At Henderson Middle School, Kathy Kirkland, RN, is losing her voice, captivating a class of eighthgrade biology students with her tales of emergency room encounters and working the night shift.

It's 1 p.m. on career day, and she's been talking since 8:30 a.m. This is her third class, and she candidly fields students' questions as their teacher looks on.

The students want to know how many hours a nurse usually works, how many patients a nurse may have and what kind of pay they can expect. They also want to know about liability issues - what happens if a nurse makes a mistake and is sued?

"The more education you get, the higher your salary can be," Kirkland tells the students.

"...You can work days, you can work nights, you can work weekends - nursing is pretty flexible.

"...Do nurses make mistakes? Yes. Do they get sued? Yes. But more often, if you make a mistake, how you treat a patient matters. Niceness counts."

Kirkland tells students that her job is both challenging and rewarding.

"Nursing is emotionally, physically and mentally tasking. You have to learn how to balance your life," she said. "But God knows, I love it."

Talking to middle schoolers about nursing is a new strategy to attract young people into the profession.

"We've found that by high school, many students have already made up their minds about their careers," said Kirkland, a Toccoa resident and a travel nurse.

For nursing recruiters, the strategy is this: get them when they're young, get them when they're looking at a second career, reward them when they're working and keep them engaged in their profession.

From schoolrooms to boardrooms, these are the messages nurse recruiters and educators are sending to potential nurses across the state.

And it's working. Nursing school enrollment is up - in some cases, more than 50 percent higher than four years ago.

Sense of urgency

Nursing and hospital officials worry that these efforts still won't be enough to fill nursing vacancies that hover between 10 percent and 15 percent statewide. The demand for health professionals in Georgia is predicted to grow by 37 percent, according to the Georgia Hospital Association and the Georgia Department of Labor, which project that the state will need 30,000 additional registered nurses by 2010.

The aging of the nursing work force and the aging of the state's population also have contributed to the sense of urgency. With the average age of nurses around 45, many are scaling back their work loads as they age, leaving gaps in care.

That trend has spurred collaborative arrangements. In Savannah, the Coastal Georgia Nursing Consortium - a group of of hospitals, academic nursing programs and professional nursing organizations in southeast Georgia and on the South Carolina coast - have set aside their rivalries to educate the public about nursing opportunities. A similar program has sprung up in Macon.

The group found that working together enabled them to have a wider range of activities and a diverse group of members to implement programs, said Helen Taggart, RN, DNS, chair of the consortium and professor and director of student services for nurses at Armstrong Atlantic State University.

In its fourth year, the collaboration includes Armstrong Atlantic, Coastal Georgia Community College, East Georgia Medical Center, Georgia Southern University, Memorial Health University Medical Center, St. Joseph's/Candler, Magnolia Coastlands AHEC, Southeast Georgia Health System, Savannah Technical College, the Georgia Organization of Nurse Leaders and the Georgia Nurses Association.

This year, the group designed and presented a hands-on educational program for Girl Scouts, sponsored its annual "Day in the Life of a Nurse" programs for high school students, held a forum on nursing as a second career and put on an event to attract men into nursing.

The programs have been successful, Taggart said. "[The hospitals'] attitude for this whole consortium is, ‘we want to recruit into nursing. We will fight for them after they graduate,' " she said. "It has truly been a joint effort."

"We are now inundated with applications," she said. "But that's not just us, it's every nursing program that I know of. In fact, we have applicants that we can't accept. Now our bigger problem is not enough faculty."

Keeping nurses

But attracting students to nursing and getting them in the door doesn't mean they will stay. Retention is just as important, and that means helping new recruits develop a sense of loyalty by giving them the support they need, said Merideth Northcutt, Gwinnett Health System director of recruitment.

"Today the focus really needs to be on the manager knowing what the goals of their nurses are, and helping them get there," Northcutt said.

For example, she said, if a nurse is in pediatrics and would like to be in critical care, that nurse's manager should be helping him or her reach that goal.

"That's a different mindset than before [when many nurse managers were protective of their own departments], but that's the retention strategy for the organization, not just one department," she said. "And as recruiters, we're OK with that, because that means that managers are thinking bigger than their own area."

That strategy is being talked about statewide.

"You have got to pay attention to these issues, and help them [new nurses] transition from student to an employee of the organization," said Karen Waters, of the Georgia Hospital Association.

"It's a lot different having one or two patients in clinical, and then being responsible for your own patients and your own workload," Waters said. "You want to do everything possible to make that transition smooth, and help them become accustomed to that environment."

As vice president of professional services, Waters works directly with many hospitals and serves on the state's Workforce Initiative for Health Care. The GHA is putting plenty of information and educational efforts into retention. Making these efforts effective requires developing mentoring programs, internships and residencies to give new nurses an idea of areas where they could potentially work, Waters said.

At DeKalb Medical Center, a residency program helps acclimate new nurses. Hospital staff Patricia Horton, RN, and Greg Hinesley, RN, say word-ofmouth is still the best way to recruit and retain nurses.

"We don't do sign-on bonuses, but we do referral bonuses to existing employees for referring hires," said Hinesley, a nurse for 20 years at DeKalb who now works in human resources at the hospital. At DeKalb, referral bonuses are between $1,000 and $5,000, Hinesley said.

Both Horton and Hinesley point to the number of employees who have family members working for the hospital system.

"It is recognized that if you can retain staff, you'll have more success in recruiting," Horton said. "[Monetary] compensation isn't everything. You need to create a work environment where employees are celebrated, appreciated and recognized for their work."

Avoiding burnout

Sometimes staying in the nursing field requires choosing your work environment.

Marcell Crockett, RN, has been a nurse for more than 28 years. As a hospital nurse, she felt she was losing the one-onone patient care relationships that she cherished. She changed her focus to home health 10 years ago, and has never looked back.

"I graduated from nursing school in 1977, and did hospital nursing for 18 years," Crockett said. "I changed because I recognized that I was performing tasks more so than dealing with individuals."

Now, as a preceptor for Visiting Nurse/Hospice Atlanta, Crockett's job is to help nurses who are new to home health hone their organizational skills.

Crockett said home health is the job she needs for "my temperament and personality." But she cautions that burnout is still one of the biggest reasons for losing nurses.

"It's very easy to get burned out. The acuity of the patient is higher now than it was 10 years ago," Crockett said. "People are living longer, but they are sicker. It's important for nurses to recognize when they are getting burned out, and do something about it, whether that means changing their shifts or changing their jobs."

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