Study of U.S. Nurses Finds Young Leaving Profession; Shortage May Reach Crisis.... - page 3

Study of U.S. Nurses Finds Young Leaving Profession; Nurse Shortage May Reach Crisis Sooner than Thought September 5, 2002 In one of the most far-reaching studies of... Read More

  1. by   papawjohn
    Hey Y'all

    I just was reading this LOOOOONG thread under the UK Nurse's forum about adjustments they have to make upon moving to the US. Apparently they have different work expectations and environments. Are there any UK Nurses reading here that want to toss in their .02 worth?

    P-J-
  2. by   directcare4me
    Quote from ocankhe
    It is not about education. The question is are nurses who are working in nursing but not in the hospital at the bedside, are they leaving the profession as rapidly as those working at the bedside? If they are then something is wrong with the profession as a whole. But if it is only the bedside nurse that is leaving then one must look at the working conditions of the bedside nurse. Remember even though when we think of what nursing is we have an image of a bedside nurse over 40% of nursing employment is not hospital based. I didn't read the whole study so I am not sure if these variables were taken into account.
    I think you've made a very good point here, and it touches on something that's been a major pet peeve of mine for years. Conditions at the bedside will never improve, and will probably only get worse, as long as "bedside nursing" is looked upon as the "bottom rung of the ladder" in our profession.

    My thinking is pretty radical, because it would involve making bedside care givers lateral to educators and managers, instead of "beneath" them. Long-time bedside nurses would reach a point where they were not required to work weekends or holidays; new grads would know that if they stayed and put in the years, they too could remain a direct care provider and have these benefits.

    This is just one superficial example. Having the different areas of nursing be lateral to one another I think would increase respect and bedside nurses wouldn't feel like they had to leave the bedside in order to "advance" their career.

    JMHO.
  3. by   TinaRiy85
    I think one of the reasons people are leaving earlier is because they are told all these great things about nursing. How much it pays, huge sign on bonusese,benefits, etc. I used to think I would make 50,000 starting out as a nurse. Boy was I wrong. That is what poeple are led to believe. Nursing is so built up and peopler are rarely told about all the downsides to nursing.
  4. by   Hellllllo Nurse
    Quote from papawjohn
    Hey Helllllo

    Gosh. Where do y'all live?

    Papaw John
    Texas panhandle, and my friend is in KS.
  5. by   OC_An Khe
    Quote from TinaRiy85
    I think one of the reasons people are leaving earlier is because they are told all these great things about nursing. How much it pays, huge sign on bonusese,benefits, etc. I used to think I would make 50,000 starting out as a nurse. Boy was I wrong. That is what poeple are led to believe. Nursing is so built up and peopler are rarely told about all the downsides to nursing.
    Yes there are downside to the nursing profession, but there are downsides in all professions also. If you are willing to move you can easily make over $50k per year. But as many posters on this board have said, salary isn't everything. Adequate staffing, professional respect, as well as commensurate salary and benefits are needed before we can begin to address this shortage.
    It would also help if nurses would stop their professional destructive behavior that is so often aimed at their fellow nurses.
  6. by   neonatalRN
    People here in Minnesota do make $50,000 starting out. I guess I am very lucky, at the hospital I work at, nurses are treated very well. I am sorry to hear that isn't the case everywhere.

    Heidi
  7. by   babs_rn
    I have also noticed a bit of a drop in wages. With 17 yrs nursing behind me, I'm at the max-out level in the ER in which I work per diem (to be able to make a living on top of my nursing management job) and that max-out hasn't changed in a few years. I get a small lump sum check every year instead of a raise. But I also notice that the agencies aren't paying much more than a staff nurse gets paid anymore. Sometimes less. Travel reimbursements aren't keeping up with the costs of travel. In the end, sometimes it just doesn't seem worth it. I could make as much or more driving a truck for UPS. Without all the stresses. Without all the wild and crazy hours. Without all the abusive drugged-out patients who think no one else matters but them and what they want.

    $50K a year? After taxes, that simply won't pay the bills anymore. Not for a single mom with two teenagers anyhow (I pay the child support thanks to nursing shifts). I'm shelling out nearly $5000 a year just in gasoline alone thanks to the hefty commute that is required to have a position that allows me weekends with my children. (Nope, no gas-hog of a car. Just a long commute.)The fact remains that in any other industry we would be paid twice as much for the level of responsibility that we hold.

    I agree that there is a problem with the nursing schools and the only thing I can figure that has spurred that is the push to get as many graduate nurses as possible so the demands that used to exist in nursing education are simply not being enforced. How do I know? I used to supervise nursing students in a previous job and their instructor graduated them without coming to my place of employment and getting their evaluation forms. I called her to remind her I had them (and some were not good - some would just stand around and socialize, leave early, etc). She never returned my calls. Apparently clinical evaluations weren't really even necessary. The school was under pressure to pass them to keep getting the tuition money and to get nurses out into the working world. Whether or not they stayed or succeeded was inconsequential to them.
    Last edit by babs_rn on Sep 24, '05
  8. by   hipab4hands
    Quote from sbic56
    Makes me crazy when administration instructs us how to speak on the phone. Might as well add receptionist and secretary to the list of what we as nurses must do...and do well! Give me a break!
    The worse part of the whole thing is that they have a "script", we are supposed to follow, when we speak to patients on the phone.
    It's frustrating to know that you have saved a pt's life by getting paramedics out to them, but be written up by Quality Assurance because you didn't say "Thank you or address the patient as "Sir or Ma'am".

    I feel like a telemarketer, rather than a nurse.
  9. by   Judee Smudee
    Quote from babs_rn
    I have also noticed a bit of a drop in wages. With 17 yrs nursing behind me, I'm at the max-out level in the ER in which I work per diem (to be able to make a living on top of my nursing management job) and that max-out hasn't changed in a few years. I get a small lump sum check every year instead of a raise. But I also notice that the agencies aren't paying much more than a staff nurse gets paid anymore. Sometimes less. Travel reimbursements aren't keeping up with the costs of travel. In the end, sometimes it just doesn't seem worth it. I could make as much or more driving a truck for UPS. Without all the stresses. Without all the wild and crazy hours. Without all the abusive drugged-out patients who think no one else matters but them and what they want.

    $50K a year? After taxes, that simply won't pay the bills anymore. Not for a single mom with two teenagers anyhow (I pay the child support thanks to nursing shifts). I'm shelling out nearly $5000 a year just in gasoline alone thanks to the hefty commute that is required to have a position that allows me weekends with my children. (Nope, no gas-hog of a car. Just a long commute.)The fact remains that in any other industry we would be paid twice as much for the level of responsibility that we hold.

    .
    I have noticed same thing. Was a jump in pay for a while but it seems as pay is slumping again. I recently checked out agency pay. It was the same as it was 10 years ago. Couldn't believe it but I think maybe the institutions are setting the rates now instead of the agencies.
  10. by   jtmcphee
    I'm just one of those lowly "tech" LPN students facing 8 more months of training that I know will be inadequate, with the fear that I will never get the apprenticeship and mentoring that might make me a really good nurse. How many RNs, BSNs and MSNs on the wards today have the energy or interest to bring newbies along and help them not to kill patients? Maybe I should just qualify as a nurse's aide and call it good? Seems like that is the level of esteem that lpns garner in a lot of quarters, even though many of them have the potential to be Nightingales of their generation. The money is not all that different from what LPNs get anyway, with a lot less risk and liability.

    Going into the nursing business (which IMO like everything touched by capitalism, "entrepreneurship" and the profit/greed motive, health care inevitably becomes), and coming from another "profession" -- law -- that displays the worst of human commercial and consumer traits, I have my eyes pretty wide open. My prayer is that there are still niches where the all-consuming reach of the "other" Masters program (MBA) does not extend.

    There seems to me, on obviously short acquaintance, there is no real set of "solutions" to skill shortages, lousy pay for risks assumed, flight from the profession, "eat your young" syndrome, the bottomless gluttony of drug manufacturers, hospital-owning corporations, a couple of "lost" generations with no learning in civics, no common goals, no sense of governance in most of our leadership, the flood of "my idea is just as good as yours" content that runs away from what you might call social homeostasis, and the pervasive greed, tribalism and other ills that beset us.

    If the goal is to have caring people with at least minimal skill sets at bedside, in a sufficient ratio of caregiver to patient such that caregivers aren't forced constantly to work at the limits of human endurance and competence, there are some major things that have to change, which appear to this former lurker to have been discussed widely here and also appear unlikely to improve in this lifetime. If the goal is to set the bar high, in hopes that shortages of professionals will drive up the price of nursing services (lawyers used to do this, until universities discovered that law schools are very profitable), that may be good for those with the credentials and already in the profession but not so good for the aging population that needs health care services.

    Maybe it would be interesting to look at our culture, our nation and our species the way a physiologist looks at an organism. There's a complicated Krebs cycle that produces energy (wealth from the economy), and a whole host of positive and negative feedback mechanisms that tend to maintain some kind of stability in the conditions necessary for life. If we let our schools teach dreck because teachers know less every year and morph into "educators" that are forced by politicians to focus on teaching just what's needed for the next generation of teachers to barely pass standardized tests, that's about on a par with respiratory acidosis on the way to the endpoint outcome of that condition.

    IMO we are all part of a larger organism, and like the individual cells of the body we die if the organism does. There are lots of pathogens and malignancies constantly challenging that body. It's too bad that more of the billions of little decisions that, like chemical reactions in living processes, make up the commerce and energy exchanges that keep our bodies alive, aren't informed by "genetic" instructions to work toward keeping the body healthy. Too many "cells" and tissues in the body politic seem to me to be neoplastic and malignant -- like tumors, drawing blood supply and energy to themselves at the expense of the rest of the body and ultimately resulting in death. Look at the corporate and government types who pay themselves huge incomes while cutting pay and benefits and squeezing the last drop of performance out of the breathless wage slave. Look at the Big Lie of marketplace capitalism, that says price gouging on a wasting energy resource (petroleum) is just peachy, and informs the attitudes of "leaders" who don't give a rat's whatever for what comes after the last drop of sweet Texas crude and cubic foot of natural gas. Because they will have lived well in the little bracket of time that they occupy. "Apres moi, le deluge," said a notorious French king.

    I'm not sure any more which body system nuirsing might be analogized to. Some part of the immune and tissue repair functions, I guess. One would hope that nurses, even more than MDs, would appreciate the critical functions that maintain homeostasis. It seems to me that all medical interventions are big-hammer attempts to compensate for failures of homeostatic systems (e.g., glucose metabolism as mediated by insulin and other hormone systems). One would also hope that nurses, at least, might be able to step back from their daily woes and personal pride and desires, and apply critical thinking to look at what's good for the whole patient, lying there in the bed with all those tubes bleeding energy out into bottles for vampires and neoplasms to live on.

    But then again, I'm just an LPN student in a tech program, so what do I know?
  11. by   allymiami
    The article states that rookie nurses are leaving profession but that's not the only problem. The faculty shortage is another that is turning away students who want to pursue nursing. I am one of them. I am a mid-life career changer (34 yrs old) have been teaching 5 years and now doing prerequisites to hopefully be admitted to nursing school but people I know are being rejected left and right with GPAs of 3.5s so they have to go on to something else. Maybe it's just here in Miami, I don't know but I now have to make a decision whether to continue on this path or take a job offer (non-medical). I want to do nursing but can I take that chance of not being accepted after preparing so hard because nursing school has only a limited # of students they can accept? I don't think so. If somebody knows about this happening in their city or state, please talk about it? Or if you know of a good nursing program in your area that is not so limited and has an ACCELERATED OPTION ONE YEAR PROGRAM (program for people who already hold a B.A. in another field) please advise. Thanks!


    Quote from VickyRN
    This is very troubling and I have noticed this trend during the short time I have been a nursing instructor. Already, some of the students who graduated from our school just 3, 2, and even 1 year ago are no longer at the bedside. Others have come by my office stating how unhappy and overworked they are. I have also noticed (since I conduct clinicals in many different units) just how sicker and sicker the patients are becoming. I go back to the units every year, and notice how much more responsibility keeps getting heaped on the nurses. Even the "stable" postpartum unit has very acute patients. The "stable" med-surg patient of the past does not exist anymore - they are all very sick and just a few years ago most would have been in the ICU!
  12. by   jtmcphee
    I'm just one of those lowly "tech" LPN students facing 8 more months of training that I know will be inadequate, with the fear that I will never get the apprenticeship and mentoring that might make me a really good nurse. How many RNs, BSNs and MSNs on the wards today have the energy or interest to bring newbies along and help them not to kill patients? Maybe I should just qualify as a nurse's aide and call it good? Seems like that is the level of esteem that lpns garner in a lot of quarters, even though many of them have the potential to be Nightingales of their generation. The money is not all that different from what LPNs get anyway, with a lot less risk and liability.

    Going into the nursing business (which IMO like everything touched by capitalism, "entrepreneurship" and the profit/greed motive, health care inevitably becomes), and coming from another "profession" -- law -- that displays the worst of human commercial and consumer traits, I have my eyes pretty wide open. My prayer is that there are still niches where the all-consuming reach of the "other" Masters program (MBA) does not extend.

    There seems to me, on obviously short acquaintance, there is no real set of "solutions" to skill shortages, lousy pay for risks assumed, flight from the profession, "eat your young" syndrome, the bottomless gluttony of drug manufacturers, hospital-owning corporations, a couple of "lost" generations with no learning in civics, no common goals, no sense of governance in most of our leadership, the flood of "my idea is just as good as yours" content that runs away from what you might call social homeostasis, and the pervasive greed, tribalism and other ills that beset us.

    If the goal is to have caring people with at least minimal skill sets at bedside, in a sufficient ratio of caregiver to patient such that caregivers aren't forced constantly to work at the limits of human endurance and competence, there are some major things that have to change, which appear to this former lurker to have been discussed widely here and also appear unlikely to improve in this lifetime. If the goal is to set the bar high, in hopes that shortages of professionals will drive up the price of nursing services (lawyers used to do this, until universities discovered that law schools are very profitable), that may be good for those with the credentials and already in the profession but not so good for the aging population that needs health care services.

    Maybe it would be interesting to look at our culture, our nation and our species the way a physiologist looks at an organism. There's a complicated Krebs cycle that produces energy (wealth from the economy), and a whole host of positive and negative feedback mechanisms that tend to maintain some kind of stability in the conditions necessary for life. If we let our schools teach dreck because teachers know less every year and morph into "educators" that are forced by politicians to focus on teaching just what's needed for the next generation of teachers to barely pass standardized tests, that's about on a par with respiratory acidosis on the way to the endpoint outcome of that condition.

    IMO we are all part of a larger organism, and like the individual cells of the body we die if the organism does. There are lots of pathogens and malignancies constantly challenging that body. It's too bad that more of the billions of little decisions that, like chemical reactions in living processes, make up the commerce and energy exchanges that keep our bodies alive, aren't informed by "genetic" instructions to work toward keeping the body healthy. Too many "cells" and tissues in the body politic seem to me to be neoplastic and malignant -- like tumors, drawing blood supply and energy to themselves at the expense of the rest of the body and ultimately resulting in death. Look at the corporate and government types who pay themselves huge incomes while cutting pay and benefits and squeezing the last drop of performance out of the breathless wage slave. Look at the Big Lie of marketplace capitalism, that says price gouging on a wasting energy resource (petroleum) is just peachy, and informs the attitudes of "leaders" who don't give a rat's whatever for what comes after the last drop of sweet Texas crude and cubic foot of natural gas. Because they will have lived well in the little bracket of time that they occupy. "Apres moi, le deluge," said a notorious French king.

    I'm not sure any more which body system nuirsing might be analogized to. Some part of the immune and tissue repair functions, I guess. One would hope that nurses, even more than MDs, would appreciate the critical functions that maintain homeostasis. It seems to me that all medical interventions are big-hammer attempts to compensate for failures of homeostatic systems (e.g., glucose metabolism as mediated by insulin and other hormone systems). One would also hope that nurses, at least, might be able to step back from their daily woes and personal pride and desires, and apply critical thinking to look at what's good for the whole patient, lying there in the bed with all those tubes bleeding energy out into bottles for vampires and neoplasms to live on.

    But then again, I'm just an LPN student in a tech program, so what do I know?
  13. by   Kelly_the_Great
    Quote from elkpark
    My first thought on beginning to read the OP was that, IMO, part of the problem is that current nursing programs do not prepare students v. well for the reality of practicing nursing.

    I think it's a larger, systemic problem. I'm not advocating doing away with college nursing programs and all returning to hospital-based diploma schools, but there must be a better way ...

    Hey Elkpark ,

    I've always had a tremendous respect for the diploma nursing program. My mom also graduated from a diploma program (over 35 years ago). I always admired her so much as a nurse, it just seemed like she could "do it all", you know? But let me ask you, what do you think the dropout rate from nursing school would be if the students had to take on full loads?




    Do you feel like the instructors are being forced to "teach the test"?

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