A year ago, leaders in Rhode Island’s health care sector and in work force development and education held a summit to tackle a major problem: the growing shortage of nurses and other skilled workers to fill jobs at local hospitals, nursing homes and other facilities.
They agreed that to avert a crisis, they would need to collaborate – among competitors, with other organizations, and across the public and private sectors. On Nov. 15, they met again. Brandon Melton, one of the leaders in this effort, spoke with Providence Business News about the progress so far.
PBN: How big an event was this?
MELTON: We had just over 120 people. … We had labor unions, we had the higher education commissioner. Ray Di Pasquale, the president of [the Community College of Rhode Island], was there. We had two of the three public college deans … and some of the regulatory agencies, if you will, like the State Board of Nurse Registration. But the biggest group was the providers – the hospitals, a VNA or two, I saw hospice there, nursing homes.
PBN: And the whole premise is that you need to collaborate?
MELTON: That was a major area of recommendations that came out of last year’s event, that we had to build collaborative partnerships, especially among the chief nursing executives at the hospitals, the deans of the nursing colleges, and the senior human resources managers. … Because we know no one entity – the employers can’t fix it alone, the universities … the public sector can’t fix it alone.
PBN: Does it affect all of the industry, all ranges of jobs?
MELTON: Not really. Right now it’s very focused on a few key areas. We call them “hot jobs” here at Lifespan. … It’s focused largely on nursing and radiologic technology, and then, depending on the year, we have seen shortages in physical therapy, pharmacy and respiratory therapy, and in some areas like speech and audiology.
PBN: How big a share of your work force is that?
MELTON: Nursing is central to patient care … just over 3,000 of our 11,000 employees are registered nurses. And Sandra Powell of the R.I. Department of Labor and Training said [at the event] that of all the vacant positions in the state, 40 percent are health care positions. I was shocked by that. … But when we did this summit last year, we reported that there were 600 nursing openings in the state alone. We didn’t run the number for this year, but I have no reason to believe that number is any less than it was last year. … We at Lifespan last spring completed a labor forecast … to the year 2025, and we looked at our employees that would be retiring, and the labor supply, and the demand for health care increasing because of the baby boomers aging … and we created three scenarios of low growth, middle growth and high growth. We found that the nursing shortages are going to get significantly worse over the next 20 years … we found the vacancy rates, which for the last five years in nursing has been averaging 13 percent .. might actually go into the 30- and even as high as 55 percent.
PBN: The General Assembly just overrode the governor’s veto of legislation banning mandatory overtime. Will that worsen the shortage?
MELTON: I don’t believe so. I look at that statistic from time to time, and … every time I looked at it, it was .00-something, and I think the highest I ever saw was .0012 percent of all the nursing hours, so we’re talking about a small percentage of one percent of all hours worked. And mandatory overtime is not a good thing … so while we did fight it, because we believe it’s something we need as a last resort for staffing the hospital, we’ll figure out a way.
PBN: How big a deal is retention?
MELTON: That was one of the big issues that came out [at the summit]. We need to focus on retaining the talented nurses that we already have, [as well as] other health professionals. … But while our overall turnover in the company is just over 10 percent, which most health care organizations would kill for, our turnover in nursing is about 5 percent. We’ve been working for three years on an objective to reduce the turnover in the first 12 months of employment. … We’ve increased retention from about 81 percent to about 85 percent. … But frankly, any turnover is bad turnover. … We calculated about three years ago that it cost us $42,400 for every nurse we lost – in advertising, in time for hiring, orientation …[and] overtime and contract labor use.
PBN: You’ve started a program with the United Nurses and Health Professionals to sort of breed your own nurses and radiology techs. How is that going?
MELTON: It’s going great. At the summit, we featured it. Rick Brooks, the director of UNAP, who I think is a visionary in these things, spoke about it. This is a joint venture with Care New England and Lifespan, three of our unions, and the funders – the United Way, which is by far the biggest funder, and the Casey Foundation, the Rhode Island Foundation and the City of Providence, have together put in $550,000 into this program. … We’re working primarily with CCRI and the Rhode Island Hospital Diagnostic Imaging School, so we’re really encouraging entry-level employees to go into these fields. And we’re working with Dorcas Place … and the Genesis Center, along with our own employees, to be the feeders into this program.
PBN: To what extent are you trying to build a sense that growing health care is good for the economy?
MELTON: Absolutely. It’s huge. Our average nurse last year at Lifespan made $82,000 … So the idea is that these are great jobs. The environments are clean, we get to do something that is a value to mankind, and there are good salaries, too. •
Interview: Brandon Melton
Position: Senior vice president of human resources, Lifespan
Background: Before joining Lifespan, Melton had served from 1996-2001 as vice president of human resources for Catholic Health Initiatives, a health system sponsored by 12 women’s religious congregations with more than 120 facilities in 22 states. Previously, he had served vice president of human resources for Catholic Health Corporation from 1988 to 1996; and as executive director of the American Society for Healthcare Human Resources Administration of the American Hospital Association from 1983 to 1988. Melton later served as the president of ASHHRA, in 2002.
Education: B.A. in liberal arts, 1971, and M.A. in counseling psychology, 1973, both from the University of Evansville, in Indiana
Residence: East Greenwich
Age: 59
