Nursing shortage worsens in South Dakota as COVID-19 reappears

At a time when they are needed most, South Dakota faces a shortage of nurses that medical professionals say could negatively affect patient care at state hospitals.

The nursing shortage has been going on for years but has worsened during the pandemic.

High stress, long hours, and fear of infection during the ongoing COVID-19 pandemic have prompted more nurses than usual to leave the field, move to other states, or retire anticipated.

From 2015 to 2016, approximately 1,700 registered nurses left the South Dakota health workforce. Last year, more than 2,500 nurses left the state’s workforce. A national nursing organization estimates that there will be a shortage of nearly 2,000 nurses in South Dakota by the end of the decade.

“The pandemic has kind of worn them out,” said Michelle Bruns, interim chair of the nursing program at Oglala Lakota College. “It’s a difficult situation.

The state’s higher education system has not produced enough nursing graduates to cope with a growing population and growing demand for health services, and educators are scrambling to find ways to attract more students and produce diplomas faster.

Meanwhile, a shortage of nurses in other states has increased competition to attract new graduates and experienced providers, but South Dakota’s healthcare systems are at a competitive disadvantage as the median salary of Nurses in South Dakota is the lowest in the country, according to federal labor data. .

The recent shortage has exacerbated the long-term shortage of nurses in South Dakota, and some health officials are increasingly concerned that patient care in the state may suffer, especially if the highly transmissible delta variant. of COVID-19 is causing an increase in infections and hospitalizations.

“Across South Dakota and the United States, this pandemic has shown the world how important health is,” said Nicole Kerkenbush, nursing and performance manager for Monument Health in Rapid City. “You need this workforce to help people facing any kind of health crisis, be it COVID or whatever. ”

Nicole kerkenbush

South Dakota is ranked seventh in the country for the greatest need for nurses, according to RegisteredNursing.org. The state ranks last in the country in nursing pay with a median of $ 55,660, according to 2017 data from the U.S. Bureau of Labor and Statistics.

The aging nursing workforce is likely to exacerbate the need for nurses in the future. Nurses over 50 represent 35% of the state’s nursing workforce.

The greatest need now is to have nurses experienced in critical settings.

Monument Health is offering a $ 40,000 enrollment bonus for highly skilled positions in intensive care and operating rooms, Kerkenbush said. Eye-catching hiring bonus billboards and advertisements can be found in the Black Hills area and a few other states across the country, such as Maine, Connecticut and Mississippi, she said.

“These are two specialty areas in very low numbers across the country,” she said. “If someone needs a complex procedure and we can’t do it because of the staff, that’s not a position we want to be at all. We want these people to be able to get the care they need. ”

The rate of RNs joining the state’s workforce has declined over the past five years. Over the same period, more and more people have left the workforce, according to the 2021 South Dakota Nursing Workforce Survey Report.

“We know there are various influences on the supply of nurses that are not new. We think of the increased health care needs associated with the retirement of baby boomers, this is a conversation that has gone on for a long time, ”said Kelly Hefti, vice president of nursing and clinical services at Sanford at Sioux Falls.

Kelly hefti

While the total number of registered nurses in South Dakota has increased slightly in recent years – from 17,693 in 2016 to 18,693 in 2020 – the supply of workers has not kept up with the increased demand. In 2016, more than 1,600 positions were added to the workforce, compared to around 200 between 2019 and 2020.

According to the report, the state recorded a net loss of 478 licensed practical nurses between 2018 and 2020. Those who left in 2020 reported retiring, leaving the profession, leaving South Dakota and inactivating the license. as the main reasons for the decrease.

Rural areas have had more difficulty recruiting nurses.

According to the 2021 South Dakota Board of Nursing report, although 28% of the state’s population live in Minnehaha and Lincoln counties, nearly half of the state’s RNs are located in these areas.

More and more patients are coming from the surrounding rural counties, adding to the need for nurses in the area.

To address the shortage, Kerkenbush said she spent her days focusing on ways to support staff, increase efficiency and use technology to their advantage.

At the height of the pandemic last fall, Sanford brought in mobile nurses to hospitals in Sioux Falls to fill staff shortages, a practice that is not the norm, Hefti said.

“Late last fall, we brought in mobile nurses at the height of our COVID outbreak – we balanced our growing adult volumes with the need to give our own nurses a break,” said Hefti.

Due to recent inpatient admissions, due to COVID-19 and other conditions, Sanford is once again using itinerant nurses, Hefti said.

When it comes to day-to-day operations, Sanford approaches staffing based on the needs of its patient population and the skill mix of nurses while also using unlicensed positions such as licensed practical nurses, Hefti said.

This challenge and the need for more nurses has been around for years in South Dakota.

“I have been a nurse for about 30 years, and during that time there has not been a period where we have not talked about a shortage of nurses,” said Kerkenbush, who was a nurse in the military for. about 25 years before starting at Monument.

Hefti and Kerkenbush said creating competitive job opportunities and making education more accessible are ways the state can address the shortage.

Hefti said that offering 401K retirement packages, paid time off and staff flexibility are some of the ways Sanford tries to provide a competitive package.

Some of the state’s nursing programs strive to strengthen the workforce by keeping education modern and up to date.

South Dakota State University’s nursing program is designed to prepare future nurses for the modern workforce, said Mary Anne Krogh, dean of the College of Nursing at SDSU.

“Students need to have a broad understanding of nursing to pass their nursing advice,” Krogh said. “We have a few programs for students to have clinical opportunities in rural areas. “

Changes to nursing programs are underway to meet the workforce needs in South Dakota.

In August, the South Dakota Board of Regents approved a plan for SDSU to expand its nursing program in Rapid City, while phasing out a program at the University of South Dakota, thereby increasing attendance at the SDSU program from 48 to 72 students.

“I hope we make a big difference in nursing, especially in western South Dakota,” Krogh said.

The South Dakota Board of Regents also this year approved a nurse anesthetist program at the University of South Dakota, addressing a need in a growing field.

Augustana University’s Accelerated Nursing Program allows people with a bachelor’s degree to become a nurse in 16 months, said program director and longtime nurse Lynn White.

Depending on the degree, a student may have to take prerequisites in anatomy or physiology. The program is attractive to those who no longer want to take a four-year degree program, and most graduates stay in the area, White said.

The same goes for the state’s public universities. In 2019, South Dakota’s public universities graduated 520 nursing students, 64% of whom are employed in South Dakota, according to data from the South Dakota Board of Regents. South Dakota students who graduated in 2019 had 78% of jobs in the state after graduation, and 31% of out-of-state students stayed after graduation. graduation.

Internships and residencies are an important part of a nursing student’s education. While gaining real experience as a nurse, students also gain insight into the culture and environments of South Dakota healthcare providers, which can lead to employment after graduation.

Although some nurses left the field during the stress of COVID-19, the pandemic has also sparked interest in the nursing profession among some future healthcare workers, Krogh said. Technology has played a major role in keeping nursing students on track during the pandemic.

Kerkenbush said she also noticed more and more young people taking an interest in health care when the pandemic revealed the need for health workers. Engaging the younger generation in nursing will be essential for the future of the profession.

“We certainly need our young people and those looking for career changes to consider this option, which is a vital workforce for the health of our communities,” said Kerkenbush.

– News Watch reporter Danielle Ferguson contributed to this report.