A report released by the North Carolina Health Talent Alliance provides a snapshot of trends in the Cape Fear Region’s health care workforce.

Survey responses from health systems, hospitals and clinics in the Wilmington area show the region’s 28% open position rate for registered nurses is higher than statewide levels and the churn rate for medical assistant positions – 73% – also trends higher than the statewide rate. 

The data comes from a workforce demand survey sent to health care employers across the state in February by the N.C. Health Talent Alliance, a collaboration between the NC Center on the Workforce for Health and the NC Chamber Foundation. 

Last fall, the N.C. Health Talent Alliance launched the first pilot program of a statewide initiative in the Cape Fear Region in partnership with the Wilmington Chamber of Commerce. The initiative aims to create a talent pipeline to recruit and retain nurses and other health care professionals to help offset staffing shortfalls.

The group’s inaugural survey aims to understand “health care employers’ current, former and future workforce information, by profession and by geography,” according to the report’s executive summary. The data will then be used to drive “regional action led by health employers in collaboration with health educators and workforce entities through the Talent Pipeline Management framework,” the executive summary states.

Health care organizations in the South East Area Health Education Center (SEAHEC), a region that encompasses New Hanover, Brunswick, Pender, Columbus and Duplin counties, provided 34 individual responses to the survey.

In measuring the open position rate, the survey compared filled positions with open positions for two weeks in January 2024. In the SEAHEC, the 28% open position rate for registered nurses (RNs) was higher than the 15% statewide open position rate. 

However, the 20% open position rate for licensed practical nurses (LPNs), the 12% rate for certified nurse assistants (CNAs) and the 13% open position rate for medical assistants (MAs) were lower than state levels. Statewide, the survey showed a 24% open position rate for LPNs and a 16% and 14% open position rate for CNAs and MAs, respectively.

The survey also showed that churn rates – the total number of employees hired and non-retirement exits compared to total staff – in the Cape Fear Region were largely similar to statewide rates. 

In the SEAHEC region, reported churn rates for RNs were 47% compared to 50% statewide while regional LPN and CNA positions had a churn rate of 46% and 90%, respectively, compared to a 48% and 80% churn rate at the state level.

However, regional rates of churn for MAs – 73% – were higher than the 52% statewide churn rate, according to the survey. Respondents also noted a need for more nurse practitioners, environmental services and physician positions outside of nursing roles.

The report identifies several key challenges to health care recruitment and retention, including the ability to offer competitive salaries and benefits, finding candidates who remain in the hiring process and, if offered a job, will accept, and finding new grads with the knowledge and ability to work in a professional setting.

Suggested policy changes include adjustments to “any levers” that enable organizations to pay staff higher wages, regulating staffing agencies, adjusting federal policies around reimbursement and regulation to offer more autonomy at the local level and increased support for student and educational training.

The study also used NC Nursecast to project future worker shortages. By 2033, the Cape Fear region is expected to have a 4.1% RN shortage, concentrated in hospital settings, and a 4.4% LPN shortage, concentrated in nursing homes and long-term care facilities.

The report also surveyed the universities and colleges feeding each region’s health care workforce. In SEAHEC, that includes the University of North Carolina Wilmington (UNCW), Cape Fear Community College and Brunswick Community College, among others. 
The report concluded the educational infrastructure of SEAHEC’s community colleges is robust, and even though UNCW is the region’s only four-year institution, it regularly produces graduates with a Bachelor of Science in Nursing.

Statewide, the report notes that community colleges have faced challenges in recruiting and retaining qualified faculty, securing clinical sites and recruiting and retaining students. Community colleges also reported a lack of funding for positions and equipment and limited classroom and lab space.

Potential policy solutions highlighted in the report include increased state funding and support for community colleges, elimination of unnecessary testing requirements, clearer state guidelines and communication, flexibility in hiring and credentialing and support for clinical site expansion.