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State nursing shortage exacerbated by the pandemic

Sanford Health
Sanford Health

When Geno Healy entered the nursing field in the early 1990s, job prospects were difficult to come by.

“When I graduated, I was one of the few, probably handful of people that had a job waiting for me,” Healy said. “Because everybody was going into nursing. They were starting to pay more.”

Prior to entering the health care field, Healy worked as a machinist and welder in the Black Hills. He worked for the railroad for 12 years. After he and his wife had three kids, he wanted a change. His sister-in-law suggested nursing.

“She said, ‘Geno, you should go into nursing. You’d be good at it and you’re personable and caring.’ So I did,” Healy said. “It was hard to get in back in '91.”

Healy worked for nearly five years at the Avera hospital in Yankton before taking a registered nurse job with Ability Building Services, a nonprofit serving people with intellectual and developmental disabilities.

Healy worked there for 25 years. Then, the coronavirus pandemic took off.

By 2020, Healy had a staff of about 100 that was administering medication under his supervision. He says increased stress from the pandemic led him to retire in November 2020—before he anticipated.

“My biggest fear was COVID going through a group home. We have staff 24/7 in these houses. We don’t know where staff has been, and are they wearing masks when they come in?" Healy said. "It was stressful."

That stress affected his sleep, so he stepped away.

He wasn’t alone.

The number of open health care jobs in the state has Gov. Kristi Noem’s attention. She says health care jobs account for about 20 percent of the jobs open in South Dakota.

According to a state Department of Labor report, there are about 13,000 registered nurses in the state. It projects the state will need another 1,700 by 2028.

The average wage for a registered nurse in South Dakota is around $61,000. According to the Bureau of Labor and Statistics, that ranks toward the bottom in the nation.

In November of 2021, Noem launched a public service announcement urging prospective nurses to move to South Dakota. Noem said in an interview that the pandemic made the announcement urgent.

“We’ve known for several years we were going to have nursing shortages,” Noem said. “We’ve been pushing people to get into our training programs and recruit them. This public service announcement, this marketing campaign to get more nurses to the state is incredibly important to make sure we can still take care of people.”

The governor’s proposed budget calls for over $35 million in federal spending to expand nursing programs East River and consolidate nursing programs West River. Noem also wants to increase state funding for health care providers by 6 percent.

Deb Fischer-Clemens is with the South Dakota Nurses Association. She said the health care industry is stretched thin.

“Every entity that requires a nurse is very busy,” Fischer-Clemens said. “It’s a steady, constant busy.”

Fischer-Clemens said the pandemic hangs over the nursing shortage. She said most nursing school graduates will have a job almost immediately.

Fischer-Clemens said the proposed 6 percent increase in funding may not alleviate the nursing shortage entirely, because the cost of care has also gone up.

“Certainly, it’s going to make an impact, but just to say that it helps the shortage—not so sure," Fischer-Clemens said. "It helps to deal with the cost that health care entities are having to deal with.”

According to the 2021 South Dakota Nursing Workforce report, the number of actively licensed nurses increased from 2018 to 2020.

Many nurses go into what’s called travel nursing, where they can make more money. Travel nursing is an industry that places nurses in temporary nursing positions.

Kara Moser is a nurse from Yankton. She’s a travel nurse on a 36-hour a week contract for a hospital in Bellevue, Nebraska, which is just south of Omaha.

She works in the emergency department and commutes one or two times a week. Prior to that, Moser worked full-time at the Avera hospital in Yankton. She had been in nursing for three years before the pandemic first reached the U.S.

Moser said there were times when she worked 60 hours a week. She started travel nursing in November so she could work less hours and make the same amount in pay. She might end up travel nursing somewhere else when her current contract ends.

“The amount of overtime that was worked, travel nursing allows you to work your full-time hours, make the same amount that you were making, and more at times," Moser said. "That was the biggest thing is working fewer hours to be able to spend more time with my family.”

Moser said hospitals should increase salaries for nurses and hire more staff. She also said the state should consider more loan repayment programs for nursing students.

Lee Strubinger is SDPB’s Rapid City-based news and political reporter. A former reporter for Fort Lupton Press (CO) and Colorado Public Radio, Lee holds a master’s in public affairs reporting from the University of Illinois-Springfield.