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New England looks
to ease healthcare woes
 According
to a November 2000 report released by UnitedHealth Group,
New Hampshire is the healthiest region in the country. The
state ranks first in such areas as lowest violent crime, highest
adequacy of prenatal care, highest support for public health
and lowest infant mortality rate. To receive accolades like
this, New Hampshire must be doing something right, not the
least of which is hiring competent professionals. Like the
rest of the nation, however, this state is experiencing shortages,
and it is working hard to solve its labor concerns.
The
most critical area for New Hampshire is nursing. RNs and LPNs
are particularly in need. Specialized areas, such as intensive
care units and emergency departments, are having the most
difficulty recruiting qualified professionals. Lisa McGunnigle,
vice president, health law and policy at the New Hampshire
Hospital Association in Concord, says the number of open RN
positions has exploded in the past few years. "The unemployment
rate for RNs has tripled from what it was five years ago,"
McGunnigle explains.
Not
only are hospitals looking for nurses, but home healthcare
agencies and nursing homes are as well. Deborah Yeager, director
of communications for the New Hampshire Health Care Association
in Concord, describes the situation as severe. "All aspects
of healthcare are looking for nurses," Yeager shares. The
issue is particularly acute for home healthcare because of
the type of work that it involves. "It's not so much nursing
as personal care," Yeager explains. "They are direct caregivers.
They dress the patients, feed them, change sheets and are
responsible for getting to know the residents." And nursing
is not the only area in which home health facilities are facing
a shortage. Long-term care is in need of all types of employees,
including dietary and housekeeping staff.
Some
of the key issues that the state faces include the differences
between rural and urban institutions. Areas that aren't anchored
by a metropolis sometimes have trouble attracting workers.
Unlike major cities that can boast a wide array of cultural
activities and after-work opportunities, rural regions must
count on drawing people who are looking for a more laid-back
lifestyle. Of course, what is rural to one person may not
be to the next, says Stephanie Pagliuca, program manager for
the New Hampshire Recruitment Center in Concord. "Some people
coming from New York want to move to Nashua, which is practically
rural to them," Pagliuca notes with a laugh. "To us it's urban."
Another
concern for healthcare workers in New Hampshire is salaries.
Between sign-on bonuses and pay raises, some professionals
are finally beginning to earn what they are worth. Unfortunately,
not everyone is reaping the rewards, says Sally Becker, administrative
director of the New Hampshire Nurse Practitioner Association
in Concord. "Some do very, very well," Becker shares, "but
some salaries are just awful." Part of the problem lies in
recent Medicare reductions. The federal healthcare program
accounts for about 36 percent of all inpatients, making it
the single largest payer for area hospitals. When reimbursements
were sliced down, it affected institutions' bottom lines,
causing them to make reductions in staff and push their remaining
employees even harder.
Besides
nursing, other areas that the state is deficient in include
nursing assistants, home health aides, physical therapists,
respiratory therapists, pharmacists and nursing teachers.
To recruit candidates, healthcare institutions are using newspapers,
trade journals and the Internet. Also helping are various
government and private programs that hope to educate and attract
more people to the industry. With this group effort, New Hampshire
is making a concerted effort to keep its healthcare concerns
from becoming an epidemic.
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