WANTED: Nurses – Blacks should aim for specialization and management

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When Garth Robinson migrated to the United States from the Caribbean at seven years of age, a career in nursing was the furthest thing from his mind. In June, he will graduate from the nursing program at Borough of Manhattan Community College. The profession simply crept up on him, he says. ?When I was growing up I never considered nursing as a career but I worked in a hospital as a pharmacy aide and had to deliver medication,? he recalls. ?My wife was a licensed practical nurse at the time, and we had both taken classes and stopped.?

A member of 1199, the nation?s largest health-care union, Robinson?s salary and tuition are covered by the union through a federal grant at Brookdale Hospital in Brooklyn, where he works. DC37, another powerful union, also subsidizes the education of many nurses. ?I knew I wanted to go back to school and I thought of becoming an X-ray technician. My wife suggested the registered nurse program,? Robinson says.

Despite today?s economic uncertainty, jobs in health care continue to grow steadily, sprouting opportunities in various areas, particularly nursing. Figures from the Bureau of Labor Statistics project that nursing will see solid growth through 2020 as society ages. With starting salaries ranging from $55,000-$60,000, the field is becoming more attractive to career changers and to students who are cognizant of the difficulties of finding work in other sectors.

?The good thing about nursing is that it?s more than just bedside care. There is research, education, nurse practitioner and Ph.D. programs so there is a lot of growth and development,? says Reginald Williams, who holds a bachelor?s degree in nursing from the College of New Rochelle, and who has worked as an emergency room nurse in England and in the United States.

Even so, an already alarming shortage of nurses threatens to grow much worse. According to the American Hospital Association, 126,000 nursing positions are currently unfilled in hospitals across the country. Nursing schools are turning out fewer graduates. The American Association of Colleges of Nursing reports enrollment in bachelor?s programs has declined for five consecutive years. Enrollments fell nearly 5 percent last fall from the previous year. The Centers for Medicare and Medicaid Services says 90 percent of long-term care organizations lack sufficient nurse staff to provide even the most basic care.

?Younger college students don?t see the opportunities that exist in nursing, while many older nurses retire and leave the profession,? Williams says.

The Journal of the American Medical Association forecasts that unless more nurses come into the field in the next decade, hospitals face the prospect of shrinking staffs just as the estimated 78 million baby boomers begin to reach the age of 65, the Medicare age. The crunch is expected to get worse before it gets better. At its present rate, the national deficit of registered nurses is expected to rise to 29 percent by the year 2020, leaving a gaping shortage of more than 400,000 nurses by 2010, the U.S. Department of Health and Human Services estimates. The U.S. Department of Labor?s Bureau of Labor Statistics contends that by 2008, there will need to be 450,000 more registered nurses and 136,000 more licensed practical nurses.

A licensed practical nurse (L.P.N.) generally completes a one-year training program, while a registered nurse (R.N.) completes a two- or four-year training program, which yields an associate?s or bachelor?s degree, respectively. Both L.P.N.?s and R.N.?s must pass a state board certification exam to become licensed. In 2000, 86.9 percent of all registered nurses in the country were white and only 4.9 percent were Black, figures from the U.S. Department of Health and Human Services? Bureau of Nursing show.

While the most lucrative opportunities are in specialized nursing, Blacks remain concentrated in bedside care. The stress of the more specialized professions contributes to that concentration, suggests Angela Heron, an L.P.N. at the Wayne Rehabilitation Center in the Bronx. ?I was attracted to the humanitarian side of nursing [but] I?ve noticed that the stress level is much higher, there?s more paper compliance and nurses have to do more with fewer resources,? she says.

Janet Gordon, an R.N. who worked as a nursing manager at Brooklyn?s St. Mary?s Hospital for nine years, attributes the low specialization levels among Black nurses to security. ?They like the security of bedside care,? she says. With diabetes ravaging the African-American community, Gordon, who has been laid off from St. Mary?s, is contemplating her future in a diabetes-related field. It?s an area of nursing that has held her interest for years, she says. ?I?m thinking of focusing on diabetic education because I?m concerned about the growing diabetic population,? she says.

Anesthesiology is one of the least known areas of specialization. ?Specializing in anesthesiology is nursing?s best-kept secret,? says Jennifer Harvey, a certified registered nurse anesthetist and adjunct professor in anesthesia at State University of New York?s Downstate campus. Harvey began her nursing career at 19 as a home health aide and subsequently earned her bachelor?s and master?s degrees in nursing at SUNY Downstate. ?I wanted to go to law school, but once I got into health care I liked it,? she says.

Only Columbia University and SUNY Downstate offer a program in anesthesiology in the New York City area. Each institution accepts no more than 20 students a year. With graduates earning between $100,000 and $110,000, students flock to the program from all over the country. Few African-Americans are among them. ?Most of the students are Caucasian males,? says Harvey.

Vernita Forde, a trauma nurse with Response Medical Staffing in Melville, N.Y., is seriously considering specializing now that she has graduated from Borough of Manhattan Community College. ?I started the nursing program at Kingsborough Community College in 1981 but didn?t finish,? she says, noting that her mother is a certified nurse?s assistant and her aunt is a nurse practitioner. Forde completed the L.P.N. course in Florida then returned to New York in 1997, where she joined the staff at Montefiore Hospital.

Having worked in sub-acute and rehabilitation settings since the late 1980s following her graduation from Mid Manhattan School of Nursing, Heron of Wayne Rehabilitation Center plans to return to school to further her education. When she does, chances are she will be not be taught by a Black professional.

?Colleges and universities rarely have Black nurses because the educational aspect of nursing doesn?t pay as much as the practical experience. This leads to a shortage of [Black] professors,? says Williams. A passionate advocate for the field, Williams intends to pursue his master?s degree later this year and is thinking of being more involved in the educational side of nursing as well.

Equally disheartening is the relatively small number of Black nurses at the administrative level. Most of the administrators in nursing homes, for instance, are Caucasian males or Filipino females, says Gordon. Many young Black nurses with administrative potential choose to work per diem for the flexibility, she says. ?I love working in specialized areas and I liked the front line of being a manager because I got the chance to use my management skills,? Gordon says.

From basic bedside care to highly specialized care and teaching, opportunities in nursing will expand well into the century. There will be myriad opportunities for Blacks already in the field and those contemplating it. ?After I was laid off from St. Mary?s I thought about becoming an adjunct professor,? says Gordon. Nursing is about ?patient teaching?empowering people with information,? she says.