Angela Cravens, a longtime employee of the microbiology lab at the Department of Veterans Affairs Medical Center in Albuquerque, hears almost daily about the state’s crisis-level nursing shortage.
“You read the stories,” she said. “…They need help.”
Cravens wants to help. She is studying at the University of New Mexico to become a nurse in hopes of transitioning into a second career.
A July 2020 legislative report said New Mexico needed an additional 6,223 registered nurses, a number that likely increased amid the pandemic as overworked nurses got worn down and burned out.
But the state’s nursing woes are only part of the story — one that’s not completely tied to a grueling and seemingly never-ending health care crisis wrought by the coronavirus.
New Mexico lacks medical professionals in many critical areas. A legislative report released in August cited numerous shortfalls: 328 primary care physicians, 238 certified nurse practitioners, 249 physician assistants, 524 physical therapists, 2,510 emergency medical technicians, 521 pharmacists and 117 psychiatrists.
Those preparing to enter the medical field say they are happy to lend a hand. But experts say the problem – there wasn’t enough of it in the medical field before the pandemic and far from enough now – won’t be solved with enthusiasm alone, especially when it comes to nursing.
This area is central to the efforts of this legislative session, and the reasoning is simple: medical officials and legislators agree that there are not enough training programs, not enough facilities for the programs and, often , not enough nurse educators.
“To have more students, you have to have more space, more facilities,” said Sen. Liz Stefanics, D-Cerrillos, who sponsored Senate Bill 50, which seeks $15 million. to boost nursing school curricula.
The proposed state budget for fiscal year 2023, House Bill 2, includes $5 million for the initiative.
Proponents say the funding would allow more students like Cravens to enroll in university nursing programs. Lawmakers have also proposed several other bills to address the shortage. One would allow out-of-state graduate nurses to work in New Mexico within 30 days; now the process could take months. Another would allocate $750,000 to help nurses pay off student loans. Two pieces of legislation would extend a $5,000 tax credit for rural health professionals to chiropractors, midwives and practitioners of oriental medicine who work in remote communities.
The question remains: Will either of these measures be enough for the state to begin rebuilding a workforce that has been in decline for years?
The New Mexico Hospital Association wonders if the array of piecemeal proposals will have much effect. Pamela Blackwell, the organization’s policy director, wrote in an email that there were no “comprehensive bills that would effectively address the healthcare worker shortage issues”.
It is also unclear whether tax credits for rural health professionals are effective. Nurse lobbyist Linda Siegle said she was not aware of any studies analyzing whether the incitement worked.
“We don’t know what kind of effect that has in terms of recruitment or retention in rural areas,” she said. “We think it could help with retention.”
The August report recommends a more robust initiative: establish a loan program offering up to $150,000 to doctors and other medical workers to establish or expand practices in rural areas.
Still, some health care experts say lawmakers are on the right track, especially when it comes to attracting more nursing students and expanding training programs for nurses.
Tim Johnsen, chief operating officer of Presbyterian Healthcare Services, called the student loan bill “a nice wink”.
He also said he hopes the legislature will approve more funding for Medicaid reimbursements for hospitals because “it helps us recruit and retain providers and staff. When we know reimbursement is coming, we can better prepare ourselves for budgetary challenges such as staff increases”.
Increase in enrollment in nursing schools
“The prioritization of funding for nursing programs is important,” said Terri Tewart, dean of the nursing program at Santa Fe Community College. Although enrollment in the local college’s nursing program has declined over the past year, she said there is continued interest in the profession.
Christine Kasper, dean of the College of Nursing at the University of New Mexico, said enrollment there has grown 108% in the past five years — a welcome sign for a state that has seen many nurses leave the field. .
“I wouldn’t say it’s a worst-case scenario, but it’s pretty close,” Kasper said. “There are so many nurses out there, but a lot of them aren’t working in nursing. They’re stressed; they’ve quit or changed jobs.”
According to the most recent data provided by the state Department of Higher Education, there were approximately 7,625 students enrolled in nursing programs in New Mexico in the fall 2020 semester.
Interestingly, the field of nursing is starting to attract some mid-career people who worked in other professions.
Cravens, 42, said she saw nurses from the Raymond G. Murphy VA Medical Center caring for her grandfather, a World War II veteran, and was inspired to change careers. . She plans to graduate from UNM nursing school by the end of 2022.
Sandra Adondakis, a 52-year-old nursing student at Santa Fe Community College, jokingly calls her future job a “third career.”
A former lobbyist for the American Cancer Society who also worked at the state Department of Health’s Office of Infectious Disease Prevention and Control, Adondakis said she wanted to make a difference in an industry that needs help. aid.
“I know that as a nurse I can advocate for my patients, make sure their needs are met, make sure they are active in making the right decisions with their own health care,” he said. she declared.
Like Cravens, she is convinced that a job in New Mexico awaits her.
But she cited other issues hampering the development of a stronger health workforce: a lack of qualified nurse educators and a delay in sending student nurses to hospitals for practical clinical experience.
“The easy solution is to say we need more nurses in our nursing school,” said Troy Clark, president and CEO of the New Mexico Hospital Association. “That’s a true statement, but we need more educators who can help teach more enrollment.”
Clark said state nursing programs graduate about 1,200 students each year, and there are 300 more waiting to enter the programs. Even if those 300 potential students had places in nursing programs and schools graduated 1,500 a year, it would take at least four years to fill the gap, he said.
“A multifaceted solution is needed”
Efforts by the Legislative Assembly to address the shortage in recent years have been “sporadic or spotty,” Clark said. “The problem is that a multi-faceted solution is needed. It will take five years or more to see the benefits. [traveling] nurses, by bringing in already trained foreign nurses”.
These staffing solutions have become much more expensive. Salaries for traveling nurses rose from $65 to $80 an hour in the early months of the pandemic to well over $250 an hour — “a huge financial burden on hospitals,” Clark said.
He added: “Until we get to the point where we can develop our own nurses and healthcare workers, we won’t be in a sustainable position.”
Blackwell, the hospital association’s policy director, wrote in an email that lawmakers should develop “a nation-wide healthcare career and workforce pipeline effort.” State”.
With just over 10 days left in this year’s legislative session, she wrote: ‘We don’t think there is time to put more [legislation] this session. We will work during the interim with our members and other healthcare provider partners to seek opportunities and best practices to build on in preparation for the 60-day session in 2023.