MONTGOMERY, Ala. (AP) — It's a rare break at the nurses' station, only a few minutes before her next call, but Brittany James' voice fills with emotion as she explains why she decided to devote her life to becoming a caregiver. She doesn't talk about salary, or hours, or opportunities. She talks about the last moments of her grandmother's life.
"I watched the hospice nurse literally care for her up until the point she passed," James said. "It meant a lot to be part of that, even at a young age. It inspired me to be that nurse, that person who helps other people.
"I had no idea what it paid. I had no idea how to research jobs."
There are plenty to find. A rapidly aging Alabama needs a small army of young nurses, personal care aids, physical therapists and other health professionals, and the need is growing. In fact, 13 of the 20 fastest-growing jobs in Alabama are health care related, according to state figures.
That top 20 includes nurse practitioners but doesn't include the about 6,500 more registered nurses Alabama will need in the next six years, according to state estimates.
There are also some of the highest-paying jobs in Alabama. Nurse practitioners make an average of $93,000 a year here. Physical therapists average nearly $87,000 a year. That's more than industrial engineers.
But James, now a 28-year-old nurse manager at Baptist Medical Center South, said that's not what matters to her or to most of the other young people who are considering health care. "We have a lot of young students that come through this hospital, and they all have something special," James said. "They've helped care for a loved one, or they've been in a situation where they've been cared for. It just takes a special person and a want to do this."
Baptist Health employs more people in the River Region than Hyundai, and it wants more. It has started recruiting in area high schools. Baptist South COO Ginger Henry asked a class of 20 at Prattville Christian Academy how many of them want a job. Every hand went up. "I can hire every single one of you," Henry said.
Universities would like to train all of them, too, or at least enough to meet the demand. Unfortunately, it's not that easy.
First of all, they'd need more faculty. Alabama State University's College of Health Sciences trains physical therapists and occupational therapists, two of the fastest-growing jobs in the state. But they have to maintain a minimum student-to-faculty ratio.
"It's not like English where you can put 100 kids in a lecture hall," Dean Cheryl Easley said. "We have a tremendous student demand, and that's the case across the country in many (health care) professions. Where we're stymied is we don't have enough faculty. And the faculty we currently have is aging."
But recent industry changes mean that faculty must have or be pursuing doctorates. That means they'd have to give up lucrative careers in private practice to go back to school for several more years, for little financial reward. Few make that decision.
It took ASU three years to fill two open faculty spots at the college. Expanding the program — even with administration support — would mean finding even more.
Then they'd need a bigger building. They've maximized their teachers and space by training different disciplines together early on. "With our faculty shortage, if we were not interdisciplinary, I don't know that this program would still be here," said Susan Denham, chair of the Occupational Therapy Department.
The three health programs at AUM's College of Nursing and Health Sciences also share space, and all three expect to have their largest enrollment in history this fall. They've hired three new teachers and are looking for more. A graduate program starts this summer.
"We certainly have more applicants than we've ever had to the nursing program, and better qualified applicants," said Jean D'Meza Leuner, dean of the college. "We're hoping to open our doctoral program in a year. We want to continue to grow."
One of the limits on that growth, for AUM and others, is the pool hospitals and clinics where students can train.
"We're a medically underserved state," Denham said. "Everybody thinks about UAB. Well, you can't send 300 students to UAB for every rotation.
"We graduate 24 students, typically. We don't have 24 spots in Montgomery, and we're the third largest city in the state."
Out-of-state health care providers are drawing away a chunk of the ones who do graduate by promising to pay for their education. Denham said up to half of the program's new occupational therapists immediately leave the state to go to work for a company that will repay their student loans. "There are companies (in Alabama) that do this, but they're national companies," Denham said. "If they have a greater need in Atlanta than they do in Alabama, they're not going to promise a student that they'll keep them here."
Meanwhile, the need for new therapists keeps growing. Easley, the dean of the college, was at work recently after knee surgery and is currently going through physical therapy. She's part of an Alabama Baby Boomer population that isn't settling in for an idle retirement.
"People are not aging like a stereotypical grandma in her rocking chair," said Jill Heitzman, interim director of ASU's physical therapy department. "They're aging very actively and they're working a lot longer. Now, they're living into their 80s, their 90s, and even their 100s."
Some of AUM's growth came through a partnership with Baptist. For the past five years, Baptist has funded the development of a specialty nursing course to help fill its specific needs. Baptist Health paid the teachers and paid the tuition for the students.
Molly Moon was part of the most recent class, all of whom were hired. She starts in the emergency room at Baptist South this summer. Moon said a lot of her friends graduated in other fields and are happy to get any kind of job, but she had a choice of several.
Still, the 24-year-old Moon described it as "a calling" and said she's thankful universities are preparing her generation to care for an aging Alabama.
"The more we can do to prepare nurses to meet them with compassion and understanding, the better," she said. "You have 20-year-olds coming in taking care of 80-year-olds. It's important that we offer them the same dignity that we would want, or that we'd want our grandparents to receive."