On July 2, the new Vermont Psychiatric Care Hospital opened in Berlin. The $28.5 million facility is the centerpiece in the state’s mental health care network that has suffered to find enough beds for psychiatric patients since Tropical Storm Irene damaged the state hospital in Waterbury almost three years previous to this opening.
But as of just a few weeks ago, only 21 of the new care facilities’ 25 beds were available, in part because of a shortage of nurses. The new hospital was using traveling nurses to fill some of the open slots.
Christine Ryan, the executive director and lobbyist for the Vermont State Nurses’ Association, estimates that 40 to 50 percent of the nursing workforce at the Vermont Psychiatric Care Hospital is made up with traveling nurses.
"The Berlin facility is a state facility, and I think that's going to be a challenge if you’re going to be paying state wages compensation, when nurses can get jobs in other parts of the state." - Christine Ryan, executive director and lobbyist for the Vermont State Nurses’ Association
“From a nursing perspective, there is a Vermont nursing shortage within that facility,” she said.
There are a couple of problems caused by this shortage: one is continuity. Although traveling nurses fill an important need in the community, their temporary presence can be disruptive to a medical facility’s community.
“Over the long run, you’re looking to build continuity, you’re looking to build teams, you’re looking to create a strong foundation within a facility,” Ryan said. “When you have folks who are coming and going over periods of time, that is disruptive.”
Traveling nurses also pose another concern for hospitals in terms of budgeting. The daily rate for a traveling nurse tends to be higher than that of a staff nurse due to the cost of traveling, which can lead to budgeting challenges.
“It’s very difficult to build a budget when you have that type of influx,” she said. “You are dealing with a much higher rate for travelers than you would be for Vermont state nurses, and I think that that poses many challenges.”
"Over the long run, you’re looking to build continuity, you’re looking to build teams, you’re looking to create a strong foundation within a facility. When you have folks who are coming and going over periods of time, that is disruptive."
Vermont does not have a shortage of nurses-- the Vermont State Nurses’ Association represents 18,000 nurses in Vermont. Instead, despite an increased need for psychiatric nurses, the state the state is suffering a shortage of specialized nurses—particularly in psychiatric care.
“I think we have seen an increased need,” Ryan said. “Our state and our leaders have done a great job by saying ‘this is an area of care. This is a patient population where we can do better, and they can be better served.’ But with that comes the need to build infrastructures around that.”
Ryan attributes this shortage to several factors: issues with new infrastructure, worker compensation and the effects of the recession.
When Tropical Storm Irene hit, there was a displacement of patients and nurses, which led to a need to create a new infrastructure “down to the number of beds,” she said.
“We have been looking at our health care system delivery in Vermont as well as nationwide, and we’ve recognized that the way we utilize our emergency rooms needs to be improved upon,” Ryan said. “It’s not as simple as ‘if you build it, they will come.’ My sense is that we built this infrastructure, but we forgot a foundational piece of it.”
On top of that, after the 2008 recession, nurses who may have decided to change careers or retire stayed in their positions, leaving fewer open positions for newcomers.
A third factor contributing to the shortage is compensation. Vermont nurses can go across state borders to New York or New Hampshire to earn better wages.
“The Berlin facility is a state facility, and I think that’s going to be a challenge if you’re going to be paying state wages compensation, when nurses can get jobs in other parts of the state".
To combat this shortage, Ryan recommends developing a training program for nurses.
“I think some of the other things would be to develop a training program for nurses currently in school, or nurses looking for a change, to create a conduit between this facility or facilities like it in Vermont, and the nursing programs in Vermont.”
