Monday August 13, 2012

PITTSFIELD -- For the first six months she worked as a nurse at Berkshire Medical Center, Tory Street wanted to quit every day.

"I had no idea nursing is so hard," said Street, 62, who started as an RN last year after a career in the television industry.

As medicine gets more complex, so too do the jobs in the field. At BMC, a mentoring program started within the last year aims to address the fact that nurses on the front lines of hospital care often feel overwhelmed in their first months, and may give up on the profession early on because of the frustration.

Nurse attrition is a problem closely watched in the health care world.

Tory Street, who is benefitting from Berkshire Medical Center’s nurse mentoring program, gets patient information at the computer at the start of a
Tory Street, who is benefitting from Berkshire Medical Center’s nurse mentoring program, gets patient information at the computer at the start of a shift. (Caroline Bonnivier Snyder / Bekshire Eagle Staff)
The turnover of RNs is not only costly, but threatens the future of an industry that will increasingly need experienced professionals to face the influx of baby boomer patients in the coming years.

The nurse mentoring program at BMC, which began in August 2011, includes 13 seasoned RNs who advise one or two new nurses who work on different floors than they do. The system is informal -- some mentors pop in at the beginning or end of their shifts, others take their charges out for a cup of coffee at Starbucks. But however it's done, the "mentees" say it made all the difference to have someone outside of their immediate work environment that could advise them on technical issues or simply be an ear to listen.

"You think, is it only me that's having these issues?" said Melissa Canata, a clinical educator at the hospital who spearheaded the mentoring program.

For Street, having a more experienced nurse she could trust to share her concerns with smoothed the career transition. She found out she wasn't alone in feeling in over her head.

"It made me able to handle that feeling," Street said.

New-job jitters are common everywhere, and any industry wants its rookies to stay on for the long haul. But many studies suggest that hospitals are particularly vulnerable to the effects of nurse turnover, both financially and from a patient care standpoint. Numbers cited by the American Association of Colleges of Nursing indicate that the median voluntary turnover rate of nurses in their first year is about 27 percent, with the average cost associated with that portion estimated at $88,000 per nurse. Having an unstable staff can also mean more stress and a less consistent knowledge base and clinical judgment.

At Berkshire Medical Center, the turnover rate for all of the hospital's RNs for 2009 to 2011, the only years for which data was available, was about 4 percent annually, according to spokesman Michael Leary. It's a low number that reflects the fact that there were few nursing jobs available statewide because of the economy, he said. But part of the reason to start a mentoring program is to keep that number low, no matter what happens.

Beyond the immediate costs of attrition, efforts to support nurses are a part of a complex long view on the health care system, said Timothy Diehl, executive director of the Berkshire AHEC (Area Health Education Center).

"The train wreck is coming," Diehl said. "When all the baby boomers become retired and become in need of geriatric services, there will need to be many, many more nurses and medical persons to support a big bump in population in the United States and here."

The Massachusetts AHEC Network, which includes the Berkshire office in Pittsfield, keeps its thumb on the pulse of nurse retention because without young nurses sticking around now, there won't be experienced professionals when the influx of aging patients comes in the future.

"I want those young nurses to be working now, so when I need their care, they'll have the experience and longevity to be good caregivers," Diehl said.

At age 26, Jason Smith is the kind of young nurse that many say will be necessary to counter the "brain drain" that's coming when the older population of nurses retires, and the large aging demographic puts a strain on the medical system.

Smith has been a mentee in the BMC program since he began as an RN last year. He spent the six prior years as a nursing assistant, but said the transition into the more professional position has been difficult.

"It's scary, to say the least," Smith said. "Just realizing you have all these responsibilities of the patients in your care, and keeping them safe."

But with the support of his mentor and the other new nurses he's met through the program, Smith said the anxiety of the job isn't getting the best of him any more.

"It's comforting to know that someone's there," he said.