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Eight nurses, clad in blue scrubs, tend to patients as they roll out of surgery to the post-anesthesia care unit at Presbyterian Hospital.

Even on a Monday afternoon it's a busy place, with machines beeping out heart rates in the background as caregivers hover and check on groggy patients to make sure they're recovering properly.

The setting is also somewhat uncommon in the health care world - about half the nurses are in their 20s and 30s, and the patient load averages two or three per nurse.

More common - even in other departments at Presbyterian - is an aging nurse population, with nearly three-quarters of the staff older than 40, and worker shortages that sometimes make it necessary to split a nurse's attention between six or more patients.

"The ratio can get so high its overwhelming," said Tanya Jaramillo, 39, who just started working in the post-anesthesia unit. "You can focus better here."

Hospitals all over town have similar issues, where the ratio of nurses to patients is 1 to 6 or even higher, said Jaramillo, who graduated in December with a two-year nursing degree from CNM.

"There's no staffing limit in this state," Jaramillo said. "The hospitals try to balance it out, but it's just evidence of the shortage. It's everywhere."

This is only the beginning. A deep breath before the real nursing shortage begins.

Across the medical field, the staffing problems are likely to get worse before they get better, experts say.

The majority of nurses working today are baby boomers - a generation of about 77 million people born between 1943-61. The next generation, born from 1962-81 and known as Generation X, only has about 44 million in its ranks, said Breda Bova, a generational expert at the University of New Mexico.

That means that as boomer retirements continue to rise during the next decade or two, the number of nurses available to fill those empty positions could drop dramatically - at a time when the elderly population that needs health care is growing.

"Really it's across every industry - the problem is how do you manage the large departure of people with a much smaller work force coming in to fill those gaps," Bova said.

The population of doctors is dropping, as well. A 2004 study found 30 percent of physicians were 55 or older. Between now and 2020, that study predicted 23,000 physician retirements and deaths, and only 16,000 to 17,000 replacements coming in, Bova said.

As nurse and doctor populations drop, the situation in health care 10 years from now looks grim, said Sharon Phelan, director of career advancement at the University of New Mexico School of Medicine and a professor in the Ob-Gyn Department.

"If there's not something major that happens, I think we're going to see a widening gap of people that don't have access to care," said Phelan, 57. "If people want to see a doctor, they could wait months. I fear there's going to have to be some sort of rationing. There's going to be an infinite need and finite resources."

Hospitals have already started plotting ways to recruit Generation X and the younger Generation Y - the 70 million people born between 1982-98 - into a labor market that has started shifting to their favor.

What those generations are looking for in a job, however, is far different than what the boom generation demanded, Bova said.

"If you look at a boomer nurse, they had to work their way up the ladder, put in long hours," Bova said. "We often find now the younger generations don't want to work like that."

That's something Lea Gerkin, another nurse in the post-anesthesia unit who was born at the tail end of the baby boom, said she's noticed.

"My parents told me to work hard growing up - you don't call in sick; you have a responsibility to your employer," Gerkin said. "In the old days, when you got out of nursing school, you'd have to do your induction. That's six to 12 months of heavy shifts. The younger generations don't have to do that anymore."

Generations X and Y are more likely to demand a greater balance between their work and their life. They don't want to work 36-hour shifts. They want time for their families, Bova said.

"Gen X college grads, especially women, are looking for a lot more flex-time," Bova said. "They want to spend more time with their kids and have a life. Organizations are trying to figure out how to court them and keep them."

Generation Y has similar demands, but its members also want variety. They want the ability to move around and explore different areas; they don't want to settle down, Phelan said.

"Generation X and Generation Y are very dedicated, hard-working folks, but they're also saying, `We have a life,' " Phelan said. "When they're working, their work is hard and diligent, but they're not willing to be the 24/7, work-is-their-life people that the baby boom and silent generation (before the boom) were."

Flex-time is a growing trend across the medical industry. Nursing hours have changed to a mostly 40-hour workweek, with optional overtime, Phelan said.

But that also increases the labor shortage issues - and might not improve the overall situation much, Phelan said.

"To replace an older nurse or physician might take you 1.4 younger ones, because they won't work the same hours," Phelan said. "But those kinds of hours that the older ones worked maybe made you not as attentive and more burned out. It's a mixed bag."

Managers at University of New Mexico Hospital are trying to lure workers through several types of schedules to meet mixed demands, said Valerie Grant, the interim recruitment manager who hires nurses.

"Some do 12-hour shift schedules, with three days on and four days off," Grant said. "Others work four 10-hour shifts or five eight-hour shifts, depending on where they work."

Keeping boomers in the work force longer has become another priority at many hospitals, and it could help lessen the impact of the shortage, Grant said.

But as their bodies age, some tasks become harder, said Cisco Sedillo, director of recruitment and retention at Presbyterian.

"We've been trying to figure out how to get boomers back in the work force," Cedillo said. "There's a lot of technology with lifting patients. The hardest part is the physical demands, so we're trying to figure out how we can accommodate them to make that better."

Shorter shifts - like eight-hour rotations - seem to help boomers, Gerkin said.

"When you get older, the 12s get harder," she said.

For the younger, variety-hungry Generation Y, Presbyterian is trying another way to lure nurses through its residency program. In that approach, nurses work rotations in several specialties, then get to pick the one they like best, Cedillo said.

"They can float between programs and experiment," Cedillo said. "It's been received very well. The more flexible you can be, the more choice you give employees, I think it makes them happier."

That's what drew Amanda Torres, 28, to Presbyterian. She graduated in December from CNM with a two-year degree and has tried rotations in two areas so far, she said.

"All the types are so different," Torres said. "If I wanted to go into research, I could go into research. You can do politics and government work. It's such a diverse career under one title."

Hospitals are also reaching out to the youngest members of Generation Y - those still in the K-12 school system - in hopes they can draw more nurses and doctors into the field, Grant said.

"We're talking to students, giving tours, developing mentoring programs to keep kids engaged," Grant said. "We're studying their demands, and we're talking to our employees about what they think will help."

Will all that be enough to make a difference? Nobody really knows.

In some ways, it's a matter of bodies, and the labor situation doesn't look too hopeful.

Still, Jaramillo says she isn't leaving anytime soon.

"I hope in 10 years things are still OK, but I don't know," Jaramillo said. "They need to bring nurses back that left. They need to hire more. We'll see what happens."