Area’s Nursing Shortage Called ‘Extremely Bad’

After more than a year of searching, advertising and making do with temporary help, California Christian Home in Rosemead finally hired a director of nursing last week for its convalescent hospital.

Westminster Gardens in Duarte has not been so fortunate. A similar retirement home with a 64-bed convalescent hospital, it has been trying to fill a registered nurse position for more than a year.

In both cases, administrators said they could not attract a single applicant last year, even though they offered competitive salaries and tried every means of recruitment.

“It’s an extremely bad situation,” said Jim Stricker, executive director of California Christian Home. “We couldn’t get anyone qualified to even talk to us” until last week.

The nursing shortage in the San Gabriel Valley reflects national trends. And it is not restricted to nursing homes or small convalescent hospitals.

Queen of the Valley Hospital in West Covina always needs at least 20 more nurses, and Pomona Valley Hospital in Pomona has at least a dozen vacant RN positions, according to spokesmen who noted that all acute-care hospitals in California are short of nurses.

Meanwhile, four college nursing programs in the San Gabriel Valley are graduating about 270 registered nurses a year, with a far broader spectrum of ages and ethnicity than ever before. About 16% of them are men.

But that is far below the number of nursing students the schools enrolled even five years ago. The National League of Nursing estimates that enrollment in nursing schools has steadily declined since 1983, falling 22% in just the past two years. The same decline is evident in local nursing programs.

Spokesmen for schools and hospitals say nursing graduates from Cal State Los Angeles, Pasadena City College, Mt. San Antonio College and Azusa Pacific University do not begin to meet the needs of the San Gabriel Valley’s growing population and its increasing numbers of elderly. Bedside care, they noted, is hard work with a high burnout rate, and many go into other fields of nursing.

Kristine de Queiros, who chairs the Pasadena City College nursing program, said that 20 years ago, PCC had 800 applicants for 100 openings each semester. Last fall, she said, 55 nursing students were accepted, 41 actually enrolled in the program and rising dropout and failure rates are sure to drive that number down. There were 32 in the January graduating class.

Karen Myers, dean of health sciences at Mt. San Antonio College, said the pool of nursing applicants on file has dropped from 300 to 150 over the past 10 years, and many who apply do not qualify for the nursing program.

“This has been going on for a decade,” Myers said. “We feel that society is in for a very hard time if we can’t attract more people.”

Azusa Pacific University, a small private school with a 12-year-old nursing program, has 110 nursing students and room for 200.

Cal State Los Angeles, which offers bachelor of science and master’s degrees in nursing, has “a capacity much greater than our enrollment,” according to Jo Ann Johnson, acting chairman of the department. “We could handle twice as many as we have.”

PCC and Mt. San Antonio College offer two-year associate of arts programs that qualify students to take the state exam for registered nurses. Azusa Pacific and Cal State Los Angeles have four-year programs, and their graduates tend to be nurses who go into management fields. Many registered nurses with associate of arts degrees seek bachelor’s degrees at Cal State, and 130 nurses are currently seeking master’s degrees there.

All the schools said they actively recruit nursing students, the majority of whom are older students who attend school part time.

Spokesmen at the colleges said new career opportunities for women are the main reason for the nursing shortage. They cited static hospital nursing salaries--usually under $30,000 a year--and poor media images of nursing as other causes.

“I had a special day to recruit high school students into our nursing program, and I got very little response,” De Queiros said. “Three schools said their girls were going into med schools.”

“People see it as a lot of hard work and high burnout,” Myers said.

Rhea Williams, an associate professor of nursing at Azusa Pacific who researched the nursing shortage while earning a doctorate at UCLA, found that in 1987 only 4% of freshmen women in the country said they preferred nursing as a career.

“This is the lowest it’s ever been,” Williams said. “We knew we had a problem. Now we see it as alarming.”

Her research shows that those most interested in nursing had lower grade averages in high school than other college students and were from lower socioeconomic levels.

On the brighter side, Williams said, the majority of nursing students chose the field because they believe that it is important to help people in difficulty and to have a meaningful purpose in life. However, the number who said good salaries are also important has more than doubled in the past 15 years, her research shows.

“Nurses haven’t lost their altruistic side,” Williams said. “But they want to make a good living and to be recognized for what they do.”

Several students at Cal State Los Angeles agreed with Williams’ findings.

“It’s important that my life have meaning, and only nursing looks at the total picture of the patient,” said Gretchen Santucci of Duarte, an RN now seeking a master’s degree as a mental health clinical specialist. “Medicine is disease-focused, and nursing is holistic.”

Molly Fleming of Pasadena, a nurse at Huntington Memorial Hospital who will soon have a master’s degree, said: “People are made up of their social, psychological and biological environments, and nursing takes all this and gets close to the patient.”

Michael Ramos of Los Angeles is one of a growing number of men entering nursing and one of the few interested in gerontology.

“Being a young male, this is the last thing people expect,” Ramos said. “My friends are out for money--they’re so preoccupied with other things. But I really enjoy showing that someone cares. I value that I’m able to do this.”

Linda Ehlig of South Pasadena earned an associate of arts degree in nursing at PCC, works as a nurse while she studies for a master’s degree and intends to get a doctorate in nursing. She said: “Some nurses are so smart, and people ask them, ‘Why not be a doctor?’ Well, nursing needs good nurses, as smart as any doctor.”

Besides, Ehlig said, “a nurse can go anywhere, do anything. You can go overseas, work in movie studios, be an aeronautic nurse. It’s not like doctors, who have to set up a practice and then stay there.”

The students said nurses are not adequately paid, and they were disappointed that striking Los Angeles County nurses last week settled for lower pay than the union had sought. But they said nursing’s greatest reward is its close contact with patients.

“It’s a privilege to be in such intimate contact with another person,” Santucci said. “The nurse sees the true person in crisis. It’s a gift to intervene. Maybe in our quest for money and prestige, some people have lost sight of this.”

However, Santucci added: “Hospital nurses are underpaid and overwhelmed. I intend to change that. I would like to work for better salaries and reasonable workloads.”

Several nurses and teachers said a major problem in recruiting nurses is the image portrayed in many television shows.

“Nurses are portrayed as handmaidens to doctors, and not too bright,” Williams said. “The image is carrying a bedpan in one hand and a syringe in the other. That has not at all helped to build a positive image. We’re really important people who have to make a great many important decisions.”

Directors at both California Christian Home and Westminster Gardens said they had advertised in local newspapers, professional publications and on the radio for more than a year in an effort to fill their vacancies.

“It’s been extremely difficult to get anyone to talk to us,” said Stricker of California Christian Home. “The situation is really bad.

“There are a lot more exciting, high-tech things nurses would rather do,” he said. “Skilled nursing has not been a high priority” in the profession.

John Rollins, executive director of Westminster Gardens, warned: “It’s going to get worse before it gets better. Meantime, we can’t change the type of patient we have, and there will be more of them.”