TRI-CITIES, Tenn. (WJHL)- A nationwide nursing shortage is impacting local hospitals, and healthcare professionals are trying to manage the problem.

A 2019 report released by Nursing Solutions, Inc. estimated the shortage of registered nurses will reach 1.13 million by 2024.

The U.S. Health Resources and Service Administration projected Tennessee will only be able to meet half of the demand for registered nurses by next year.

“We have a great need for more nurses and there are multiple reasons for that,” said Lisa Smithgall, senior vice president and chief nursing executive for Ballad Health.

On Wednesday, the Tennessee Center for Applied Technology Elizabethton honored dozens of practical nursing students at a pinning ceremony at Bristol Regional Medical Center.

“I think TCAT is playing quite a significant role in providing nurses for the region,” said Practical Nursing Director Cathy Bullen.

Bullen said, on average, 98 percent of graduates pass their certification exam to become Licensed Practical Nurses after completing nearly 13 hundred hours of clinical work and classes in one year.

She estimates 40-50 percent take courses to become Registered Nurses in the five years following graduation.

Bullen estimated the average starting salary for an LPN in Northeast Tennessee is $36 thousand. She said an RN makes an average of $45 thousand.

“One of the largest barriers is probably time and money,” Bullen said. “Students are taking on student debt, student loans and there’s a real fear associated with that.”

As baby boomers age into retirement and leave a gap in the workforce, Smithgall said younger RNs are moving out of rural areas to seek higher salaries in metropolitan markets like Asheville and Knoxville.

“I do believe those areas pay more because their Medicare Wage Index is much higher than here. So, therefore, they get more reimbursement and can afford to pay higher salaries,” said Smithgall.

In June, Smithgall said Ballad made its first annual investment of $10 million dollars to increase nursing wages to attract and retain employees.

A press releases notes, “This investment represents 100 percent of Ballad Health’s operating income from the last fiscal year.”

In the meantime, Smithgall said Ballad has offered incentives for current nurses to work extra hours.

She said they’ve also filled labor gaps with temporary travel nurses.

A press release said the hospital system has decreased travel nurses by 50% in the last year.

“The salary for travel nurses is very much elevated, you’re paying a lot more for the same resources,” Smithgall said, “You want someone who is committed to the region.”

This year, Ballad said low-acuity admissions are down by 5 thousand as part of an effort to reduce the demand for nurses.

“To be able to care for an influx of patients, we may want to put a hospital on diversion so that we don’t overstretch the existing resources,” Smithgall said.

In public hearing before the state-appointed Local Advisory Council, some Ballad employees raised concerns about changes the hospital system was making to pay practices.

A summary of the comments made in the LAC’s report reads:

Several public comments addressed decreased staff pay through cuts to bonuses, hours, holiday pay, and shift differentials. Concerns expressed included cuts to staff compensations, primarily regarding those of RN’s and LPN’s, and that pay decreases impact the ability to attract new staff, the ability to attract specialists, and specialty certifications.

Local Advisory Council

“All of those statements are not necessarily accurate,” said Smithgall.

Smithgall said Ballad standardized pay practices that were inconsistent across the two previous healthcare systems.

She said any changes to shift differentials or certification compensations were added to the base pay of employees.

“I don’t think that the things that we’ve done…because we didn’t fiscally penalize any of our team members, are the reason that we’re not being able to recruit,” she said.

If you’re interested in applying for a position at Ballad Health, you can visit the company hiring page here.