2030 as baby boomers continue to retire. We’re hearing that fewer students are going into nursing because there are so many other career options. In some cases, schools of nursing are limited and can’t grow the number of students. It’s a perfect storm of so many external factors, but the fact remains that there are not enough to replace the number of nurses who are retiring.”
The COVID-19 pandemic exacerbated the already-existing trajectory. “During the pandemic, the workforce dried up,” Brobst reports. “We see shortages in other disciplines where we hadn’t seen them traditionally.”
They decided to start with addressing the nursing shortage first because there is a clear need, and “nursing is core and central to the care that [Mercy] provides, especially in the acute-care setting,” Brobst explains. “Nursing is the biggest percentage of our workforce, and we thought that if we could do this successfully with nursing programs, then we might be able to take it out to other disciplines, like pharmacy technicians, med lab scientists, radiology, and more.”
Without a solid move to address these challenges, Brobst adds, the medical field would be facing a “highly competitive and volatile market.”
The How
At a brainstorming session with other Mercy Medical Center leaders, Brobst discussed the need to replenish teams and build them back up. They knew they needed to “be as creative and entrepreneurial as possible.” They also capitalized on existing relationships with local colleges.
“At Mount Mercy, we’d worked with them on several initiatives already, and we were founded by the same Sisters of Mercy,” Brobst shares. “[The Sisters of Mercy] were really focused on education and saw a need for healthcare for the sick, the poor, and marginalized, so we’ve had a unique relationship with Mount Mercy for that reason.”
Mercy Medical Center recognized this partnership was not one-sided. It also would benefit the university’s students. “When we went to them, we simply asked, ‘What do your students need and how can we help?’” Brobst explains. “We discussed how hospitals have benefits around loan forgiveness, etc., but we took it a step further and asked them, ‘What would it look like if we helped their students to graduate debt-free?’”
The program allows both two-year and four-year nursing students to participate. Brobst acknowledges that since many case management departments require a bachelor’s degree, this program could help provide candidates for those roles as well. However, entry-level nurses are needed the most, as nurses who have been in the field for some time often advance to higher levels of nursing, like case management, leaving gaps in nursing departments.
“More so than in the past, there is higher turnover, and yet there is no shortage of people with advanced degrees. [In case management], we have openings but not yet a shortage, mostly because it is the higher-level nurses with more experience and advanced degrees who are in the coordinating roles for discharge and transitions of care,” Brobst says. “Still, the work that they do has become so much more complex. It takes a special person to balance the needs of patients with the available resources, the rules and regulations of the payers, and more.”
The program results will be tracked by the hospital’s clinical coordinator, who works with schools of nursing, as well as the recruiting team who will track the number of applicants and hires. At the end of a student’s program, the hospital asks for a work commitment of 12-18 months, with an even better offering for a 24-month commitment. Brobst reports they have already seen an increase in employed students in both the two-year and four-year programs.
Mercy Medical Center expects to see an increase in their new hires due to the financial assistance. There is no limit to how many students can participate in the programs.
Meanwhile, the Cedar Rapids community has taken notice of Mercy Medical Center’s proactive approach to addressing this healthcare challenge. The community has hoped for students to stay in the city after graduation rather than moving out of the area to another, often larger, city.
“If we can have an impact on having kids graduate locally and stay to work locally, that is seen as a positive thing,” Brobst says. “As this program becomes more successful, and as we continue to fund it, we hope to look outside of the Cedar Rapids metro area and expand in concentric circles. The possibility is unique, and I believe it’s one path, one initiative, to help us mitigate the shortage of nurses that hospitals are experiencing everywhere.”
In addition to helping manage the immediate and increasing need for nurses, Brobst hopes programs like this will help students fall in love with a career she has enjoyed for more than 30 years.
“We hope [the students] continue to pursue an advanced degree here, and if an associate nurse wants to do their RN to BSN, we have pathways for that,” Brobst says. “I’ve stayed for 30 years because within nursing, you can change roles and jobs as you go through life, from being a newlywed, to starting a family, having high school kids in sports, then college kids. Each phase of life brings a different need for that work-life integration, and nursing is great for that.’
Brobst also has high hopes for case management. “When nurses are ready to leave bedside nursing, yet still desire to interact with patients, families, and physicians, [case management] is a great stepping stone because they can continue to coordinate transitions of care,” she says. “Case managers are such good role models. They work so well with social work, with everyone, so case management continues to be a sought-after role.”
REFERENCES
- American Association of Colleges of Nursing. Nursing shortage. Page last updated September 2020.
- Mount Mercy University. Mercy Medical Center and Mount Mercy University announce education assistance program to jumpstart nursing careers. March 1, 2022.
- The MedQuarter. Mercy Medical Center & Coe College announce Earn & Learn education assistance program to jumpstart nursing careers. June 22, 2022.
It is no secret nursing shortages are causing considerable anxiety and trouble for hospitals and health systems nationwide. As expected, shortages can negatively affect patient outcomes. Some hospitals are even covering full tuition for nursing students to potentially combat the shortage and provide undisrupted healthcare services to their patients.
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