The Nursing Shortage: A self-inflicted wound? - Page 2

Two words that are like fingernails on a blackboard to me are "Nursing Shortage".....where I am in Southeast Florida there really IS no shortage and has not been for some time.

Same reasons....too many schools now, hospitals cutting staff....yada, yada, yada.....I personally know several experienced ICU nurses who have not gotten jobs in almost one year....and a new grad that is still looking for almost 2.

There are some jobs in LTC because of our abundant elderly population.....but I am really tired of hearing "that " phrase....

I agree with a lot of the article except for the statement that there is a nursing shortage and that there is a lack of new grad nurses willing to pick up the slack of those nurses fleeing the work place. I also disagree with the idea that this is a "self-inflicted" wound.

There is no nursing shortage and it needs to be repeated and repeated until the media gets it right, otherwise we will continue to have these completely futile discussions about how to create better conditions in nursing, and we will continue to focus on nurses themselves as the guilty party in creating those poor conditions to begin with.

Nurses have no control over the way the medical industry works. There are a lot of powerful people and corporations, big Pharma, for-profit organizations, the insurance industry, the media, lobbyists, and politicians who work together to create the current system. Nurses are just cogs in the wheel.

And I hate it when I have to read yet another article about how we have done this to ourselves because....well, I'm not sure what the because is.

Because apparently it's not enough that we have gotten through one more day of 10/10 stress, taken ourselves home, cried, tried to find some quality time with our families, paid our bills with a diminishing income, struggled to hold onto our homes and our pensions, struggled to find some joy in life, to take care of our kids, to continue our education so we can be better nurses, looked for some outlet for spiritual support, tried to eat or exercise, deal with our own health issues, and slept.

And then after trying to do all of that we haven't picked ourselves up and taken to the board rooms and the streets to go head to head with the power structure to change the medical industry, because somehow, the onus for change lies squarely on our shoulders and no body else's.

I'm just tired of the structure of this dialogue. To accomplish change, we need to first address the flawed foundations of the debate. Meaning that there is NO nursing shortage and there is NO shortage of new grads and the health care industry has no real impetus to change the way they treat nurses.

I'm seeing many signs in my area that hiring has improved dramatically. My hospital lifted a hiring freeze last year and new grad residency classes have 40 or so participants.

I graduated in May of 11. During our last semester, my school had a "Reality Panel" where 6 or so recent grads come and talk to the graduating class.

It was terrifying. Almost none of them had jobs. One was thrilled to have been recently hired in a nursing home and another was very hopeful about his chances at landing a hospital CNA job.

This year, I was a member of that panel. We all had jobs that varied from hospital to home health to contract work for insurance companies. In fact every new grad from my class who wants to work is working. Now, many of them aren't working where they want (in a hospital) but they are all working. (One of the grads from the Terror Reality Panel when I was in school was in my orientation class)

I know every area isn't experiencing the job prospect improvements we see in the Twin Cities, MN area, but things sure are looking better here.

I would also like to say that I don't believe there is a nurse shortage at all in this or many parts of the country. I'm in Western New York State and see only a shortage of good jobs as the hospitals seem to think nurses are just an expensive nuisance to keep on staff and much better to have lesser skilled staff take their places since any female in scrubs will be perceived as a nurse by the patients and a nuses is a nurse with no differentiation.
If the hospital gets caught in a bind and actually needs a RealNurse for some reason, then call an agency for one to be sent over. This is not to disparage LPN's or aides as I have worked with many who were just as skilled or smart as any RN, but lacking the paperwork, they are considered less skilled.
Just out of curiosity, I just went to the Indeed web site and put RN in the job search for my region-of the first 30 jobs listed, 18 were for agency/travel positions, 1 RN for dialysis (2 years ex. required), 1 RN for a psych pos. 2 years ex. req., 1 LPN nursing home, 2 RN pos with CCM cert., RN exp. in OB/GYN., RN to train aides for homecare, RN PT for cardiology,, 1 NP pos., 4 for TBI agency that was multiple posting of the same job, and a billing and coding pos.
This is what is out there in my area-either work an agency job, have a experience in a specialized area, or have home care experience so you can direct or train the aides doing the hard work. Where are the jobs for a new nurse wanting to go into a hospital to work?
I have 4 years of hospital med/surg. experience but got downsized out of my last position 2 years ago when the powers to be decided to close departments and cut the number of beds. Since then it has been pick up health screening clinics, flu and Zostravax clinics etc., nothing that is full time and with benefits.
I constantly get calls from agencies wanting me to take a position in Texas or California for a 13 week assignment, so from my observation, those are the states with nurse shortages, but not true of many others as I have two friends who are in a similar boat as myself in New England and Ohio.
Kathy, RN

Actually, it IS nursing fault that this has occurred. For YEARS, nursing has refused the ONLY solution to the problem-to unionize, en masse, and take control of our professsion.

Without a union to protect you, it is impossible to, "take to the streeets", like other professions, like teaching has. Teachers go right to the parents, when their profession is under fire, and cuts are made to the classroom. The are out in numbers, in the streets to protect their classrooms. Yet, no one has ever died because they could not do long division, or diagram a sentence. How many have died in the hospital because of deliberate short staffing?

The, "martry marys", of the nursing profession, "have nailed us to the cross", to prevent us from being the power we should be with out numbers. They use terms like, "unethical", not fair to our patients if we have to strike", or, my personal favorite, " I could never leave, MY PATIENTS", and walk out on strike.

In the first place, they are NOT, "YOUR PATIENTS". They have not contracted with you for care, they way they do with the hospital or doctors. It is the hospitals' responsibility to provide staff to care for them. Get over it.

It continually amazes me, that nurses have not figured out what is going on. The PTB, terrorize us, to prevent us from taking control, not unlike the slave owners of past centuries. As long as they have the power to control us, the problem remains. If and when we finally decide to take control of nursing, they will not longer have that power over us.

Doctors contract with the hospital to admit patients to the hospital. They have their lawyer, who are on their side, negotiate their services to the hospital, and have legally signed contracts, to uphold them.

Why can't nursing do the same? Because there are TOO many who are afraid to have control over anything. Let alone their practice of nursing.

Make it a priority to change the way you think. Call the NNOC to start an organizing campaign in your hospital. Just say no, to too many patients. Get together in groups on non work hours, and plan the takeover of your profession in your hospital.

Work with the members of NNOC, to make it happen. Remember, no one can take advantage of you without your permission. You can do it.

JMHO and my NY $0.02.

Lindarn, RN, BSN, CCRN
Somewhere in the PACNW

I do agree with this point. I work in a union facility and the idea of going back to a non-union facility scares the daylights out of me.

Even still, we don't really change things in my facility as we do hang onto our hats and try not to lose our jobs at the whims of management.

The problem I have with the national and state-level advocacy organizations is that they seem concerned only about the needs of RNs and advanced practice nurses.

I am an LPN, and am constantly frustrated, discouraged, and depressed that this dialogue has no room for the voice of LPNs.

We are nurses, we experience the same deplorable work conditions, the same challenges, failures, obstacles, rewards, and disrespect from management as RNs, and we have a lot to say about it, and yet, our voices do not count at all.

I am registered with my state's nursing organization but every single initiative they have taken, every communique, every newsletter, every outreach, is for RNs and above. Not a word of concern for LPNs.

If nurses want a stronger, more cohesive, and more powerful voice, then we need to include the voices of the millions of LPNs out there who are dealing with the same issues.

Getting back to the OP

There is not a nursing shortage, but nurses are still finding jobs better than in almost any other profession.

According to The National Association of Colleges and Employers, only 24% of new graduates across disciplines in 2010 had a job after graduation - My God, look at lawyers. However, new graduate nurses had a 56% employment rate right after graduation and that rose to 88% within 6 months after graduation. Although there is no promise of a job right after graduation, nurses are finding jobs much easier than in other professions. This is regional. I can tell because the coasts seem to have a bigger problem than the rest of the country. Here we had a record number of hires in 3 hospital systems across the state.

Lastly, if we are in fact going to 'fix' the problem, we cannot make sweeping brushstroke statements about the health of nursing. The statement that schools are "pumping out nurses" is not true when compared to census, aging populations, and prior need.

More than 50% of nurse applicants were denied admission into accredited nursing schools in 2010. Furthermore, according to the AACN and NLN, there has only been in increase of about 250 programs across the US in the last 10 years. Seeing as hospitals were begging for nurses in the last 2 decades (until the recession of 2008 hit) nursing schools were trying to provide the workforce with the supply of nurses it said it needed.

Since the US population grew by more than 25 million people since 1995 and the nation's population is projected to increase to 392 million by 2050 -- more than a 50 percent increase from the 1990 population size (U.S. Census Bureau), the rise in accredited programs was warranted. No one saw the massive economic doom of 2008 and as we recover, which I know we will, the system will balance out again.


I know it is horrible to be unemployed, but this a country-wide and even global issue - this is not specific to nursing.
http://www.aacn.nche.edu/media-relat...ollchanges.pdf
http://www.aacn.nche.edu/media-relat...ollchanges.pdf

Problem for nursing is that the profession tends to react rather than act, and this comes across on both ends (employers and nursing).

Aside from a few brief periods in the history of modern nursing there has never been *enough* qualified and well trained nurses. This is one of the reasons behind the creation of various UAPs such as NAs, scrub assistants, OR techs and so forth.

Then there is the fact the profession being a mainly female occupation it is very responsive to changes in the world of women.

Up until rather recently there was always a need for new grads because so many experienced nurses for various reasons such as marriage and or having babies, left their jobs or went to part-time status.

However as one has said often on this forum the nursing profession in both the United States and other developed western nations has never recovered from various laws/schemes meant to end employment discrimination against women.

While it may seem a joke to young girls today life before Title IX was *very* hard for women, especially those seeking to enter the medical professions. By *medical* I mean just that, doctors, dentists, etc..., for back in the day you would have had your head handed to you on a plate by including "nursing" under the same heading.

In order to gain entry into med schools one has to lay down educational chops starting almost in high school. Many girls simply were told flat out they couldn't take the required math and science classes because it would displace boys. If a girl wanted to do something in the healthcare field she was directed you know were; nursing. While this was on paper great for the profession as it produced vast numbers of new grads, many of those new nurses hated every minute of their job and quickly found a way out (marriage for instance). Of those that remained provided some of the most passive aggressive care one could imagine.

Once the educational and employment landscape opened up for women enrollment in nursing programs began a slow but steady decline. That coupled with changes in the healthcare system lead to many nursing schools closing. One other nail in the coffin was when the *managed care* craze swept though the USA in the 1980's and 1990's. Hospitals looking to cut budgets began getting shot of experienced senior nurses by the dozens. This despite warnings that from those ranks clinical instructors and professors were drawn. So what many in the profession predicted would happen came to pass. There was suddenly a "nursing shortage" but too few programs and worse instructors/professors as well.

Now things have come full circle as everyone and their mother ran to staff up and or create new programs churning out scores of new grads every six months. However as there always seems to be something, no one could have foreseen the economic meltdown of the past several years and how it would affect healthcare.

Another problem for nursing is what began during the managed care era; hospitals have been examining their business model and determining anything not central to that core has to go or at least be reduced.

Using the popular college class excercise, ask yourself what is the function of a hospital? This is not a purely academic query as the replies have a direct impact on the nursing profession.

Time was most all functions not falling under medicine fell under nursing. Licensed professional nurses did everything from clerical work to running CSS. Hospitals via their schools of nursing were also very involved in the education and training of nurses as well. But over the years for various reasons all that has changed.

I've said this before and though it pains many of you all to hear it am saying it yet again, nurses are labour for hospitals. Labour is a cost that all businesses seek to control. As the cost of providing nursing service (wages, benefits, etc..) increase hospitals are using them only for what is required; direct and or perhaps some indirect patient care. Up and down this country hospitals and their consultants are taking apart the role of a professional nurse to see what is the best use of her/him for their money. What can be done by UAPs for less cost is being farmed out to them. If you examine those rosy predictions about employment growth in healthcare you'll see CNAs, techs, and home healthcare aides make-up a large precentage of those numbers, indeed in some areas outpacing the hiring of nurses.

Patients by and large aren't that aware of whom is providing care at the bedside, and many probably do not care long as they are treated properly. Now that nurses by and large no longer wear caps and whites, but dress in most cases like everyone else from housekeeping to techs it is kind of hard to tell whom is doing what. This of course is not lost on hospitals and "patient care" then becomes a very large umbrella and not just restricted to "nursing services" provided by RNs and LPNs.

From my side of the world I have to say there still is a Nursing Shortage.

My hospital is constantly hunting for staff, every graduate I know had a job once completing their bachalor.

So in Australia there still does seem to be one, I'm from an industrial town. I think it's the economy if I had to make any guesses in America that killing job opportunities. Hard for me to say as I don't live there nor know how hard things are financially other than what I read and hear on AN and the news.

I personally just hope staffing improves over there and they allow budgeting for more staff it always sounds horrible when I read all the articles of nurses waiting for that postgrad job, interviewing and searching.

I wonder does the universities/collegues that way assist in placing nurses? Into jobs like they do here? It would be some help for new graduates maybe?