In Alaska nurse recruitment is even more difficult; harder still in hospitals in small Alaska communities.
In response, Central Peninsula General Hospital is refocusing some of its recruitment efforts.
Rather than just hunting the market for qualified nurses, CPGH is turning some of its attention toward cultivating them.
To that end, CPGH is contributing $50,000 to the University of Alaska Anchorage School of Nursing Expansion program, a contribution that will help sustain the program's outreach site at Kenai Peninsula College.
"When you grow your own, you're more likely to keep them," Flanders said.
The KPC branch of the program began in 2005 and accepts 12 qualified applicants every two years.
If the program increases the pool of local nursing applicants, the benefits to the community could be great, said Ryan Smith, chief executive officer of the hospital.
Nurse recruitment has been costly in rural Alaska. In the last year, urban centers have paid approximately $10,500 in recruitment costs per nurse.
But in rural areas, hospitals pay as much as three times that amount - an average of $36,000 for every nurse hired.
"There is a nationwide shortage so the competition for them is pretty high," said Loretta Flanders, president of the CPGH board.
"(But) particularly in a place like this where we're geographically isolated."
Flanders said when CPGH does not have a sufficient number of nurses, finding substitutes is costly.
"At times we have to bring in the traveling nurses," she said, referring to nurses hired to fill in temporarily when a hospital has a nursing shortage.
"And they're very expensive. They cost more than a regular hire."
With the exception of specialized nurses, CPGH has been relatively successful in its ability to recruit nurses, Smith said.
Nonetheless, a greater pool of nurse applicants would greatly benefit the hospital and the community, he said.
Between CPGH and Heritage Place, a skilled nursing facility purchased by the hospital and Kenai Peninsula Borough this year, 139 registered nurses are employed. In 2005, the hospital's turnover rate was 14 percent.
There are currently 10 open positions available at the hospital.
In addition to boosting the local pool of nursing applicants, a local nursing program allows the hospital and potential applicants the opportunity to foster a relationship while the aspiring nurses are still in school, said Jan Harris, associate dean of Health and Social Welfare at UAA.
"It means the students have an opportunity to work at your facility," she said. "And your facility gets to see the students at work before they graduate. It's a great recruitment tool to have students right there."