CSON holds a meeting on the Massachusetts nursing crisis

Representatives of 33 Massachusetts nursing organizations brainstormed solutions to the state's worsening nursing shortage at a summit meeting held at Boston College on June 14. At issue was a job vacancy rate for registered nurses of about 9 percent, and an aging and homogeneous workforce in which 96.6 percent of the state's 113,000 nurses are female, 95.5 percent are white, and the average age is 48. With a motivational speech by the 2002 Olympics organizer and Republican Massachusetts gubernatorial candidate Mitt Romney, and impassioned discussion among nurses about problems of image and substance encountered in the workplace, the conference built overwhelming support for the creation of a statewide center dedicated to nurse recruitment.

The summit planners included the dean of BC's Connell School of Nursing, Barbara Munro (representing the Massachusetts Association of Colleges of Nursing), and representatives from eight other nursing groups. Romney had been invited to speak months earlier, before his re-entry into the state's political fray. The organizers had been looking for a speaker who might inspire a truce between rival Massachusetts nursing factions, and Romney had demonstrated the ability to coax together coalitions as he rebuilt the once scandal-ridden Salt Lake City Olympics. Even so, one key nursing organization, the Massachusetts Nursing Association (MNA), representing 17,000 unionized nurses, declined to show up at the conference.

As the keynote speaker, Romney mercifully stayed off discussions of state politics, but still managed to seduce his audience like a seasoned pol. He called nurses heroes and related the story of his mother, who passed up hospice care because she couldn't bear to switch nurses. Romney also drew parallels between the recruitment challenges of the Olympics and those of nursing. He had taken over an Olympics tarnished by charges that Salt Lake City organizers had bribed Olympic Committee members, and he had quickly faced the need to attract 24,000 volunteers for arduous, sometimes tedious work. "People don't sign up because of what you need," he said. "People sign up because they want to do it." Romney described a marketing campaign that promoted volunteer jobs as "the experience of a lifetime" and positioned former professional quarterback Steve Young as the chief of volunteers. Some 67,000 volunteers applied, believing--as nurses might--that they were serving a higher purpose. After the Olympics, a star-studded concert honored all the volunteers--emblematic of the kind of professional respect and reward system often found wanting in nursing.

If Romney was the inspiration, the summit's afternoon speaker was the reality. Dennis Sherrod, associate director of recruitment and retention for the North Carolina Center for Nursing (NCCN) spoke about his organization, which was mandated by state law in 1991 to plan workforce strategies so enough nurses will be available to meet residents' health care needs. The NCCN—which is 75 percent funded by the state, with the remainder coming from grants and donations—is recognized as a national authority on nursing workforce data. Its recruitment strategies include posters for schools, a nursing badge earned by Scouts and other youth groups, and coloring pages to plant a positive image in even the youngest consumers. To help reward—and thereby retain—nurses already in the workforce, NCCN hosts pampering retreats for nurses, who frequently tell Sherrod that the getaway inspired them to earn advanced degrees.

North Carolina's strategy seems to be working. In recent years, while many states have watched their nursing workforces shrink, the number of nurses in North Carolina has grown faster than the state population. While the NCCN has no hard data to take credit for such success, it can count the 600 nursing scholarships it awards yearly to students who graduate from high school with a B average. The center also calculates hits on its Web site, which went from 100 to 600 per week after a recruitment campaign mailed more than 30,000 brochures, videos, and posters to schools, libraries, employers, and others.

Between the speeches by Romney and Sherrod, more than 80 nurses and other health-care professionals broke into small groups to discuss ways to tackle the shortage in Massachusetts. Nurses repeatedly lamented their difficulty with recruiting minorities and men to the profession, and stressed the need to get positive messages about nursing to children, teachers, and guidance counselors. One told the story of a Vietnamese girl who was advised by her guidance counselor that she couldn't be a nurse because she was an immigrant. Audible sighs of understanding greeted another nurse who recalled a medical resident telling her, "You're just a nurse."

Wish lists grew quickly, cataloging hopes for increased financial aid for nursing students, better P.R. to polish the profession's image, and even a Nursing Hall of Fame. The overarching idea, nurtured by summit planners, was to create a state center like that in North Carolina, dedicated to nurse recruitment and retention.

The summit meeting closed amidst rousing support for such a center. Like impassioned members at a revival meeting, one nurse after another stood up to pledge the support of her organization. Some offered meeting space or staffing, others promised financial backing, Web site links, Web design, or fund-raising help. Flyers were circulated announcing an August 1 meeting for the proposed center's design team.

Chances are that the ex-citement would have been muted if the MNA had accepted its invitation to the summit. The union's absence was not unexpected. The Massachusetts Association of Registered Nurses (MARN), which coordinated the conference, was created after the century-old MNA withdrew from the American Nurses Association in 2000. With just 400 members, the new organization is dwarfed by the older union, which is, says BC's Munro, "the biggest bargaining unit for nurses in the state."

According to its spokesman, David Schildmeir, the MNA didn't attend because it views the summit's focus on a statewide nursing center as a distraction from the union's main goal, which is passage of legislation to ensure reasonable nurse-patient staffing ratios. "We saw nothing on the table about that," Schildmeier said in an interview. Even if a center successfully recruits more nurses, he said, "if you haven't fixed the core problem and given them a safe ratio, they're just going to turn around and leave."

Little was said at the conference about the missing organization, although MARN's past president, Karen Daley, described the MNA as "critically important" in her speech and said she hoped the group would join future discussions.

When the summit was over, dozens of nurses trooped back to their emergency departments and community centers, to doctors' offices and hospices, all seemingly revved up to work on a state center for nursing—with or without help from their unionized colleagues.

Gail Friedman

Gail Friedman is a freelance writer based in the Boston area. Her article on the nation's nursing shortage, "Who Will Care?" appeared in the Spring 2002 issue of BCM.

Photo from left: MARN's Karen Daley and Susan Krupnik, the Connell School's Barbara Munro, the Olympics' Mitt Romney

Photo by Lee Pellegrini


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