Health care leaders gathered at the Greater Wilmington Business Journal’s Power Breakfast Series: Checking Our Pulse Thursday morning at the Wilmington Convention Center. 

The event featured a panel discussion among four officials representing major health care institutions and education systems in the region: Jeff James, CEO of Wilmington Health; Jeff Lindsay, executive vice president and chief operating officer of Novant Health; Jim Morton, president of Cape Fear Community College; and Justine Reel, interim dean for the University of North Carolina at Wilmington’s College of Health and Human Services. 

Common themes quickly emerged – staffing pressures, unsustainable cost models and a shifting marketplace. 

Last summer, staffing shortages at Novant Health New Hanover Regional Medical Center were critical, and while the hospital has since steadied its rolls through the use of travel nurses, the issue of finding and keeping nurses remains. 



Efforts are underway at both CFCC and UNCW to expand the number of nursing graduates produced each year. Earlier this month, crews broke ground on renovation work to expand CFCC’s nursing program into its new building at 319 N. Third St. CFCC aims to welcome 60 additional students for its spring 2024 cohort, which begins in January. 

At UNCW, Reel said officials are eyeing plans to expand simulation space that students use before entering the field. 

Before the pandemic, Morton said the focus was primarily on registered nurses, but has since shifted to licensed practical nurses and certified nursing assistants as well. 

Finding instructors to teach courses that educate nursing students is a challenge for both institutions, Morton and Reel said. 

“They can make much more working for a hospital than they can for UNCW,” Reel said. UNCW is studying faculty compensation to attempt to lure and retain more nursing instructors, she added. 

James with Wilmington Health said staffing is a challenge at all levels – not just nursing. “It’s pervasive,” he said. 

The nation is soon set to face a physician shortage, he said, as baby boomers continue to age. New physicians face steep debt loads that can deter students from entering the field, he added. “We’re not seeing as many people going into medicine as they used to,” James said. 

To address the shortage ­– and burnout – James said Wilmington Health has had to get more creative with the kind of flexibility it offers employees. This includes remote and hybrid opportunities, plus experimenting with part-time work arrangements – a request he’s seeing more of. 

“We can’t ask physicians, we can't ask providers to be on this never-ending treadmill that they’re on right now,” he said. 

Reel said burnout can also affect new nursing graduates and students, prompting new professionals to exit the field altogether. Compassion fatigue and stress can be rampant, she explained, which can quickly dull the excitement for new students and graduates. “This isn’t what I signed up for,” she said they often realize when faced with the pressures of the job. 

CFCC’s retention rate for its nursing program was 50% last year, Morton said. 

“It’s basically a 40-hour-week bill,” he said of the rigorous program. While most students obtain some financial aid for the roughly $12,000 two-year program, the drop in income proves too much of a burden for many students. 

Most students entering CFCC’s nursing program are young women averaging 25 years old, he said, and many have familial obligations which make losing their income unsustainable. 

CFCC is experimenting with a pilot daycare program for students, Morton said, which he said would be the first of its kind statewide. “We’re the only community college that wants to take this on,” he said. 

Asked about the “retailification” of health care – the entrance of Walmart and Amazon into the space – both James and Lindsay said while the business giants are competitors, the shakeup will ultimately change the landscape for the better. 

“We have got to get out of our own archaic way of doing things and meet the patients the way they want to be met,” James said. “What other industry would you call and have to negotiate to be seen by wherever you're going to pay to go to be seen?”

Lindsay said he sees partnership opportunities with the retail giants but added they can’t compete with the continuum of care that organizations like Novant provide. “It will push us to get better,” he said. 

A transition from the current “per-click sick care” to a more preventative approach based on value, Lindsay said, is the direction the industry ought to be headed in. 

Complete price transparency “in a way that we all can understand it,” James said, “is the one thing that is keeping health care from improving.” 

Watch the full discussion on YouTube.

Correction: This article has been updated to correct the price of CFCC's nursing program and to correct a figure about UNCW's retention rate. UNCW's retention rate is about 86%, which refers to the overall figure and not only its nursing program.