Economic woes have become a matter of daily living, it seems, as more and more employees lose their jobs and companies go out of business.

But one field that appears to be immune to the crisis thus far is health care, and nursing as a career remains a viable for many North Country residents entering the workforce or changing career directions.

"Health care is a special field," said Julie Brunell, associate vice president of patient services at CVPH Medical Center. "It doesn't matter whether it's tough times or good times: people will still need health care."

If anything, an extended nursing shortage across the nation has fueled a need for more nurses to enter the field over the last decade, a situation that only deepens as the country's baby boomers grow older.

"The baby boomers represent such an extensive and demanding population mass," Brunell said. "This is a group of individuals that are health conscious and want to be more active and more healthy. They are seeking out more health care than any previous generation."

Many nurses in the field today are baby boomers themselves and will be looking toward retirement in the upcoming decade, adding another twist to the shortage.

CVPH Medical Center struggles each year to fill its needs for full-time nurses and typically will hire a large percentage of nursing from each graduating class at Clinton Community College as well as through recruitment from other areas.

"We do seem to be getting more candidates from metropolitan areas," said Zaidee Laughlin, director of recruiting for the hospital. "There seems to be more economic uncertainly in the larger cities. It's a good time for working in a smaller community."

The nature of nursing itself has also opened up possibilities for new nurses while adding to the consternation of hospitals.

"There are a lot more options for nurses to go in different places than there were historically," Brunell said. "Generally, nurses would go directly from school into the hospitals. Now, there are a lot more physicians offices, health clinics, public-health specialists."

Such specialty areas as dialysis units are becoming popular attractions for both experienced and new nurses entering the field, she added. Those areas allow nurses to develop a long-term relationship with their patients, she explained.

The nursing staff already in place at many hospitals also remains in flux as nurses move from one area to another as they search for the care that suits them best.

"Zadie and I talk a lot about retention," Brunell said. "We ask our nurses, 'Where would you like to be?' and then we try to accommodate their needs. We don't believe a nursing career in the hospital should be a negative experience."

Although a majority of nurses who become registered nurses through an associate's degree program don't continue their education beyond that point, a major emphasis in the health-care field has been on expanding the role of education.

"Without a certain percentage going through and getting their bachelor's degree, we won't fill the need for leadership roles," Brunell said.

Margaret Sorensen, vice president of Patient Care Services for Adirondack Medical Center in Saranac Lake, recognizes the benefits of a career in nursing but is also cautious about the negative impact one may have when moving blindly into a career out of financial necessity.

"A lot of people who choose nursing go into a two-year program, come out as a functioning RN and make a solid career for themselves," she said.

"But the field can become very competitive. A lot of time people who are experienced nurses come out of retirement, and that may slow down opportunities for new nurses."

Joann Gleeson-Kreig, director of Nursing at Plattsburgh State, has a similar concern from an education perspective.

"I am seeing an explosion of interest in nursing," she said. "I'm seeing more and more students who want to change from their current major into Nursing."

"Nursing requires a certain skill, a certain set of characteristics," she added. "Not everyone is going to possess those characteristics. Some people may want to come into nursing because it is a job, but that is really not the best reason to choose nursing.

"You really have to have an intellectual ability and an emotional commitment. Otherwise, nursing is not going to work for you."

Sorensen also questioned whether the need for health-care providers will remain steady if economic woes continue for an extended time.

"The federal government in general is looking to cut costs (in such programs as Medicare and Medicaid)," she said. "When hospitals aren't getting paid, they may look at the work force. If a place isn't busy, are they to remain fully staffed?"

As unemployment rises and people lose their health insurance, such things as elective surgeries will see dramatic declines, creating a "downward spiral that affects patient volumes, Sorensen noted.

Those concerns are sometimes compounded in a rural community where it can be difficult to recruit doctors, but AMC has had good luck attracting quality nurses, particularly with its strong relationship with the nursing program at North Country Community College.

Clinton Community College, a major source of new nurses for CVPH, has seen a significant increase in numbers applying for the Nursing Program.

"We've seen a large increase in the number of applications this year," said Martha Hewitt, admissions adviser for the college, noting that the college received 351 applications for 70 seats in the 2009-10 Nursing Program.

The college will typically receive between 250 and 300 nursing applications, she said.

"This year, I've noticed more applicants who had previous degrees and are considering a switch into nursing," she said.

Traditional students — those coming out of high school — have also been better prepared with strong math and science backgrounds, she added.

The college uses a points system to determine which applicants will move forward into the Nursing Program. They receive points for having appropriate courses in high school along with such areas as experience, college credits, recommendations and a personal narrative.

"The trick is to be the most competitive you can be," Hewitt said. "There are several pre-requisites for nursing admission."

Prospective students must have successfully completed high-school biology and chemistry along with a math background that will enable them to enter a college-level math course," she said. They must also have adequate scores on SAT or ACT tests that demonstrate their ability to complete college-level coursework.

Students without those requirements can enter a pre-nursing program to help bolster their chances for admittance into a program.

"It's been a very competitive year," Hewitt said. "We're extremely pleased with the applicant pool. Nursing is a rigorous program, and these students have to be able to dedicate a lot of out-of-classroom time in order to succeed. This class, I think, is going to be very strong."

A major issue significant to nursing for some time now has been continued education toward bachelor's and master's degrees.

Plattsburgh State's Nursing Program has seen significant increases as well, but a more ominous issue is with finding qualified educators to help fill the classrooms that are needed.

"There are a large number of programs across the U.S. where they turn away applicants because there are not enough faculty to teach the classes," Gleeson-Kreig said.

"This is still a large shortfall in what's going to be needed (in nursing) and the number of nurses being educated. I'd love it if we had a situation in which we could meet that shortfall, but we just don't have the faculty (nationwide)."

Many of the nurses graduating from the four-year program at Plattsburgh do not remain in the area to begin their careers, but Gleeson-Kreig said she believes the number of graduates staying local is higher than most people think.

"When I'm walking in the hallways at CVPH, I am always being greeted by nurses that came from the program," she said.

Plattsburgh State is seeing a large increase in the number of RNs with two-year degrees returning to college for a bachelor's in Nursing, she added.

E-mail Jeff Meyers at: jmeyers@pressrepublican.com