Healthcare employment options way up north in Alaska, LV Review Journal 10/12

Long, harsh winters with little daylight can be deal-breaker for candidates By LISA FERGUSON When Lynn Kennington worked in Las Vegas, he never witnessed a moose wandering around outside of his office. These days, however, such sightings are not an uncommon occurrence for him. Last year Kennington, who spent four years as chief financial officer of Desert Springs Hospital, accepted the same position at Alaska Regional Hospital in Anchorage, a campus that is favored by the massive creatures. “Here at the hospital, we actually have to shut down some of the walkways because the moose will come here and live for months at a time, and you can’t go out there because they’ll stomp on you,” Kennington explained. The wildlife encounters (bears have also been known to roam very near his home) are one of the things he says he enjoys about living in Alaska and working at Alaska Regional Hospital, which earlier this year began recruiting workers in Las Vegas to fill various positions at its facility. The hospital’s decision to search for workers here was partly Kennington’s doing. He said he encouraged its human resources department to recruit in Southern Nevada. “Vegas is a great place to get trained” in various aspects of the health care field, he said. “I think a lot of the (industry issues) that Alaska is facing, Vegas and Nevada probably saw 10 to 15 years ago … and I think they’ve been fairly successful in addressing them” in Southern Nevada. Nevertheless, Kennington said his job in Las Vegas had lost some of its appeal, which played a role in his decision to move with his wife, who was raised in Anchorage, and five children to Alaska. “The expectations of any (health care) company in Vegas are really high,” he said, because of the tremendous rate at which the local economy grew before it faltered in recent years. As a result, Kennington said, industry executives “had a hard time tempering their expectations” and instead wanted a hospital’s bottom line to be maintained “by cutting expenses down to the bare bones to the point where you’d really have to question whether or not you could provide the level of service the patients deserve and expect with the amount of staff they were allowing us to have.” Kennington said he observed a “fairly significant” number of hospital layoffs while working in Las Vegas. “A lot of times when you lay people off, it’s not the cream of the crop, but we were cutting deep enough some years to where you’re laying off some pretty good people, “ which Kennington said was hard for him to experience. “I love health care. I truly believe in what I’m doing, but I want to be able to do it in a way that I can go home at night and feel good about what I’ve done.” He said he has that with his new position at Alaska Regional Hospital. “All in all, the health care industry is good up here.” Through a link on its website, www.alaskaregional.com , the hospital posts openings for registered nurses, respiratory and occupational therapists and phlebotomists among dozens of other positions. Aron Bouknight, the hospital’s human resources recruiter, said she recently put feelers out in Las Vegas in search of a physical therapy manager. Good candidates “are hard to come by,” she said. “And then you find them and have to convince them to come to Alaska.” That is no small feat: The state’s extreme climate — long, harsh winters with few hours of daylight — can be a deal-breaker for some who might otherwise consider accepting a job there. “It’s a total shock,” Bouknight said. She relocated to Anchorage from South Carolina nine years ago. “You’re coming from a place where winter (conditions are) nothing compared to here, and it’s day in and day out from the end of October until April — and maybe even longer. And the darkness sometimes gets to people.” Bouknight said while the hospital often offers job candidates signing bonuses and pays for relocation expenses, it’s still a tough sell. “We have people who get here and they work a few months,” especially during the pleasant summer months, “and then winter comes and they’re like, ‘I’m going back home.’ ” Some candidates throw in the towel even before they arrive in Alaska, as was the case earlier this year when she attempted to hire a man from Las Vegas. “He was ready to move up here; he had stuff packed,” she said. “Then, after it was all said and done, the length of the winter was something that really put a damper on it.” That’s unfortunate, since the state is in need of qualified health care personnel. In 2011 Alaska’s population was nearly 723,000, according to the U.S. Census Bureau. Dan Robinson, chief of research and analysis for the Alaska Department of Labor and Workforce Development, explained the state’s population has historically been younger than the national average due largely to an influx of people during the 1970s and ’80s as a result of the Trans-Alaska Pipeline project. “A lot of those people stayed, and now they’re having a bigger effect as they age than in the U.S. overall, where the numbers (of aging adults) are big enough that it kind of gets absorbed easier,” Robinson explained. By 2034, it is projected that 125,000 senior citizens will call Alaska home. Also, in the past two decades, “As our population has grown, our health care services have kind of filled in,” he said. “Where Alaskans used to go to Seattle and (other cities) outside of Alaska to get care, we’re big enough now that we can have maybe a neurologist … or services that used to be gotten from outside.” “There’s a lot of attention being paid to health care in Alaska,” said Kathryn Craft, staff coordinator for the Alaska Health Workforce Coalition, a publicprivate partnership created to address health-workforce issues and needs. In 2011, the organization developed an “action agenda,” which identified 15 health care industry occupations and labeled them top priorities for the state. They include primary care providers, direct care workers (including home health care workers and those trained to treat adult mental disabilities, among others), behavioral health clinicians, physical therapists, nurses and pharmacists. “Those are the six that we’re working on right now that we actually have goals and activities and strategies that are ongoing not only by our state government, but also (private) industries as well,” Craft said. Members of the Alaska Health Workforce Coalition meet regularly to review and track the progress of the more than three dozen strategies it is focused on in an effort to improve the state’s health care workforce. The organization is currently conducting a “vacancy study” with the state of Alaska’s Area Health Education Center, Department of Labor and Workforce Development and the University of Alaska’s Institute of Social and Economic Research. Upon its completion in December, the study should help determine the number of nurses the state will need going forward, among other data. To Alaska’s credit, Craft said, “I don’t think most states can get their university system, their department of labor, their department of education, their department of health and social services, all of the state hospitals and nursing home groups, their primary care association … together monthly. And all we do is talk and work on the strategies toward resolving the issues we’re finding.” One of those issues is how to go about keeping health care professionals in the state. Alaska’s isolation — from the lower 48 states, as well as within its own boundaries — presents issues for potential job candidates. While larger cities such as Anchorage, Fairbanks and Juneau offer most of the comforts and conveniences found in other big cities throughout the nation, the state’s outlying areas — snuggled deep within its vast, rugged wilderness — can prove overwhelming to newcomers. Rural “hub” communities can be the main area for obtaining services for as many as 10 smaller nearby “villages,” which are inhabited largely by native Alaskans. Such hubs may be accessible only by travel on “very small bush planes,” Craft explained. At state conferences, she said, health care industry members often share stories about job candidates who, upon arrival at these hubs, “get off the plane, look around and get right back on.” “It’s a rare individual who can come from Las Vegas and go out to Nome or Kotzebue or Point Hope. People think they can imagine, but it’s very different than city living,” she said. For that reason, Craft said, efforts are under way to find “up-and-coming” residents of these tiny communities and “make sure they get the education they need through distance delivery and have them stay” to practice medicine in the area where they were raised. “What we’ve really focused on in our hub and village areas is integrating behavioral health and primary care needs” via “all-in-one” medical facilities, Craft explained. Such facilities better protect patient confidentiality in communities where most residents know one another. “People might need help with a mental health issue or a substance abuse issue,” she said. “If it’s in a medical, primarycare setting … nobody knows why you’re going into the building.” Rest assured, Craft said, living and working in Alaska is “not for the weak at heart. But I think there are a lot of people out there that would enjoy working up here. It’s a good group of people.” From a health care perspective, “It’s a small state. We’re a big state in size, but we all know each other.” Kennington concurred: “People kind of think of … Alaska as a whole as an outpost, but Anchorage is as sophisticated of a city as I’ve ever lived in. They offer everything here. All of the restaurants, all of the dining opportunities, the symphony, any of the musicals that come through down there in the lower 48, they come up here. “The biggest thing is getting over the perception of what it’s like to live in Alaska. You never think that you’ll be able to go out and walk on a glacier that’s four miles wide and 26 miles long.” Compared to his years spent living the desert climate of Southern Nevada, he said, “This is just as good, but in a different way.”