Published in Nursing Spectrum, August, 2004
You will find six times as many pilots per capita in Alaska as you will in the rest of the country, and 14 times as many airplanes. With countless towns and villages across the state that aren't, according to the local parlance, "on the road system," and a land mass twice the size of Texas, a plane comes in pretty handy.
Alaska is the country's 49th state and its biggest. Juneau is the state capital, but Anchorage, which local authorities report is nearly the size of the state of Delaware, is the state's largest city.
It is believed that Alaska's first inhabitants migrated from Asia across the Bering Land Bridge more than 20,000 years ago. Today, almost half of the state's population can be found in Anchorage, where newcomers and natives enjoy what the Anchorage Convention and Visitors Bureau (ACVB) calls "a surprisingly mild climate" and rich cultural heritage. Average temperatures in the city of some 260,000 range from a high of 65 degrees in July to a low of 11 degrees in February.
Adding to Anchorage's appeal for nurses is the Alaska Native Medical Center (ANMC), the only hospital in Alaska to have earned the prestigious Magnet designation from the American Nurses Association. ANMC, which is also the state's only Level II trauma center, is a 150-bed hospital providing care to members of the 229 tribes of Native Alaskans and American Indians that call the state home. Three other hospitals in Anchorage, as well as a number of small hospitals across the state, offer a full range of services to meet the medical needs of the non-native population.
"At ANMC, our vacancy rate is less than five percent and our turnover rate is less than four percent," says Cindy Hamlin, RN, BSN, Commander USPHS and On-Boarding Coordinator for ANMC. "However," she points out, "vacancy rates are as high as 41 percent at some of the rural sites run by the tribal authority."
"We need OB and pediatric nurses," specifies Maryann Schaffer, Patient Care Administrator at Yukon-Kuskokwim Health Corporation, a tribally-managed 50-bed facility in Bethel, Alaska, approximately 400 air-miles west of Anchorage. Schaffer, who also serves as Chair of the Alaska State Hospital and Nursing Home Association's Workforce Development Committee, originally signed up for a two-year stint in Alaska. She's now been there for eight. "It's a very, very rich experience," she says, but admits it has its challenges.
"For many people in our region, English is a second language," Schaffer says. In addition to that, nurses relocating from the lower 48 are likely to find the customs, culture and even the cuisine to be different. And then there's the weather, which can play a significant role in day-to-day affairs. "If you've got someone down for a 10:00 appointment," she points out reasonably, "you can't count on the plane landing at 9:30. Same with the discharge," she adds, "if the plane can't fly, the patient isn't going home."
"It's always been a struggle," Hamlin says of the challenge of filling vacancies in the state's more remote areas, "but even more so with the national shortage." Several programs have been instituted to help meet the growing need.
"We are working to 'grow our own' so to speak," Hamlin says, referring to various programs in the state designed to increase the number of nursing students at the University of Alaska Anchorage (UAA) and to increase the number of Alaska Natives working in the field of healthcare.
"We work with the National Health Service Corps on a program which gives loan repayment to nurse practitioners working in underserved areas," Jean Findley, health program manager, State of Alaska, Department of Health and Social Services, says, adding that student scholarships for nurse practitioners are also available through the program.
The UAA School of Nursing offers programs to prepare individuals for practice as Registered Nurses, Licensed Practical Nurses and for advanced nurse practitioners, clinical nurse specialists and nursing administrators. "ANMC serves as a clinical training facility for the University of Alaska-Anchorage associate, baccalaureate and graduate nursing programs," Hamlin says, adding, "ANMC also collaborates with the Recruitment and Retention of Alaska Natives into Nursing (RRANN) program at UAA." RRANN, a program launched with federal grant money in 1998, is designed to recruit and mentor Alaska Native students pursuing nursing degrees.
Expect things to be different in Alaska. According to the Alaska Travel Industry Association (ATIA), the state has an estimated 100,000 glaciers as well as 80 percent of all the active volcanoes in the U.S. Alaska has the busiest floatplane base in the world. It also has more than three million lakes. Alaska even has its own time zone.
"You can start the day in a city that has everything from Wal-Mart to Nordstrom's and end the day in a village without running water," Hamlin says. "Many small villages are still living a subsistence lifestyle. Many still speak the native tongue," she reports, but adds, "In even the most remote village, they'll have television."
The simplicity of many tribal lifestyles shouldn't necessarily be confused with economic hardship. The state's abundant natural resources continue to provide the basis for a stable economy, but where fur trappers and gold mines once fueled the financial engine, oil and natural gas now dominate. Since the Trans-Alaska Pipeline was completed in 1977, more than 13 billion gallons of oil have flowed from the North Slope to the port of Valdez in Prince William Sound, according to the ATIA. The cost of living in Alaska tends to be high, largely because most commodities have to be shipped in. On the bright side, however, taxes are low and the scenery is spectacular.
Within the Arctic Circle, whaling continues to play a pivotal role in the life of the large Eskimo settlement at Barrow. Nome, located on the southern coast of the Seward Peninsula, isn't on the road system, but from Anchorage it's only an 80-minute flight or, for those who follow the trail of the annual Iditarod Trail Sled Dog Race, a mere 1,200-mile long sled ride.
The breathtaking fjords and dramatic scenery of Alaska's Inside Passage provide a home for bald eagles, sea lions and whales as well as for the onion-domed churches that hint at the role Russia played in the region's past. With a population nearing 30,000, Juneau is the Inside Passage's largest city. It is also the state capital, a great spot for glacier viewing and, according to American City Business Journals, one of the top 20 places to live in the U.S., based on quality of life.
From volcanoes to the windswept Aleutian Islands and from hills and plains to the birds and bears that populate them, "For those with a naturalist streak," the ATIA reports, "few places on earth compare with the wonders of Southwest Alaska." In the state's interior, Mt. McKinley, the tallest peak in North America, climbs high above tundra and forests populated with mighty grizzlies and stately herds of caribou. Fairbanks, the state's second largest city, is the regional hub and serves as a gateway to some of Alaska's most popular wilderness destinations and recreational activities.
"Before I moved here, I thought it was all ice and snow," Findley admits. Now, after 25 years in the state, she knows, "There's a lot of variety in Alaska and a lot of opportunity."
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