After the state announced last week that Maine faces a looming shortage of nurses, my phone started ringing. Several nurses called to share what they viewed as a serious omission from state officials’ plan to address the shortage: job dissatisfaction.
Nurses in Maine, and across the country, are overburdened and burning out, they said. They’re working within a health care system that prioritizes profits over patients, discouraging new nurses from entering the field and leaving experienced ones dissatisfied, the nurses explained.
At age 60, Bruce Becque, a registered nurse at Maine Coast Memorial Hospital in Ellsworth, is among a wave of nurses nearing retirement in Maine. They’re a big driver of why the state is projected to need 3,200 new nurses by 2025.
“We went into nursing because we wanted to do work that mattered, that was in alignment with our conscience and our morals and our sense of social responsibility,” said Becque, who works in the operating room at the hospital, which was acquired in 2015 by Eastern Maine Healthcare Systems.
Today, “it’s a business,” he added. “Health care isn’t something whose primary purpose is to take care of people.”
Health care (and social assistance) accounts for more than 10 percent of Maine’s gross domestic product and employs more Mainers than any other single industry. But it will need to employ even more if Maine is to adequately care for its aging population.
To forestall the shortage, Maine must recruit and retain new nurses to replace retiring ones like Becque. But nurses fresh out of school often start their careers in units that are chronically understaffed, he said.
“Everyone who’s working a shift works shorthanded,” Becque said. “New nurses get thrown into the fire and they get shellshocked. They are not prepared.”
Staffing ratios are one of the most visible points of contention, particularly among nurses like Becque who are represented by the Maine State Nurses Association. Nurses are caring for too many patients, the union argues, which threatens not only morale but patient safety.
They point to California, where the number of actively licensed RNs jumped by nearly 100,000 after the state passed a law in 1999 mandating lower nurse-to-patient ratios.
Cynthia Martinez-Edgar, an RN in the intensive care unit at Eastern Maine Medical Center in Bangor and an adjunct faculty member at the University of Maine’s nursing lab, said she tells graduating nurses to expect a challenging transition into the workforce. Turnover is high, and as hospitals scramble to fill open positions, new nurses may not be adequately trained, she said.
Job stress is high, on top of the life-and-death stakes of the profession, said Martinez-Edgar, also a MSNA member.
“There’s already pressure just from having to take care of someone,” she said.
Burnout is a difficult trend to measure, but some data indicate that Maine nurses are remaining more loyal to the profession than their counterparts in other states. As of late 2015, only about 3 percent of registered nurses in Maine were not working in a position for which their license was a job requirement, according to Pat Cirillo of the Center for Health Affairs at the Northeast Ohio Nursing Initiative, which has forecasted nursing trends in Maine. That’s quite low, relatively speaking, she said.
But it reflects only a snapshot in time, she cautioned. A nurse who left the field five years ago, for example, isn’t represented in the statistic. That’s significant, given that Maine’s nursing shortage has loomed for decades.
Martinez-Edgar said the state’s plan to expand training opportunities for nurses is a good start. But existing nurses also need their employers to support them in pursuing additional training, she said.
And while state officials pledged to train more nursing instructors, Becque said they’ll have to ensure it’s worth the investment. He explored becoming a nursing professor a few years ago, he said, but learned he earns more now as a nurse than he could teaching at the University of Maine.
The university system and Gov. Paul LePage’s administration are now planning a Maine Nursing Summit in the coming months to further address the projected shortage.