Experts: New Mexico's health care workforce problem is here to stay

Mar. 17—The shortage of health care workers in New Mexico worsened with the coronavirus pandemic, but the crisis was here before and won't go away soon, administrators said Tuesday.

"This is going to be a problem that I think our state, and each state and the federal government, will have to address over many years," said Dr. Richard Larson, a medical doctor and vice president of research at the University of New Mexico Health Sciences.

An aging population has placed increased demand on health care services in New Mexico and the United States, and the workforce hasn't kept up. Troy Clark, CEO and president of the New Mexico Hospital Association, said the problem goes beyond nurses, who have received the bulk of the attention.

The Legislature moved this year to address the nursing shortage, but Larson and Clark said those strides are only a start.

"It is a serious problem. It's probably the number one issue among hospitals right now," Clark said of the health care workforce shortage. He called the legislative action "the first right step to addressing the problem. It's going to have to be ongoing."

Among other things, the Legislature:

* Allocated $171 million for hospital and skilled nursing facility staff costs, including retention and recruitment.

* Distributed $15 million in grant money to expand nursing education programs in New Mexico.

* Appropriated $30 million for a nursing educator endowment to increase the number of nursing faculty in the state, thereby increasing the number of nursing students.

* Spent $4 million for nursing tuition and other assistance for specific colleges.

* Set up a $1,000 one-time tax credit for nurses working full-time in New Mexico hospitals.

In all, the hospital association said, about $284 million went toward the workforce problem. Gov. Michelle Lujan Grisham signed on to the initiatives. The state's hospitals also will get roughly $50 million for building and infrastructure improvements.

The shortage isn't unique to New Mexico. The Duquesne University School of Nursing in Pittsburgh wrote in a report that baby boomers nationwide are aging, need more care and are living longer because of health care improvements. Further, physicians and other workers in that age group are retiring.

"The number of health care workers needs to increase dramatically to meet demand in the coming years," the Duquesne piece said.

A University of Texas Health Science Center at Houston nursing professor said Tuesday it's a brave new world for nurses.

"This is all going to be about how we convert the old ways to the new," said Elda Ramirez, who is a professor and an emergency room nurse practitioner.

Some nurses have left their hospitals for much higher pay as traveling nurses, Ramirez said, while hospitals lean on federal coronavirus financial support. "But hospitals cannot pay nurses that kind of money" over the long run, she noted.

Ramirez envisions hospitals using paramedics, licensed vocational nurses and licensed practical nurses more, and more highly paid registered nurses less. This is how systems have handled physician shortages, she said — by deploying nurse practitioners and physician assistants as primary care providers.

"It's gonna look different," she said of the nursing profession of the future. "And you have to look at other ways to feed the need."

The state Department of Health this week cited "chronic under-investment in education and training of health workers" and lower wages for those in rural areas as problems for the state.

Adding to the problem, New Mexico is expected to have the second-oldest population in the country by 2030, with more than 26 percent of residents 65 years of age and older, the department wrote in an email.

Greater use of nurse practitioners and physicians in post-medical school residency training and team approaches to free up primary care doctors are being implemented or need to be, the department said.

Larson, who headed the UNM Health Sciences 2021 health care workforce report, said the Legislature's allocations to nursing "should be viewed as just the beginning."

"We're short in all health care professions," he said. The UNM report issued in October found that in 2020, New Mexico's shortages, when compared to national benchmarks, totaled 6,223 nurses, 2,510 emergency medical technicians, 524 physical therapists and 521 pharmacists, to name a few of the professions examined.

The report says national workforce concerns are compounded in New Mexico "by the unique needs of a large, frontier, minority-majority state." The report says high poverty rates and an inordinate percentage of people without a health care provider or insurance lead to health care disparities.

Clark said it's one thing for hospitals to have beds and another to have the staffers required to serve patients in those beds. The nursing shortage and the scramble to pay them, Ramirez said, exacerbates the issue.

Another factor: Some nurses retired in the midst of the stress of the pandemic.

"Obviously, we have lost a lot of nurses and other health care workers," Clark said. "So that puts a strain on our workforce."

The Kaiser Family Foundation said that by October of 2021, the numbers of health care and social assistance job departures was 35 percent higher than before the pandemic. It was also higher than the resignations among other kinds of workers during what has been dubbed "The Great Resignation," the Kaiser report said.

Clark said the state has had a nursing shortage for more than 20 years. If there's a shortage of more than 6,000 nurses in New Mexico now and the state graduates and licenses 1,200 new nurses a year, it's clear there's a long way to go, he said.

Nursing schools must produce more graduates, he said, and the Legislature helped address that situation.

"And if we have to keep addressing it [the workforce shortage] with one health specialty at a time, we will," Clark said. "But we take what we can get."