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VOL. 43 | NO. 20 | Friday, May 17, 2019

TN facing longterm shortage of health care workers

Accounting, hospitality also among fields facing worker shortages

By Hollie Deese

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Samantha Rooks, a registered respiratory therapist at Monroe Carell Jr. Children’s Hospital at Vanderbilt, says she always wanted to work in health care, though no one in her family had ever chosen that path. She loves what she does, she adds, and has been at Vanderbilt for nearly 20 years, working exclusively with children.

“I mean, it’s tough,” Rooks says. “There’s no other word for it. You take care of really, really sick kids, and a lot of them. And some days are better and then some days you just are extremely busy.”

She says the hospital could use more help, with jobs ready to be filled with the right candidates.

Health care is one of many fields facing a worker shortage in Tennessee.

Other professions in high demand through 2024 include accountants and auditors, and elementary school teachers, research by the Tennessee Department of Labor reveals. The biggest demand for workers without four-year degrees includes team assemblers and office workers.

There is high demand throughout Tennessee for workers in many health care disciplines, from specialized nursing and high-tech jobs to aides and home health workers. The lower-wage health care jobs are competing with the state’s other top in-demand jobs in the hospitality field.

“Nursing Supply and Demand through 2020,’’ a report from Georgetown University, states the economy will create 1.6 million job openings for nurses but will fall 200,000 short of filling those jobs.

Tennessee will be able to meet only half of the demand for nurses by 2020, creating one of the largest nursing shortages in the Southeast, a U.S. Health Resources and Services Administration study finds.

Samantha Rooks, left, a respiratory therapist at Monroe Carell Jr. Children’s Hospital at Vanderbilt, talks with coworker Brittany Hill, also a respiratory therapist. “You’re always going to have a job,” Rooks says of her chosen field.

-- Photo By Michelle Morrow |The Ledger

Rooks works two or three 12-hour shifts a week, starting at 6:40 a.m. and finishing at 7:15 p.m. The long hours are hard, and getting harder as the older of her two daughters finds more activities after school. But she makes it work with her husband, Craig, who is head of the adult respiratory program at Vanderbilt. And she knows her job is secure.

“You’re going to always have a job,” Rooks explains. “There’s never a chance of not having a job. It’s a very secure market. But you do it for the love of the kids and what you’re doing. Health care is just a difficult place to be right now.”

Elizabeth Moss’ business, Wholecare Connections, an in-home senior and elderly care business, grew from Moss’ transition from office to private-duty nursing. She’s been in the business about 20 years.

“People need care, and the whole reason I left the floor in a medical-model community was because I recognized that people needed whole care,” she explains. “It was this assembly-line process – delivering trays and changing bed sheets and standing by them to take showers. And nobody was engaging with the person and listening to their story.”

Moss grew up with a holistic lifestyle learned from her mother. “I feel like people deserve a deeper level, higher quality of care than they get in facilities and most other agencies,” Moss adds.

Moss has a crew of 120 caregivers, about half part time, and on any given week will run payroll for about 80 of those people, all of whom work different schedules, different days and, often, as a second or even a third job.

“We have social workers that work full-time jobs, we have Realtors that work full-time jobs, and then they do this in addition because they have a passion for caring for others,” Moss says.

Yet, it is getting harder and harder to find people, Moss says, especially after 2015 when home-care agencies became required to pay at least the federal minimum wage and overtime pay to any direct-care worker providing home care services, including certified nursing assistants, home-health aides, personal-care aides, caregivers and companions.

“The moment that changed, we needed twice the people that we had. And we’ve not been able to reach that goal in more than three years,” Moss adds. “This is the first time in history that these industries are really competing with retail, food service, Amazon – we’re all competing to get the same people.”

So, Moss focuses on treating her employees with respect, as well as increasing the pay rate, which means increasing her billing rate.

“Just in Nashville, there’s 10,000 open nursing positions,” Moss acknowledges.

“It’s such a good career to go into, so I don’t know why we’re not successful in recruiting more student nurses and techs and medical assistants,” she says. “We’ve got to have nurses and we’ve got to have techs.

“So we’re looking at all the different aspects of what we do within our business and how we can improve our culture. I’m just constantly working on everything I can to attract and retain.”

Hospitality jobs soar

Chris Blair, a restaurateur and owner of The Listening Room on Fourth Avenue, says “it’s tough” to hire and keep staff in the hospitality industry.

-- Photo By Leigh Singleton |The Ledger

Chris Blair, a musician and songwriter who, moved to Nashville in 2003, got three songs on the radio and did some touring. He got the idea for The Listening Room, a small music venue and restaurant hybrid he opened in Franklin in 2006. He moved to Cummins Station in 2008, then bought out his partner in 2009.

“Then I had an opportunity to open a Mexican restaurant in Cummins Station, so I partnered up with Cinco De Mayo in 2011,” Blair says.

Cinco opened in Cummins, and he moved The Listening Room down to Second Avenue, doing extensive work on the building. He didn’t plan to leave that building, but after giving him plenty of notice, his landlord Michael Hayes knocked that building down a couple of weeks ago for a major project.

“I had plenty of time to start looking and found the home that we are in now,” he says of his Fourth Avenue location. “We did a whole build-out there, so it’s been a good move. We really like it.”

Blair also is working on a new Mexican restaurant in East Nashville, where Mad Donna’s used to be, and will need to hire even more employees.

“It’s tough,” Blair says of hiring during Nashville’s current hotel and restaurant boom. “It’s very tough. The hospitality industry, it’s always a challenge because front of house you’re working with a lot of college kids that are in and out, summer schedules and school schedules. And then the back of the house, that’s a challenge, as well.”

There were 133 new restaurant, bar and cafe openings in Nashville last year, the Nashville Convention and Visitors Corporation reports, compared to 113 in 2017 and 90 in 2016.

And in the past five years, Nashville demand – hotel rooms sold – has grown faster than any other top 30 U.S. city.

Blair is on the board of the Nashville Originals, an organization of more than 60 locally owned restaurants, and says owners discuss the challenges smaller organizations faces when big chains – or big chefs – come to town backed by corporate money.

“On the flip side, there is so much demand for good people that people just graduating from culinary school feel like they should just walk into an $80,000 chef job,” Blair continues. “The problem is that some of those people will get hired for that because people need them so bad. And then you’ve set the standard.”

As Nashville has grown, Blair says there are just too many restaurants and not enough people to work them. So, the talent pool is not nearly as good across the board, whether it’s back of the house, front of the house or management.

“I’m looking for a general manager and going through those challenges, especially on high-level positions like that, I don’t want to just hire someone. So, it’s taking the time to find the right person,” Blair adds.

But even when it comes to filling dishwasher and line cook positions, Blair is competing with big corporate restaurants and new hotels willing to pay twice or three times as much as someone is worth to get their place up and going.

“Those kind of places will get the dollars in line, but the problem is, with so many of them opening up, the ones that are good, there’s just a lot of people that don’t go across the street to a different place for a dollar or two more an hour, let alone the places that are hiring dishwashers for $25 or $30 an hour, and some of them will do that just to get people in there.”

Kara Barrow is the bar manager at Chuy’s Mexican Grill in Knoxville. She started out as a server in 2012, three months after her daughter was born. The job worked for her at the time because the shifts were short and, if she needed flexibility to be with her daughter, she could always request time off or find someone to pick up her shift.

“It was probably the most money I could make at the time in the most flexible hours, so it worked out well for me,” she says. Plus, she adds the environment with her co-workers is similar to a supportive family. “Looking back at it now, it was a blessing. Chuy’s kind of helped me out a lot in life.”

These days, in addition to handling liquor orders, managing inventory and writing schedules, she is also conducting interviews and hiring bartenders. And despite posting on sites like Craigslist and Snagajob, it isn’t always easy.

“It’s hard to find quality people,” Barrow says. “Because we are a family restaurant, it is a lot more competitive because you have sports bars and things like that around. If you get these kids fresh out of bartending school for the very first time at Chuy’s, then it makes it easier on us. Finding bartenders that have bartended at sports bars and other places like that, they’re not coming in getting the money that they’re used to. So it is a little bit difficult.”

Barrow says their highest turnover is between 30 and 60 days, when employees go through training and connect – or not – with the team.

At Chuy’s, she says the culture fosters teamwork, so she looks for friendly, hard-working people and hopes they are drawn to the family atmosphere.

“We’ve got 60 days to make an impression on them, and that’s it,” Barrow explains. “There’s constantly new restaurants opening. Knoxville’s building up quite a bit and there’s always new opportunities for people. Unless you find a career server or something like that, you’re always going to have turnover. You’re always going to have people moving around to different restaurants to see what they can make the best money at.”

Chris Cannon, director of communications for the Tennessee Department of Labor and Workforce Development, says health care’s always been big in Tennessee, especially in the Nashville area, but the construction, food service and accommodations industry has really grown in the last five years.

“It’s been a big one specifically in the Nashville area,” Cannon says. “But you’re also seeing a lot of growth in the Knoxville area.”

In fact, Knox County and Sevier County are always in the top 10 for lowest unemployment rates, Cannon says.

“That’s because they have so many jobs, specifically in the Sevier County area in the hospitality industry,” Cannon adds. “I mean, they have more jobs there and more people that need the jobs than they have housing for the people that need jobs.”

Tennessee has had a record low unemployment for the past two months, 3.2% statewide. But Cannon says those numbers can be misleading.

“There’s a lot of economic growth in the bigger cities, in Nashville and Chattanooga and Knoxville,” he explains. “But sometimes economic growth and economic prosperity doesn’t spread beyond the borders of the metropolitan county.

“So that’s what the administration is focusing on is, giving priority to those distressed counties and trying to spread the wealth, of sorts, to make sure it’s statewide and not just in the major metropolitan areas.”

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