Staffing reflects a microcosm of Maryland, national trend

When the county’s sickest residents are hospitalized, someone must be at their bedside to monitor their treatment. And since the days of Florence Nightingale, the nursing field has found people willing to devote days and nights to doing that job.

At Suburban Hospital in Bethesda, the vacancy rate for registered nurses is 13 percent — just about average for Maryland, according to the Maryland Hospital Association, and 5 percentage points higher than the national average. A combination of factors both local and universal is causing the shortage, nurse advocates and Suburban administrators said.

Nurses ‘‘have choices about where they want to work,” said Ronna Borenstein, a spokeswoman for Suburban Hospital.

And while Suburban Hospital’s trauma unit has the intense, hyperactive atmosphere that typically draws new nurses, according to advocates, the hospital is having a hard time finding the nurses it needs for its intensive care unit and in other specialty areas.

The shortage in Bethesda, Maryland and elsewhere in the United States is explained by nurses and advocates as a vicious circle. Nurses working at hospitals that are short-staffed tend to have higher nurse-patient ratios, advocates say.

‘‘Nurses complain that they are asked to work with more people than they can safely handle,” said Michelle Lane, executive director of the Maryland Nurses Coalition, which advocates for 66,000 registered nurses in Maryland.

In response to the work load, nurses leave the field, go into private practice or cut back their hours, Lane and others said. This trend, combined with a related shortage of nursing teachers, has chiseled away at the work force.

There is a crisis ahead: Aging Baby Boomers are expected to create an overflow of patients suffering from long-term illnesses, with not enough nurses to care for them.

The latest research by the federal Health Resources and Services Administration predicted 6 percent growth in the number of nurses by 2020, with demand for nursing care growing by 40 percent.

More immediate issues may compound the effects on the workforce in a metropolitan suburb like Bethesda.

‘‘Nurses have many choices in this region and often move among many of the private and military hospitals in the area,” Borenstein said in an e-mailed statement to The Gazette.

Other hospitals in Montgomery County did not respond to inquiries about nursing vacancies.

At the National Naval Medical Center less than two miles from Suburban, nearly halfof the nursing staff is non-military and includes about 50 contract nurses working on the base at any given time, said Amy Rohlfs, a Navy Med spokeswoman.

Moving nurses and physicians from Walter Reed Army Medical Center in Washington to Navy Med during the Base Realignment and Closure process over the next few years ‘‘would potentially affect nursing staff,” Lane said. The merger is expected to bring as many as 2,500 new staff members and 535,000 patients and visitors to the medical center.

Another factor complicating matters in Bethesda is transportation.

Suburban Hospital has planned for years to expand its campus, a plan that has encountered resistance from neighbors. The expansion has been proposed in part to alleviate what administrators say is a parking shortage.

‘‘That is a complaint that we do hear. Nurses don’t like oftentimes to drive 45 minutes to get to a parking lot and have to take a shuttle” to work, Lane said.

Nurses at Suburban Hospital and the Naval Hospital come from throughout the metro area, some from as far as Pennsylvania.

‘‘It is not reasonable to ask a nurse to take the Metro in the middle of the night,” Borenstein said. ‘‘To make life easier for our nursing staff, we need to facilitate their parking on our campus. ... There are many staff members who easily spend two hours a day commuting.”

Making life easier for nurses by offering not just parking spaces, but ample staffing and wages, would help to solve the shortage, nurse advocates say.

‘‘The way we can change it is to look at the system and reduce the nurses’ workload, and make sure that the workplace is comfortable for nurses,” Lane said.

This article appeared in the Annapolis Gazette, which is the State's political newspaper.