Katherine Turner raised six children before going back to school at the age of 40 to do what she had always wanted -- become a nurse.
"I was gung-ho for this profession. It's exciting and challenging," Turner said.
But Turner's enthusiasm wore off after holding jobs at two hospitals in Northern Virginia.
Turner like her first job, but resigned to join the nursing staff at a hospital closer to her home south of Alexandria. "The pay was so low at my first job (about $6 an hour) and gasoline so expensive, it was hardly worthwhile," she said.
Turner stayed at the second hospital for only a year. "I won't mention its name," she said. "But I lasted longer than most nurses. The pay was still poor, the work was backbreaking and hours terrible . . . mostly nights and every other weekend."
Turner now works in an Alexandria dentist's office where, she said, the pay "may be even a little lower." But she no longer has to work nights and weekends.
Bonnie Thomas, an RN who lives in Fairfax County, abandoned full-time hosptial work five years ago. The low pay, "a little over $5 an hour," and the hours were the major reasons she left.
"It wasn't worth it," Thomas says."I was working mostly evening and night shifts and almost every weekend. When I began having dreams, waking up in the night and asking my husband if I'd given him his medication, I knew it was time to quit."
This spring she even left her part-time job as a Red Cross nurse, and "now finally I have Saturdays free with my husband and children."
Pam Kinnard is one of several vice presidents of a branch bank in Alexandria. Although she is a licensed practical nurse, she has not worked full-time as a nurse for 11 years.
"I keep the license for old time's sake," Kinnard says. "It only costs $2 a year. But nursing is a very difficult profession to be in. So much is expected of you, and yet the pay is so low and the rewards are few. I left because I thought, 'gee, why am I punishing myself.'"
The State of Virginia has 40,000 registered nurses and 17,000 licensed practical nurses.But, like Turner, Thomas and Kinnard, an estimated 30,000 RNs and LPNs are currently unemployed or working outside the nursing profession.
The Virginia Nurses Association is now polling nurses in the state in an effort to find out why those 30,000 RNs and LPNs are not in nursing. While the association expects to find other reasons, pay and hours seem to be the major complaints of nurses in Northern Virginia.
Barbara Bolton, executive director of the state nurses association, believes the low pay in nursing is the major reason trained nurses turn to other jobs. Staring pay for nurses in Northern Virginia averages $6.60 to $7 an hour, according to the State Board of Nursing.
"Nursing requires two, three or four years of education," Bolton said, "but grocery store clerks with no education often earn more than nurses. I know of nurses right now who are working in supermarkets." Safeway food clerks in the Washington area start at just under $6 hour and earn over $8 an hour within two years.
The reason for low pay for nurses is that, like teachers, nurses have traditionally been women and women's jobs pay less than men's, said Bolton.
"It's true that nursing has been a woman's profession. You don't hear mothers talking about 'my son, the nurse.' That's got to change," said Stephen Lipson, executive director of the District of Columbia Hospital Association.
Lipson believes one reason for the shortage of nurses is that many other better-paying careers are now open to women: "Business, law and journalism have drained off an awful lot of bright young women who would have gone into nursing. Things weren't so open for women 20 years ago."
Other factors that discourage nurses from remaining in the profession, especially in hospital nursing, are the hard work and constantly rotating night, day and weekend shifts, said Bolton.
Despite the overwhelming number of nurses not working in their profession, nursing jobs in Virginia and throughout the metropolitan area are going begging.
Virtually all Northern Virginia and other Washington-area hospitals are short of nurses. Their job ads regularly take up two or three pages in the Sunday papers. The ads extol the hospitals' locations and fringe benefits -- from health insurance to free parking -- and occasionally even mention pay.
Despite the shortage of nurses -- estimated at 100,000 nationally and 2,500 in Virginia -- few, if any, Northern Virginia hospitals have been forced to reduce services.
"There are hundreds of openings for nurses here, but the Washington-area shortage isn't as bad as in some other places," says Angela Sweeten, a nursing recruiter for Providence Hospital in the District and cochairman of the Metropolitan Recruiters Association, a 2-year-old organization of 20 local hospitals.
Sweeten said most hospitals here are now cooperating in recruitment and most offer similar starting salaries for RNs, between $6 and $7 an hour.
"We haven't had to close any beds," said Peggy Bond, spokeswoman for Fairfax County's Fairfax, Commonwealth and Mount Vernon hospitals, "and as far as the nursing shortage goes, we're better off than the District even though we're slightly less competitive (in pay)."
Pond said the three hospitals usually are short about 20 nurses out of a total nursing staff of 1,150 and the annual turnover rate for nurses is about 16 percent.
Starting salaries in the Fairfax hospitals for nurses fresh out of school are about $12,839, or about $6.25 an hour for a 40-hour work week, said Pond.
"We can't afford to pay more," Pond said. "About 50 percent of our staff is nurses and 60 percent of our hospital costs."
At Alexandria Hospital, the annual turnover among the hospital's more than 200 nurses is 30 to 35 percent, said Carol Stewart, director of nurses.
"We're short of RNs and LPNs but not critically," Stewart says."In the rest of Virginia there's a lack of bodies. Here there are enough nurses but not the inclination. There are a lot of other opportunities for work besides hosptials . . . particularly government jobs."
Susan Sims, director of nursing at Arlington Hospital where the full-time staff includes 331 nurses, said: "We aren't critically short of nurses. We have a normal vacancy rate of about 10 nurses, and last year we had a turnover rate of 27.9 per cent.
"But remember this is a country-wide problem. The average nursing turnover is 35 to 40 percent. Don't ask me where are all the nurses going? Nobody knows."
Out-of-state hospitals beckon to nurses in Northern Virginia and the rest of the area. In one sunday job ad, a Long Island hospital urged nurses to "get away from Washington, D.C., the mugginess, the snarling big city traffic" and work on presumably peaceful and pleasant Long Island. A survey now being completed by the D.C. Hospital Association finds Washington's hospitals have about 10 percent of their nursing positions unfilled.
To attract more nurses, some hospitals in the metropolitan area may be forced to increase pay scales. Suburban and Prince George's General hospitals both are advertising their own temporary nurse program, where part-time nurses can earn $10 an hour for daywork and $11 an hour for evening and night shifts. However, full-time nurses at both hospitals still earn the average starting rate of $6 to $7 an hour.
Some hospitals are considering increasing nurses salaries but reducing fringe benefits, such as health insurance, says Lipson of the city hospital association. The rationale, he says, is that many nurses are married and already qualify for such health benefits under plans at their spouses' companies.
To supplement short staffs, most area hospitals are turning to temporary nursing services, which supply nurses for a night, a day, weeks or even months at a time. Nurses working for the temporary services, like workers in similar secretarial services, may receive no company or hospital benefits. But their salaries run as high as $10 to $12 an hour, significantly more than the average $7 to $9 an hour many local hospitals pay regular full-time nurses.
One temporary nursing service, Medical Staffing Services opened a Washington office last year. Officials at the firm estimate "there are probably thousands of nursing jobs per week" going unfilled in the Washington area alone.
"This is transient area," said Deborah Haff, a spokeswoman for Medical Staffing. "Some of my nurses go to Florida, Colorado, California. They can just walk in and get a job . . . at much higher pay than the hospitals pay their regular nurses."
Few hospital or nursing officials see an early end to the nursing shortage until salaries improve significantly.
"Society has really got to get the horse back in front of the cart, and start paying nurses what they're worth," says Kristi Morris, an RN who has held three nursing jobs in the Washington area in the three years since she earned her nursing degree."