In Midst Of Financial Struggle, Vermont Hospitals Boost Workforce Programs

Nov 17, 2019

More than 100 rural hospitals have closed across the country in the past 10 years. In an effort to prevent that in Vermont, the state legislature has set up a task force, and its initial findings show hospitals here face a crushing shortage of doctors and nurses.

Nikki Boggs is a new nurse at Brattleboro Memorial Hospital. She’s in a new residency program that offers support to nurses as they navigate their first six months, and Boggs said it has made the transition from student to nurse a little easier.

“Being put on the floor with five patients, and they’re your patients, and you’re responsible for them – you’re scared,” she said. “So this residency sort of allows for you to still have that wiggle room, where you have somebody you can go to, and you don’t have it all loaded on you at once.”

Over the last 10 years, the number of registered nurses in Vermont dropped by about 25 percent according to a draft report by the state’s Rural Health Services Task Force. That report also shows that there will be almost 4,000 vacancies between now and the spring 2020. And as the state grows older, more nurses will be retiring in the coming years.

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Jodi Stack is the chief nursing officer in Brattleboro, and she said the residency program is a way of taking the long view. She added that even though the hospital is desperate to get these new nurses up to speed, it’s more important that they stick around.

“So it takes the pressure off,” Stack said. “Because when you’re short staffed in nursing, you take your experienced nurses, who are already struggling to keep up. You give them the newer nurses, there’s a sense of urgency to get these nurses ready. And we’re not going to get out of it by taking them from school, throwing them in, and having them not feel supported and burned out in a year. Because they need that support.”

When hospitals don’t have enough staff, they hire traveling nurses to fill the gaps. The nurses come from out of state through agencies, and it costs hospitals a lot more money.

The task force’s draft data shows a group of Vermont hospitals found a 113% increase in spending on traveling staff since 2015. In 2019, 11 of the 15 hospitals in Vermont spent $56 million total.

Steve Gordon is the CEO at Brattleboro Memorial Hospital, and he said workforce shortages are the “biggest budget buster” for most Vermont hospitals.

In addition to the nurse residency program, Gordon said Brattleboro Memorial is expanding its partnerships with Vermont Technical College and Community College of Vermont by investing in scholarships for nursing students.

Gordon said even though the hospital is struggling to turn a profit, it still needs to make those investments.

"... we have got to develop a much closer relationship with the schools of higher education to meet this demand in healthcare, because it is only growing." – Steve Gordon, Brattleboro Memorial Hospital CEO

“We’re willing to make those investments,” he said. “Because we have got to develop a much closer relationship with the schools of higher education to meet this demand in healthcare, because it is only growing.”

Brattleboro Memorial worked with CCV to develop an accelerated program that helps people get a degree in 15 weeks. The degree used to take two years.

This gives people like 54-year-old Sandy Sherman an easier path into the healthcare field. She applied for a scholarship through the hospital, which paid for her schooling.

“I was at a point in my life where I wouldn’t have been able to do it on my own,” Sherman said. “I’m a single mom, so I’m, you know, taking care of a house, and you know, property and a truck and the whole nine yards. So, financially this was to my best interests and I knew that I was also in a place where I was going to apply 100%.”

Relationships like this, between hospitals and colleges, are happening across the state.

CCV, Vermont Tech and Northwestern Medical Center just broke ground on an $8 million building in downtown St. Albans with a focus on the nursing program.

More from VPR: As Losses Mount, Some Hospitals Request Steep Rate Increases [Aug. 1]

And in Bennington, Castleton University and Southwestern Vermont Health Care kicked off a partnership this year that practically guarantees employment at the hospital upon completion of the Castleton nursing program.

At a recent jobs fair, Maurice Ouimet, from Castleton University, was talking with high school students about healthcare jobs.

Colleges face the same demographic challenges that plague the healthcare system, Ouimet said, and so these partnerships make a lot of sense.

“We have a crisis in Vermont,” he said. “There’s not enough young people. There’s not enough qualified workers. So how do we all pull together – and not just in the healthcare industry, but across the board – how do we work together to solve that problem? And if we do, we have to work cooperatively, and hopefully we can make a difference.”

The legislature set up the Rural Health Services Task Force to come up with recommendations to further support struggling hospitals. Laura Pelosi of the Vermont Health Care Association is a member of the task force, and she said other states are offering more generous tax incentives and loan repayment plans.

Pelosi said she wants the state to make the financial investments and then do a good job of marketing the incentives outside of Vermont, because there are simply not enough people within our borders to address the crisis.

"If we're competing against other states, we have to make ourselves attractive to folks from other places." - Laura Pelosi, Rural Health Services Task Force

“If we’re competing against other states, we have to make ourselves attractive to folks from other places,” Pelosi said. “And so I think to do that, we’ve got to do something that at least brings us up to a level playing field with our competitor New England states, and if possible, do something a little bit bolder, maybe, that really differentiates Vermont.”

The task force will present its final report to the legislature before January 15th.