Nursing crunch

When Denise Adams graduated from Chico State’s nursing program in 1984, she found herself in great demand. The United States was reeling from a nursing shortage, so opportunities for registered nurses were plentiful. She elected to stay in Chico, treating patients at Enloe Medical Center for 14 years.

Once again, the country has a nursing shortage, but Adams sees the supply-demand curve from a different angle. She’s now director of Health Occupations at Butte College, overseeing the community college’s nursing, emergency services and respiratory-therapy programs. Rather than being part of the supply, she helps create the supply.

“My patients now are students,” Adams said.

Butte College has been graduating up to 40 registered nurses per semester. Demand for them is high. Just two weeks ago, she received a report showing 90 openings for registered nurses in the area served by the Butte-Glenn Community College District. Some positions require more experience than nursing school, but the report drove home the point that the North State needs the nurses coming out of Butte and Chico State.

Unfortunately, Butte will graduate far fewer registered nurses in coming years. That’s because, at the end of 2011, the program lost some of the grant funding that had enabled the college to expand its RN program four-fold.

Before the 2006 expansion, Butte College accepted 24 RN students each fall. From 2006 through 2011, it accepted 48 each fall and added a spring class, also with 48. Now, Butte College will be able to admit only 24 students in the fall and 24 in the spring—more than it did six years ago, but a marked decline nonetheless.

“We actually feel blessed that we were able to get so many students through the program in such a short period of time,” Adams said. “The college is not thrilled about [cutting back], but funding is what funding is, and we only can do what we can do.”

Oroville Hospital and Enloe are among the medical centers that hire Butte College RN graduates. Carol Speer-Smith, chief of nursing at Oroville Hospital, is particularly concerned by the funding reduction since “a good 80 percent of our RN hires come out of there.” Speer-Smith has experienced two nursing shortages during her quarter-century at the hospital and says the quality of care improves when she can hire nurses with “longevity in the community.”

The alternative is to hire temporary, traveling nurses who are not as familiar with the hospital or the area. Each nursing student at Butte College does at least one rotation through wards at Oroville Hospital, which acquaints them with the medical center and acquaints Speer-Smith with them.

In addition, nurses at Oroville Hospital serve as part-time faculty at Butte College.

“We have a very symbiotic relationship,” Speer-Smith said. “The quality of the program at Butte College is excellent. … I worry about not having applicants and having to hire out of state. We’d rather have people who are local and very dedicated.”

Butte College’s nursing program is actually three programs in one. The college offers certification for licensed vocational nurses (LVNs). It offers a “step-up” program for LVNs to become RNs. Finally, it offers a full program that allows nurses to earn an associate’s degree on top of RN certification. The funding spike that allowed for the expansion of that program back in 2006 came from a Workforce Investment Act Healthy Communities Grant. It ended in December 2011.

In the fall of 2008, Butte College also received a California Community College Chancellor’s Office enrollment growth grant; that has allowed Adams to maintain the spring class, albeit with reduced admissions.

Butte College receives up to 400 qualified applicants for 24 spots a semester. The college conducts a lottery each April and September, weighted to increase the odds of repeat applications. The three-semester LVN program admits 24 students each 18 months.

The nursing program features 15 full-time faculty members and “a variety of part-time faculty,” Adams explained. Those nurses work elsewhere in the community and lend their real-world expertise to “clinical sections.”

“Students love working with part-time faculty because they’re actually at the bedside,” Adams said. “The nurses [on the part-time faculty] love it because they get a chance to stretch their wings.”

Adams dedicates a full-time faculty member to coordinating simulations as well as “student success.” Butte College has four “high-fidelity” simulators—that is, computerized mechanical “patients” with whom students interact—along with a pediatric simulator and a pregnancy simulator. The faculty coordinator also is available for students who have concerns or struggles in particular coursework, which Adams says has increased pass rates and decreased attrition.

Still, despite the successes, Butte College is like other nursing schools nationwide fighting an uphill battle amid funding cuts.

“The nursing shortage has not gone away,” Adams said. “It’s going to be a challenge for the local community. But I’m glad we’re able to keep our program, and our graduates are well-respected.

“We’re doing our part. We’re doing our best. We just have to see how things continue to unfold.”

Speer-Smith, Oroville Hospital’s nursing chief, added the following challenge as food for thought: “If football programs can be financed, why can’t a program for people who can save your life be financed?”