Educating an industry Featured

7:00pm EDT February 24, 2008

Successful organizations have a highly engaged work force of loyal, exceptional employees who enjoy their jobs and are eager to make a difference. With serious staff shortages plaguing our nation’s hospitals, creating such an environment is an enormous challenge, especially in California, the state facing the most severe shortages in nursing and other medical personnel. Government data projects a national shortage of 1 million nurses and 90,000 doctors by 2020. California, with the least nurses per population, is in need of an additional 116,600 new nurses by 2020. Our state ranks 50th, with 622 registered nurse (RN) jobs per 100,000 population, compared with 787 RN jobs per 100,000 population nationally.

Smart Business spoke to Barry Arbuckle, Ph.D., President and CEO of MemorialCare Medical Centers and chair of the California Hospital Association Board of Trustees, to learn more about this health care crisis.

How serious is the situation?

Unless addressed head-on, hospitals will experience cutbacks in services due to lack of qualified clinicians. Hard-to-fill positions range from RNs, nurse educators, pharmacists, clinical laboratory specialists, and respiratory, physical and occupational therapists to technologists in nuclear medicine, radiology, histology, surgery, imaging, coding, business and information services, and more.

An aging work force impacts an industry facing massive retirements. By 2010, about 40 percent of the nursing work force will be over 50, while nurses under age 30 account for just 8 percent. Add to that an aging population with multiple health care needs.

We must improve satisfaction, lifelong learning, mentoring programs and services that retain staff and create environments where employees can thrive. At the same time, we need to identify innovations to educate and train new needed personnel.

Is there interest in the helping professions?

Shortages don’t result from a lack of interest but insufficient educational capacity. In California in 2005, 8,749 slots for nursing students filled to 98 percent capacity with more than 14,000 potential students turned away.

Nationally, tens of thousands of student applicants are rejected because of insufficient numbers of faculty members and inadequate academic funding. Hospitals receive federal funding for medical education, but there’s no support for nurse training.

What is the cost to health care providers?

Shortages lead to a dependency on registry and temporary personnel costing in the millions of dollars (see MemorialCare’s January 2008 column). Even credit agencies have gotten in the act. Moody’s Investors Service, which rates creditworthiness of 550 nonprofit hospitals, considers RN recruitment and retention when assigning its ratings.

How is MemorialCare helping the situation?

On any day, hundreds of students learn and train on our hospital campuses. One example began in 2003 when we developed a unique partnership with California State University, Long Beach (CSULB). At that time, its bachelor’s degree in nursing program was educating 72 students per year. Budget cuts meant reductions to 48 — far short of the more than 400 students listing nursing as their desired major. To alleviate this problem, our hospitals — led by Long Beach Memorial Medical Center and Miller Children’s Hospital — entered into a partnership with $10 million provided by our hospitals and $5 million by CSULB. The result is a nationally regarded accelerated bachelor of science in nursing degree where students train at our new satellite college campus adjacent to our largest hospital campus and in our hospitals.

Partnerships with Long Beach City College, Saddleback Community College and Golden West College increase numbers of nursing students and offer inpatient training sites. Academic partnerships help hospital nurses advance from associate to bachelor’s degrees to master’s degrees in nursing — critical to meeting demands in nursing education.

Other partnerships educate and train nuclear medicine techs at CSULB; cytotechnicians at UCLA; laboratory techs and occupational and physical therapists at California State University, Dominguez Hills; histology techs at Mt. San Antonio College; information techs at Devry University; surgical techs at Long Beach City College; and respiratory therapists at Orange Coast College. A new BSN program with University of California, Irvine School of Nursing begins this fall. MemorialCare also partners with university medical schools like UCI and UCLA to offer extensive physician training programs.

What can employers do to help?

Because a shortage of health care providers is a cost we all bear, employers should encourage policymakers to advocate for activities that address shortages, expand coverage for the uninsured and provide a more equitable reimbursement for the hospitals and providers entrusted with the care of our communities. Offer scholarships for students wishing to pursue degrees in health care. Consider donations, grants and other assistance to nursing schools and other programs to increase slots available for future health care professionals and clinical educators.

BARRY ARBUCKLE, Ph.D., is president and CEO of MemorialCare Medical Centers ( and chair of the California Hospital Association. Reach him at or (562) 933-9708. MemorialCare Medical Centers include Saddleback Memorial in Laguna Hills and San Clemente, Orange Coast Memorial in Fountain Valley, Anaheim Memorial, Long Beach Memorial and Miller Children’s Hospital in Long Beach.