LPN shortage leads to higher patient care costs
Hale Makua is working with UH-Maui College on an educational program just for LPNs
As the numbers of licensed practical nurses decrease in Maui County and statewide, health care agencies are paying more to hire temporary nurses, who come and go, leaving instability for patients and staff, a Maui long-term care provider said.
The recently released 2017 Nursing Workforce Report issued by the Hawaii State Center for Nursing shows a “substantial decline” of 12 percent in the number of Maui County LPN licenses between 2015 and 2017. In 2015, there were 434 LPNs and in 2017, 384. These nurses traditionally work in long-term and residential-care facilities.
Statewide, the number of active in-state LPN licenses in 2005 was 2,560 and in 2017 the number dropped 16 percent to 2,148.
Nursing and health care officials said that, generally, nurses are obtaining more education and sometimes even forgoing practice as an LPN to pursue a career as a registered nurse.
State forecasts project that, by the year 2030, one in four Hawaii residents will be age 65 or older. That means that an aging population needs more long-term care, so a continuing decline in the number of practicing LPNs would lead to an unmet demand.
Hale Makua Chief Executive Officer Wes Lo said that Hale Makua, one of Maui’s largest elderly and long-term care facilities, employs both registered and licensed practical nurses. But, “we have a big need for LPNs,” he said.
An LPN license is seen by many nurses as being en route to becoming an RN, he said. He added that all of Hale Makua’s LPNs are “traveling” nurses who work for the agency on contract.
Ted Tucker, chief human resources officer at Hale Makua, said the use of traveling nurses adds about $500,000 a year to the agency’s budget.
Lo said a portion of the costs includes what Hale Makua pays the employment agency for workers’ housing.
Tucker said Hale Makua is grateful for nurses who fill a staffing void, but with the 13-week contracts, the temporary nurses work on. And, ongoing transition and turnover make working conditions hard for the staff members and patients.
To help with hiring more permanent LPNs, Lo said Hale Makua is working with University of Hawaii Maui College on an education program strictly for LPNs.
Classes will begin next week for 10 students enrolled in the program, Tucker said. Classes and medical training will be held at Hale Makua in Wailuku.
“The college has heard us loud and clear, they have been wonderful partners,” Tucker said.
Also last year, Lo said, Hale Makua began a certified nurse aide program. Nurses’ aides help LPNs and RNs.
Lo said Hale Makua offers scholarships for the program. Program officials visited high schools and places where layoffs occurred, including at Kmart, which closed its doors in June.
Lo said the program recently graduated its first class of 10 nurses’ aides this summer and he hired eight of the graduates.
“I think their initiatives are exactly where the future of nursing needs to go,” said Laura Reichhardt, director of the Hawaii State Center for Nursing, of Hale Makua and UH-MC’s LPN program.
Overall, she said, that the nurses are getting more education to become RNs because Hawaii employers are very supportive of the nurses’ career development.
“We really value a highly educated workforce. That opens the door for LPNs to move forward in their careers,” Reichhardt said.
At Maui Health System, which operates Maui Memorial Medical Center, Kula Hospital and Lanai Community Hospital, spokeswoman Chastell Ely said the system has not specifically hired LPNs. Kula Hospital may have recruited some for its long-term care of patients, and the hospital is considering offers to two LPNs.
Currently the system, which is a subsidiary of Kaiser, has 11 LPNs.
Ely said the system’s focus has been on hiring registered nurses and nurses’ aides.
In conjunction with UH-Maui’s nursing program, Maui Health System leveraged the local talent pool and enlisted the help of more than 50 new graduate nurses to support the launch of KP HealthConnect in July 2017, when the system took over Maui hospital operations, Ely said. Of those RN nurse graduates, most are still working with the Maui Health System and have transitioned to staff nursing roles, she added.
Maui Health is looking to hire more UH-MC graduates this year, she added.
In Hawaii, LPNs earn nearly $49,000 annually, on average, and RNs on average make nearly $89,000, according to Hawaii Industry Sectors website, which was developed by the University of Hawaii, Office of the Vice President for Community Colleges.
Overall, Reichhardt said, the nursing study looks at the numbers of nurses in different specialties. The nurses who responded to the survey shared information about their specialties and where they work.
The study showed that the number of advanced practice registered nurses, or APRNs, or registered nurses with graduate degree educations, specialized certifications and advanced nursing licenses in the state has more than doubled since 2005. These include nurse practitioners.
And, in Maui County the numbers of advanced practice nurse’s licenses issued has increased by 150 percent between 2005 and 2017, which is good news because these nurses serve the “critical function of being primary care providers, especially in Maui County’s most rural and remote areas,” the Dec. 28 study said.
These areas include Lanai, Hana in East Maui and Kaunakakai and Kalaupapa on Molokai, according to the study. The highest concentrations of these nurses work in Wailuku and Kihei.
In 2005, there were 30 APRN licenses and in 2017 there were 75. Reichhardt said nurses with advanced degrees are critical to help fill gaps in service as Hawaii faces an ongoing shortage of doctors.
The full report can be found at www.hawaiicenterfornursing.org/data-reports/.
* Melissa Tanji can be reached at mtanji@mauinews.com.