Despite a series of innovative programs to solve the problem, there remains a serious shortage of health-care workers, particularly nurses, in Rhode Island. Health care and social assistance is the largest employment sector in the state, employing 75,900 people, according to an October employment report from the state Department of Labor and Training.

“We’re looking at a looming public health crisis,” said Brandon Melton, senior vice president of human resources for Lifespan, which includes Rhode Island Hospital, Miriam Hospital, Hasbro Children’s Hospital, Bradley Hospital and Newport Hospital. “There won’t be enough people to take care of all the baby boomers who will be going into the hospitals.”

The problem was the topic of a daylong conference on Nov. 15 at Butler Hospital in Providence, attended by human-resource professionals, educators, community groups and state officials. The conference, sponsored by the Association for Healthcare Human Resources Administration of Rhode Island, was a follow-up to a similar meeting held last year.

Melton and Michael J. Paruta, director of Workforce Development at Women & Infants Hospital, said last month’s conference was intended not only to emphasize the problem, but also to point out that there are innovative people around the state working on solutions. “We didn’t want to say nothing is being done,” Paruta said. “We wanted to highlight some projects that are seedlings, that continue to grow.”

Still, they said, the problem is not likely to go away anytime soon.

A 2005 report by the National Center for Health Workforce Analysis projected that Rhode Island will be short 6,000 nurses by 2020. Paruta said an informal survey of current job openings in the state showed there are 600 vacancies for nurses at any given time.

Melton and Paruta said the shortage of health-care workers is not limited to nurses, but includes other occupations such as respiratory therapists and diagnostic imaging technicians. Much of the emphasis is on nurses, though, because of their numbers.

The state Department of Health indicates there were 17,623 licensed registered nurses in the state at the end of 2005. But a 2004 report commissioned by Blue Cross and Blue Shield found that some of those were not practicing, some were practicing out of state and some worked part time. The report estimated there was the full-time equivalent of 12,000 registered nurses working in the state. (Melton said the Lifespan system alone employs about 3,000 registered nurses.)

Several speakers at the conference described innovative new programs designed to increase the number of new nurses and other health care workers in Rhode Island.

Ray M. Di Pasquale, president of the Community College of Rhode Island, said the college has a waiting list for courses in all the health fields. “Students are aware that’s where the jobs are,” he said.

DiPasquale described a program called SNAP (Summer Nursing Admission Program), which began in May 2006 with 98 students. The program, which graduates nurses in 16 months instead of two years, is a partnership with Lifespan and Care New England, which runs Women & Infants Hospital, Kent Hospital and Butler Hospital. Melton said that four Lifespan nurses are working as faculty members in the program.

Rick Brooks, director of United Nurses and Allied Professionals, a union for health-care workers, described the Stepping Up Project, a joint initiative of Women & Infants Hospital, and the UNAP/Rhode Island Hospital Education Trust. The program has two goals, one to create “a community pipeline” to train people for jobs in health care and the other to provide opportunities for entry-level employees already in the field to move into better positions.

“It’s not rocket science. It’s actually harder than rocket science, because you’re dealing with people,” said Women & Infants’ Paruta as he presented an elaborate flow chart for the project. “This is not a six-week program where you get a certificate and you’re good to go.”

Lynne Dunphy, a professor at the University of Rhode Island College of Nursing, described a proposed “fast track” master’s degree program for nursing students at URI who already have bachelor’s degrees in other disciplines. Ruth Ricciarelli, executive director of the Center for Health Professions at the Hospital Association of Rhode Island, said the center is working on a Web-based clinical registry that would make it easier for nursing schools to place students in required clinical rotations around the state.

Jack Warner, Rhode Island’s commissioner of higher education, said the problem is not a shortage of nursing candidates, but the lack of educational capacity for nurses within the state. Warner said URI has to turn away 312 nursing students seeking bachelor’s degrees and Rhode Island College turned away 123. The waiting list for CCRI’s program, which offers associate degrees in nursing, was 648, down from 800.

There are five training programs for nurses in the state, at URI, RIC, CCRI, Salve Regina University and the St. Joseph School of Nursing at Our Lady of Fatima Hospital. Figures from the Center for Health Professions at the Hospital Association of Rhode Island show 1,127 first-year students enrolled in the nursing programs. Warner said two state appropriations of about $900,000 each allowed an increase of 422 nursing students at URI, RIC and CCRI over the past three years.

Warner described the problems in nursing education as “the three F’s” — funding, facilities and faculty.

Given Rhode Island’s budget woes, more money from the state is off the table for the foreseeable future. Indeed, Warner projects “significant reductions” in financing for public higher education in general in 2009. He added that nursing programs are particularly expensive to operate because of the costs of labs, high-tech equipment and maintaining a faculty-to-student ratio of about 8 to 1.

Facilities at the three state schools, he said, date to the ’70s or earlier. “They’re old. They’re tired. They’re small,” he said. New buildings are under consideration at URI and CCRI, he said, but even if voters approve bond issues in 2010 the new facilities wouldn’t be ready until 2013 at the earliest.

Finally, he said there’s the problem of finding enough faculty, particularly as current nursing instructors grow older. Warner said 76 percent of the faculty at URI’s College of Nursing are age 50 or older.

What’s more, Warner said, nurses with master’s degrees can make far more money in the private sector than they can as teachers. The starting salary of an assistant professor of nursing with a master’s degree at CCRI is $48,000, which includes a recent increase. The starting salary for an assistant professor at URI with a doctoral degree is $56,000. By comparison, he said, the average salary for a Lifespan nurse is about $82,000, and nurses with master’s degrees earn even more.

“I don’t see on our own nickel being able to make necessary adjustments to salary,” Warner said.

The answer to the problem, Warner said, is to develop partnerships with local health-care providers such as Lifespan, which is providing some of the instructors for CCRI’s nursing program.

But just how far the hospital systems can go in stretching their own resources remains unclear. “People who are qualified to teach, with master’s degrees in nursing, that’s a very small pool,” said Paruta. “It’s a very delicate balance, because we need these people.”

Warner said the labor shortage has led to hospitals recruiting nurses from out of the state and even out of the country. Finding international nurses and bringing them to Rhode Island, Melton said, can range between $18,000 and $40,000 per nurse, depending on their country.

If the state had the capacity, Warner said, nurses could be trained here for less cost than it takes to recruit them from abroad. And a Rhode Islander is far more likely to remain in the state than a nurse from overseas.

asmith@projo.com