By Diane E. Lewis, Globe Staff, 9/15/02

For as long as she could remember, LaTanya Robinson, 23, of Dorchester, wanted to be a nurse. ''There is something about taking care of people when they are sick that has always interested me,'' said Robinson. ''It makes me feel as if I am helping or doing something good.''

But after graduating from the University of Massachusetts at Boston last December with a bachelor's degree in nursing, she began worrying about the long hours, the heavy patient loads, and the stress -- byproducts of a critical nursing shortage that shows no signs of easing.

At one point, Robinson contemplated not taking her board certification exam and continuing her current job as a nurses' aide until she explored other career options more thoroughly. She has since changed her mind, and plans to take her nursing boards in a few weeks.

Increasingly, new nurses like Robinson are casting a more critical eye on the profession, and they are beginning to leave the field in higher numbers, reports Julie Sochalski, an associate professor at the University of Pennsylvania School of Nursing. She says the trend could pose long-term problems for hospitals and clinics across the country.

''We know the nation is facing a shortfall of nurses,'' said Sochalski, ''but if new registered nurses are leaving the profession after only a few years, the shortage is likely to reach crisis proportions sooner rather than later.''

Ernst & Young reports that nursing shortages at hospitals and clinics will exceed 500,000 positions by the year 2020. This trend is expected to coincide with growing demand in the biotechnology, pharmaceutical, and medical device industries for professionals with medical or health care experience, according to the management consulting firm. In the pharmaceutical industry, demand for nurses and other health care professionals will increase 35 percent in the next decade alone, according to data from the Bureau of Labor Statistics.

Sochalski's research reveals that new male nurses are leaving the profession at a higher rate than young women. Her study analyzes and compares survey data collected from 36,000 nurses by the US Department of Health and Human Services in 1992, 1996, and 2000. It shows that by 2000 7.5 percent of new male nurses left the profession within four years of graduating from nursing school, up from 2 percent in 1992. By contrast, 4.1 percent of young women in the field left the profession within four years of leaving nursing school, up from 2.7 percent in 1992.

''New nurses begin their careers with higher levels of job satisfaction, but the workplace itself seems to be convincing growing numbers to leave the bedside earlier in their careers for other professions,'' said Sochalski.

In Massachusetts, the demand for skilled nurses began increasing after hospitals reduced costs in the 1990s and laid off highly paid nursing specialists, reports Judith Shindul-Rothschild, a professor of nursing at Boston College. With the aging of the patient population, hospitals experienced new stresses. Meanwhile, the median age of nurses rose, resulting in more retirements. At the same time, fewer replacement nurses were graduated. The problem worsened when applications to nursing schools fell 5 percent by the end of the 1990s.

Asked where younger nurses are going, Sochalski said: ''We know, anecdotally, that pharmaceutical companies, biotech companies, health insurance, and managed care firms are very interested in nurses.''

That doesn't surprise Sherry Hayes, director of the Center for Industry Change at Ernst & Young in Washington, D.C. She estimates that demand in the bio-pharma industry for professionals and supervisors with health care or nursing backgrounds is expected to increase 17 percent over the next decade, and 14 percent in the medical device industry alone.

''Increasingly, it will be important for the biotech and pharmaceutical industries to have people who not only know the sciences, but also understand how health care is delivered,'' said Hayes. ''We are also seeing that job satisfaction among doctors and nurses has waned because of managed care. They've become wrapped up in a highly regulated environment. For many of these individuals, biotechnology offers an entrepreneurial and creative environment that is more flexible.''

When Sochalski examined the federal data she had collected, she discovered that close to 136,000 licensed nurses in the United States are currently working in other jobs. Of those, 45 percent had switched to health-related professions such as clinical research, safety management, drug marketing, or project management within the health research field. In all, there are 2.7 million US nurses.

Shindul-Rothschild, who has mentored several nursing students at Boston College, recalled a young woman who quit a hectic job at a busy health center 18 months after she graduated.

''She completed her night shift and was waiting for me when I got in,'' said Shindul-Rothschild. ''A child had literally died in her arms and she was very upset. She also felt helpless.... She shifted gears and used her nursing skills to get involved in research and started working for a pharmaceutical.''

The trend is also being watched by Texas-based allied health care staffing firm Martin, Fletcher. The company helps hospitals and health care institutions recruit doctors, pharmacists, nurses, anesthesiologists, and other health professionals.

''We are seeing a lot of movement in the nursing field in terms of biomedical work and even legal nursing,'' said Jody Talbert, vice president of marketing. ''At hospitals we are seeing salaries that range from $18 to $25 per hour, or between $35,000 and $47,000 per year, for beginning nurses. But some nurses, working weekends and late night shifts, are making as much as $70,000 per year.''

Faced with such intense demand, hospitals are fighting back, he said. Some have joined nurses in pushing for funding of the Nurse Reinvestment Act, which provides federal funds for education, including scholarships, geriatric training, and other grants to improve career ladder programs.

Many hospitals are also offering sign-on bonuses ranging from $5,000 to as much as $50,000, with a commitment of three to five years. About 85 percent of all US hospitals now offer sign-on bonuses, up from 50 to 60 percent five years ago, said Talbert.

''In Massachusetts, the average sign-on bonus, with a two-year commitment, is $5,000 to $10,000,'' he added. He said nurses with bachelor's or master's degrees are making $75,000 to $80,000 per year in private industry, with the added benefit of such perks as company cars.

Despite the obstacles, LaTanya Robinson has decided to pursue her dream. She's hoping to land a position as a registered nurse after she receives board certification.

''A lot of hospitals offered jobs,'' she said. ''I think all hospitals are going through the same thing right now, but I don't want to be too stressed -- wherever I go.''

Diane E. Lewis can be reached at dlewis@globe.com.