Nursing schools jammed

By Dan Nakaso
Advertiser Staff Writer

Just as the state's population is graying faster than any other, and Hawai'i's nursing shortage is expected to balloon over the next few years, the University of Hawai'i system had to turn away 243 qualified nursing school applicants last fall because it didn't have the faculty to teach them.

UH professor Chen-Yen Wang, back left, watches as nursing students Ram Pascua, Karen Angus and Joy Acoba look at Michelle Mizuguchi's tonsils. Nursing schools turn away hundreds of applicants. Gregory Yamamoto • The Honolulu Advertiser

The Healthcare Association of Hawaii represents all of Hawai'i's 34 hospitals and most of the long-term care beds and homecare providers. And Meiers has worked for years to get the Legislature to provide money for tuition assistance and loans for nursing students.

"Then we get potential students interested and get them some loans, only to find out they can't get into nursing school," Meiers said.

In 2000, Hawai'i was short 1,041 registered nurses, according to a nursing shortage task force of educators and healthcare officials trying to solve what will be a long-term problem. By next year, the shortage is expected to grow to 1,518. By 2010, Hawai'i is expected to be short 2,267 registered nurses.

At the same time, nearly 80 percent of Hawai'i's current registered nurses are expected to retire by 2026, according to the task force.

The nursing shortage hurts the bottom line of Hawai'i hospitals because they have to pay more in overtime, extra costs to fly in so-called traveling nurses and expenses to hire temporary nurses through staffing agencies, several hospitals said.

"All of those run premium costs," said Art Gladstone, chief operating officer at Straub Clinic and Hospital, who also has the title of chief nurse executive of Hawaii Pacific Health, the parent organization of Straub, Kapi'olani Medical Center for Women & Children, Kapi'olani Medical Center at Pali Momi and Wilcox Memorial Hospital on Kaua'i.

Like officials at other hospitals, Gladstone said the extra costs to cover nursing shortages "comes out of the margins of the hospital."

Lack of adequate numbers of nurses could also impact patient care.

Meiers plans to lobby legislators to approve $1.74 million for 18 additional nursing faculty, to be spread across every major island for UH's nursing program.

UH administrators separately plan to ask the Legislature for a total of $1.4 million to pay for 29 more faculty, just for the main nursing program at Manoa, covering the two-year budget period beginning July 1, 2005, said UH spokesman Jim Manke.

State Rep. Dennis Arakaki (D-30th, Moanalua, Kalihi Valley, 'Alewa), chairman of the House health committee, supports the idea of adding UH nursing faculty to increase the number of students.

But Arakaki worries that UH officials might also need more money to pay for extra space to accommodate so many more students.

"If it's high on their priority list, I think it will be given consideration," Arakaki said. "In the past, I hate to say it, but we haven't seen it very high on their priority list."

While Arakaki favors increasing the number of nursing students, he also wants to see an emphasis on recruiting trained nurses from other countries, such as the Philippines.

"It's going to take a while before we can get the nurses into the educational pipeline," Arakaki said. "We need to look at more immediate measures."

UH has about 800 students in its statewide nursing system; there are more than 1,040 in Hawai'i's other major program, Hawai'i Pacific University.

HPU has been able to find spots for all of its qualified applicants. But Nancy Ellis, HPU's vice president of student support services, worries there may not be enough faculty and nursing supervisors at Hawai'i hospitals for HPU nursing students to fulfill their clinical work next spring.

"Up until now, we've been able to accommodate everybody," Ellis said. "We're hoping to pull a rabbit out of the hat and still find some clinical positions in the spring, but some students may not get them when they want them."

The exact number of qualified nursing students who were denied admission to all UH system schools this fall has not been calculated, and may be even higher than the 243 turned down last year.

The Manoa campus alone turned away 100 qualified nursing students last year, compared to 150 this semester. Only 50 made it into the Manoa program this fall, said Lois Magnussen, interim associate dean at the UH school of nursing and dental hygiene.

UH nursing applicants have to meet minimum criteria of prerequisite courses, maintain a 2.5 grade-point average and rank in the 50th percentile of either of two entrance tests. Given the shortage of openings, UH selects the best of the qualified applicants to fill spots. The mean grade-point average of successful applicants is 3.67, Magnussen said.

Twenty students who made it into the latest UH nursing class all nodded their heads in unison last week when asked if they knew that most of the other qualified applicants didn't get in.

"The adviser told me, 'It's real competitive. You have to get A's in all your prerequisites,'" said Hana Grimm, a 20-year-old from Makiki who has a 3.7 GPA. "I guess it paid off, because I'm here."

Reach Dan Nakaso at dnakaso@honoluluadvertiser.com or at 525-8085.