POSITIVE PROGNOSIS
Health care hiring has slowed, but future looks bright
Pulse editor
Sunday, March 22, 2009
Compared to the stormy forecasts for other employment sectors such as the automotive, mortgage banking and real estate industries, the outlook for health care jobs is relatively sunny.
“Health care is defined as a ‘demand profession,’ ” said Michael Thurmond, Georgia labor commissioner. “These people have the education, skill sets and training to put them in great demand.
Photos by BARRY WILLIAMS / AJC Special
‘Projections say that health care will continue to grow, primarily because of demographics. We’re all getting older, living longer and [we are] going to need more health care services — and that’s good security for health care workers.’ - MICHAEL THURMOND, Georgia labor commissioner
Denise Flook, coordinator for workforce initiatives and prevention initiatives for the Georgia Hospital Association, says the economic crisis has forced the reduction or elimination of overtime and signing bonuses for some nurses.
Denise Flook and Karen Waters of the Georgia Hospital Association study Georgia Department of Labor health care employment data.
Employment gains in 2008 by health care subsector in Georgia
- Hospitals: +3,400
- Ambulatory health care services: +3,200
- Social assistance: +1,100
- Nursing and residential care facilities: +800
Source: Georgia Department of Labor, Bureau of Labor Statistics
“Projections say that health care will continue to grow, primarily because of demographics. We’re all getting older, living longer and [we are] going to need more health care services — and that’s good security for health care workers.”
Georgia is also the fourth fastest-growing state in the nation.
The health care sector topped the list of growth industries nationally in 2008, adding 355,700 jobs, according to the Bureau of Labor Statistics.
“We’re encouraging a lot of people who have lost jobs to retrain in health care,” Thurmond said. “A lot of the layoffs have been disproportionately in male-dominated fields — such as manufacturing and construction — and I’m not sure all those jobs will be recreated in the recovery. More men are starting to look at nursing or allied health fields, and that’s a smart move.”
It’s important for workers to recognize changes and take advantage of them, Thurmond said.
“The people who are going to succeed in this job market will be those who are most adaptable to new opportunities and good resources, like Georgia’s HOPE grant,” he said.
The HOPE grant pays tuition at state technical colleges for most Georgia residents who want to earn technical certificates or diplomas. Technical schools offer programs in many fields, including nursing, radiologic technology and emergency medical technology.
Despite a favorable long-term prediction, health care has not been immune to the recession.
“Although the sector gained jobs last year, it was the lowest number since 2001,” Thurmond said.
People often talk of health care jobs as recession-proof, but a recent Georgia Hospital Association survey of state hospitals shows otherwise.
“When the economy suffers, more people lose their health insurance and end up in the emergency room, which is the highest-cost care,” said Kevin Bloye, vice president of public relations for the Georgia Hospital Association. “Many hospitals are having to make some very difficult decisions.
“None of the 174 hospitals in Georgia has gone under, but a few are hanging by a thread. We’re watching the situation closely.”
The survey revealed that more than six out of 10 hospitals in Georgia have cut or considered cutting staff. One in three institutions have looked at cutting services.
Nearly 75 percent of Georgia hospitals are taking on more bad debt or charity care as the percentage of uninsured and underinsured patients has grown.
“Medicaid only reimburses hospitals 84 cents for every dollar and, before the stimulus package, the state Medicaid funding was $208 million in the hole,” Bloye said.
Georgia is slated to get some Medicaid funding from the federal stimulus package.
Evaluating expenses
A majority of hospitals are postponing or reconsidering capital expenditures in the areas of clinical technology/equipment (73 percent), information technology (66 percent) and building/renovations (60 percent).
“More than half of Georgia hospitals are seeing declines in elective procedures, and those are often the most profitable,” Bloye added.
Gwinnett Medical Center in Lawrenceville is still building its new 155-bed tower, slated to open in September, “but we’ll be mostly moving existing staff into it. We’ll open some beds initially, and more as needed,” said Merideth H. Northcutt, director of recruitment at Gwinnett Hospital System.
As an efficiency measure, the hospital has launched a joint venture with physicians to open a new Endoscopy Surgical Center location in Duluth.
“We’ve realized that when our doctors are invested as business partners, they are much more realistic about costs. It’s a different level of commitment, and a win/win for everyone,” Northcutt said.
The Gwinnett system is still hiring, but has greatly reduced its number of open positions and is operating on a tighter budget.
“Before we let staff go, we’d reduce the number of open positions and increase PRN (pro re nata or as needed) hours. We will keep the staffing ratios needed to deliver safe, quality care, but we won’t hire people we can’t use,” she said.
Nurses have skills that are always needed, but “nurses in a hospital setting are totally dependent on the leadership that runs and manages the facility,” Northcutt added. “If there are bad business practices, nurses will be impacted like any other employee.”
Outlook for nurses
Denise Flook, RN, MPH, CIC, coordinator for workforce initiatives and prevention initiatives for the Georgia Hospital Association, said nursing salaries aren’t decreasing, but that overtime hours and signing bonuses had been greatly reduced or eliminated at many facilities.
“In the past, nurses have changed jobs because of financial incentives. Now, more are staying put, wanting the job security of a known employer,” Flook said.
Flook hasn’t heard about any nursing layoffs, but she knows hospitals that are cutting other staff.
“They want to keep nurses at the bedside, but when support staff goes, that can make it harder on the nurse,” she said.
Some hospitals are closing units or transferring staff from low-census units.
“Another employment difference is that many hospitals are hiring fewer
new nursing graduates,” Flook said. “The orientation and internship programs it takes to make sure new nurses have the skills to work in today’s complex health care environment are costly to run.”
New nurses will find stiffer competition because of tighter facility budgets, more nurses trading half-time schedules for full-time work, and nonpracticing nurses re-entering the profession.
“People are more stressed economically for a number of reasons. They want to get back into the work force and they want to get in fast,” said Pam Reynolds, M.Ed., MN, director of the Southwest Georgia Area Health Education Center in Albany. The center offers 40 hours of self-study curriculum and arranges the 150 hours of clinical experience required for nurse re-entry.
“We’re seeing more applicants, as are all the [area health education centers] in Georgia,” she said. “I feel that a lot of people are walking a thin line [financially] and I’m excited that we have a program to help nurses get back to work.”
The health care jobs sector is still strong, Flook maintains. The nursing shortage hasn’t disappeared and will worsen as the economy revives.
“Hospitals still need allied health workers — from respiratory techs to pharmacists,” Flook said. “Our nursing graduates will find a job, but they may have to look longer and harder, and they may not get their first choice of locations. This economy has been a reality check for everyone.”
Job gains in health care and social assistance
2001: +5,900
2002: +9,900
2003: +10,900
2004: +12,100
2005: +11,500
2006: +11,000
2007: +12,500
2008: +8,500
Source: Georgia Department of Labor, Bureau of Labor Statistics