Early this year Washington County Hospital began offering hiring bonuses of $2,000 for nurses with at least one year of experience in a comparable position and $1,000 for nursing assistants, said Deborah Addo, vice president for acute care.
"It's a very stressful job and I think we have to be creative in recruiting and retaining the nursing staff we have," Addo said.
Jefferson Memorial Hospital in Charles Town, W.Va., is offering $250 cash bonuses to its employees who successfully recruit a new nurse who stays at least six months, said Nursing Director Suzanne Shackelford.
Three employees have received the bonuses so far, she said.
While there isn't a large number of vacancies at Jefferson Memorial, the door continues to revolve as the hospital hires a new person only to see someone else leave, Shackelford said.
Shackelford said Jefferson recruits most of its nurses from Shepherd College, which has seen the number of applicants decline and fewer graduates stay in the area.
Hagerstown Community College is seeing a turnaround with the number of applications returning to normal, said Ann Gossard, HCC's director of nursing.
Despite having several recent graduates hired by Washington County Hospital, Gossard said many nursing graduates are leaving the area for jobs or higher degrees.
Wendy Williams, 26, of Smithsburg, has been working at Washington County Hospital since graduating from HCC in May.
Williams, whose work schedule could be day, evening or night, said she wants to gain some experience at the hospital before pursuing an interest in geriatrics, possibly working in a nursing home.
Nursing homes and other health-care fields are not immune to the shortage.
Ravenwood Lutheran Village is having problems recruiting nursing assistants.
Instead of taking the 100 to 200 hours of training required to be a nursing assistant, young people are going out to stores at Prime Outlets at Hagerstown and getting immediate jobs even though the benefits may not be as good, said Garret A. Falcone, Ravenwood's executive director.
The most important work in the nursing home is the nursing assistant who does the hands-on care, he said.
"Our turnover here is pretty much the same as what it's been in the state and the nation - over 50 percent," Falcone said.
To help attract nurses Ravenwood recently began its own nursing pool, allowing nurses to join the pool and be called to work as needed, Falcone said.
Pool members will be paid $10.65 an hour compared with the $9 an hour a permanent nursing assistant would make or the $12 to $15 an hour Ravenwood would have to pay if it used an outside temp agency, Falcone said. Pool members will not get benefits.
"I'm finding that the need for RNs has gone up dramatically and probably more dramatically now than in the last five, seven, 10 years," said Carol Cryer, vice president for patient services for Summit Health which operates Chambersburg Hospital and Waynesboro Hospital.
Several years ago when managed care started gaining control over the health care industry, many hospitals in the nation cut back staff to reduce costs, experts said.
In recent years hospitals have discovered they need those nurses, and sometimes even more, to care for a patient load that is sicker than before, they said.
"(People) don't go to the hospital until they're really, really sick, and that's a vicious cycle," Cryer said.
While managed care has reduced hospital stays for patients, it hasn't cut back on the care and education nurses must provide to patients, nursing officials said. Now they must do the same tasks crammed into fewer days.
Even with the incentives, nursing employers are having trouble attracting nurses, said Kathryn Hall, executive director of the Maryland Nurses Association.
"Our work force is older than it ever has been," Hall said. Nationally the average age of a nurse is 44, while in Maryland it is 46.
With the aging workforce this shortage could have a more critical impact on patient care as experienced nurses retire with fewer young people to fill the voids, Hall said.
In response to the shortage, the state association is involved in a massive image campaign to educate middle and high school students about the benefits of a nursing career, Hall said.
Print and video material is expected to be sent to secondary schools within six months, and interested students will have an opportunity to talk to a local nurse, she said.