Public health short nurses

Outdated state salaries and higher paying alternatives appear to have all but depleted the amount of staff at Carbon County Public Health.

Amanda Brown, Carbon County Public Health nurse manager, informed the Board of Carbon County Commissioners (BOCCC) of her ongoing staff shortage during their April 5 meeting. Brown, who was in attendance to request permission to advertise for three positions in her department, told the commissioners a full-time position had remained open for more than a year.

“We have had our full-time nursing position open for over a year and we’ve had multiple applicants and as soon as they see the salary, we usually lose them. It’s something that the State’s trying to work on but we don’t know if the recent increases in State positions are going to affect us at public health or not,” said Brown. “It might bump up the salary just a touch but we’re still, on average, $10 an hour less than what a nurse can make anywhere else.”

In addition to the full-time position which has remained open, Brown said a full-time nurse in public health’s Maternal Child Health program would be leaving next month. There were also two part-time positions—one at 32 hours per week and one at 20 hours per week—which Brown was hoping to fill.

“With things the way they are, do you have a gut feeling of how long it’ll be or what kind of response you’ll get?” asked Commissioner Byron Barkhurst. “You guys are doing a phenomenal job.”

Brown commended the nurses on her staff, saying they had all become adept at wearing “multiple hats and doing what we need to do”. The nurse manager added with the limited staff, it also limited the programs Carbon County Public Health could do from their office.

“We’ve had to really put a lot of programs on the backburner and just focus on the priorities that we have to do for the grants,” Brown said. “There’s a lot of things we want to do that we just don’t have the staff to do, a lot of things that I would like to do as a supervisor but I can’t because I am actually running the office.” 

According to Brown, community health and working for public health has often been a “stepping stone” for nurses working in the private sector on their way to retirement. She added her department was working to make their programs more appealing to nurses just out of school and as a viable alternative to acute care in hospitals. Salaries, however, appeared to be the biggest factor in filling those positions.

Barkhurst asked if Brown had contacts in the nursing programs as a way to get the open positions filled.

“We try to get them looped in. There’s a culture in nursing where, usually, people go to medsurge (medial surgery) right out of school and that’s just kind of the nature of it. It is kind of hard to pull somebody into the idea of community nursing instead of acute nursing right out of school because you want that true nursing experience of a hospital,” said Brown. “It takes a lot of education. Traditionally, public health wasn’t really taught in nursing schools as a part of that curriculum until you get to your bachelor’s level and more of that community nursing is more of the higher levels.”

Brown added she could only hire registered nurses (RN) for the nursing positions in public health rather than licensed practical nurses (LPN). RNs are able to provide more direct care and have a more expanded practice than LPNs including the ability to perform diagnostic tests, administer mediations and educate patients on how to manage their health following treatment. 

“Is there any silver lining, looking at the job market, for this level of medicine in the Rocky Mountain region? Because, I know, with a government job here’s the salary and people are making four times that in other industries with traveling and different things like that,” said Commissioner Travis Moore. “Are they going to run out these federal funds to pay those wages eventually so that we get a chance to get some people?” 

Brown replied she believed federal funding would, eventually, run out and that the current salaries for traveling nurses would not be sustainable. She added there was even some political discussion towards putting a cap on wages for traveling nurses.

“Having a government or state job used to be kind of a good thing. I remember, when I first came to public health, we never had an open position,” Brown said. “It would be filled right away because there is a lot of pull, the benefits for the state positions were always better, the work/life balance … that was always kind of a pull for somebody that had families. That’s just not enough of a pull anymore because of the salary differences.”

Moore expressed his concern about the struggle to fill positions within Carbon County Public Health, asking if there was “a light at the end of the tunnel”.

“The State of Wyoming is behind on their pay in every department for years and to start at the bottom and be trying one, two percent at a time to get where you need to be is … that’s a bad place to be, too,” said Commissioner Sue Jones. “The State of Wyoming has a serious, serious problem.”

“You’ve got to find a nurse that’s passionate about community health to be in this type of field because we definitely don’t do it for the money,” replied Brown. “We do it because we love our communities.”

“Don’t lose your passion,” said Chairman John Johnson.

Brown’s request to advertise for the three positions received a unanimous “thumbs up” from all five commissioners.

The next meeting of the Board of Carbon County Commissioners will be at 2 p.m. on April 19 at the Encampment Opera House (622 Rankin Avenue) in Encampment.