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

  1. 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 the current state of nursing, a University of Pennsylvania researcher has discovered that newly minted nurses are leaving the profession at far faster rates than their predecessors, suggesting that the current shortage of nurses may reach crisis proportions sooner than anticipated.

    One additional surprising finding is that beginning male nurses are leaving the profession at twice the rate of women. The research, which analyzes data from the National Sample Survey of Registered Nurses collected by the Division of Nursing in the U.S. Department of Health and Human Services in 1992, 1996 and 2000, is reported today in the influential health care policy journal Health Affairs.

    "The study indicates that 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 Julie Sochalski, Ph.D., RN, associate professor at the University of Pennsylvania School of Nursing. "We know the nation is facing a shortfall of nurses. If new RNs are leaving the profession after only a few years, the shortage is likely to reach crisis proportions sooner rather than later."

    As baby boomers age, thus increasing demands on the health care system, the median age of nurses is rising toward retirement. The U.S. Department of Labor predicts a shortfall of 331,000 nurses by 2008, leading to national recruitment efforts. However, Dr. Sochalski found that nearly 136,000 nurses are working in other professions, suggesting policy makers should turn their attention to nurse retention as well as the current emphasis on recruitment.

    Specifically, the research found that:

    o in the most recent nurse survey, 7.5 percent of new male nurses dropped out of nursing within four years of graduating from nursing school, compared to 4 percent of women;

    o the dropout rate for both male and female new graduates is accelerating, rising from 2 percent of men in 1992 to 7.5 percent in 2000; and 2.7 percent of women in 1992 to 4.1 percent in 2000;

    o among new nurses, 75 percent of women reported being satisfied with their jobs compared to only 67 percent of men; among more established nurses 69 percent of women and 60 percent of men were satisfied.

    "One might predict that this new cohort of nurses may be destined to see their satisfaction levels sag over time, which, depending on the market conditions, may influence decisions to continue in their position or to leave nursing entirely," Dr. Sochalski reports in Health Affairs. "The accelerating rate of loss in the supply of nurses, at a time of substantially increasing demand, underscores the need to determine the reasons for the exodus. And while men may not yet comprise a sizable number of the total who are leaving, the growth in their retreat from nursing is nonetheless concerning."

    Source: School of Nursing Public Relations

    For Additional Information Contact: University Communications at 215-898-8721.

    http://www.upenn.edu/researchatpenn/article.php?435&soc
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  2. 39 Comments

  3. by   VickyRN
    Quote from Hellllllo Nurse
    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 the current state of nursing, a University of Pennsylvania researcher has discovered that newly minted nurses are leaving the profession at far faster rates than their predecessors, suggesting that the current shortage of nurses may reach crisis proportions sooner than anticipated.

    One additional surprising finding is that beginning male nurses are leaving the profession at twice the rate of women. The research, which analyzes data from the National Sample Survey of Registered Nurses collected by the Division of Nursing in the U.S. Department of Health and Human Services in 1992, 1996 and 2000, is reported today in the influential health care policy journal Health Affairs.

    "The study indicates that 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 Julie Sochalski, Ph.D., RN, associate professor at the University of Pennsylvania School of Nursing. "We know the nation is facing a shortfall of nurses. If new RNs are leaving the profession after only a few years, the shortage is likely to reach crisis proportions sooner rather than later."

    As baby boomers age, thus increasing demands on the health care system, the median age of nurses is rising toward retirement. The U.S. Department of Labor predicts a shortfall of 331,000 nurses by 2008, leading to national recruitment efforts. However, Dr. Sochalski found that nearly 136,000 nurses are working in other professions, suggesting policy makers should turn their attention to nurse retention as well as the current emphasis on recruitment.

    Specifically, the research found that:

    o in the most recent nurse survey, 7.5 percent of new male nurses dropped out of nursing within four years of graduating from nursing school, compared to 4 percent of women;

    o the dropout rate for both male and female new graduates is accelerating, rising from 2 percent of men in 1992 to 7.5 percent in 2000; and 2.7 percent of women in 1992 to 4.1 percent in 2000;

    o among new nurses, 75 percent of women reported being satisfied with their jobs compared to only 67 percent of men; among more established nurses 69 percent of women and 60 percent of men were satisfied.

    "One might predict that this new cohort of nurses may be destined to see their satisfaction levels sag over time, which, depending on the market conditions, may influence decisions to continue in their position or to leave nursing entirely," Dr. Sochalski reports in Health Affairs. "The accelerating rate of loss in the supply of nurses, at a time of substantially increasing demand, underscores the need to determine the reasons for the exodus. And while men may not yet comprise a sizable number of the total who are leaving, the growth in their retreat from nursing is nonetheless concerning."

    Source: School of Nursing Public Relations

    For Additional Information Contact: University Communications at 215-898-8721.

    http://www.upenn.edu/researchatpenn/article.php?435&soc
    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!
  4. by   oramar
    They don't have to go far to see the source of the disatisfaction. Just come and read these boards.
  5. by   fergus51
    Maybe I'm alone in this, but I think part of the problem is that they aren't exposed to real nursing in school. None of the nursing students I've met in the US have taken full patient loads before graduating. When I went to school in Canada we had to do this by the third year of our four year program, so at least we knew what to expect as new nurses. The new nurses here are completely unprepared for the realities of nursing. Many of them have never even done night shifts before graduating!
  6. by   elkpark
    I agree with Fergus (as usual! ) 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'm a big fan of moving the profession forward, educating nurses in academic settings, and the whole PC "ball of wax," but, on the other hand, when I graduated from my diploma program in '84, I was fully prepared to be dropped down anywhere nursing was happening and be able to function (at an entry level, granted, not as an expert) -- I was accustomed to caring for nearly a "full" patient load in clinical (and we had four full days of clinical/week our senior year, so I was also accustomed to working nearly full-time as a nurse), and I actually had experience in and knew how to do all of the tasks/skills that everyone now expects hospitals to teach new grads on the job ... I also had a very clear idea of what to expect in a full-time, entry-level nursing job, which I don't believe grads these days do!

    And I'm not speaking as some retro battle-axe longing for the good ol' days -- I've completed a BSN and MSN since then, and have taught nursing full-time in an ADN program, guest-lectured in BSN programs, and provided clinical supervision for undergraduate and graduate students. I'm progressive as all get-out, and I want to see my profession flourish. I realize that it was mostly luck that I happened to stumble into a very good diploma program, and that there were plenty of poor-quality ones out there. But my diploma program not only did a better job than the BSN-completion program I eventually attended of teaching us about critical thinking, professionalism, legal/ethical issues, prioritizing, management, and all that other good stuff, it also did a superb job of teaching us what we needed to know to be able to through a shift on a floor!

    I know it's very un-PC to say this out loud, but I think there are serious problems with the overall state of nursing education these days. I'm shocked at how little new grads know and are able to do when they graduate, compared to what a new nursing grad used to know and be able to do. I'm not blaming or criticizing the students for this -- they can only learn what they're taught. 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 ...
  7. by   EvePooh
    I'm still a student nurse, and I totally agree that we are not well prepared for the reality. On the other hand, it might be quite difficult for students to take full load of patients because all of our work or charting have to be checked by our instructor and she/he is responsibile for. So if an instructor have 6 students and each student only takes 2 patients, the instructor already gets 12. Also, due to the liability issue and the patients nowadays know more about their rights, there are procedures that students can't do, or a patient can refuse a student to do it. So we might not have as many opportunities as students 20 years ago. It is a complicated problem that I have no idea how to solve. But they are only some of my thoughts.

    Eve
  8. by   lindarn
    Quote from elkpark
    I agree with Fergus (as usual! ) 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'm a big fan of moving the profession forward, educating nurses in academic settings, and the whole PC "ball of wax," but, on the other hand, when I graduated from my diploma program in '84, I was fully prepared to be dropped down anywhere nursing was happening and be able to function (at an entry level, granted, not as an expert) -- I was accustomed to caring for nearly a "full" patient load in clinical (and we had four full days of clinical/week our senior year, so I was also accustomed to working nearly full-time as a nurse), and I actually had experience in and knew how to do all of the tasks/skills that everyone now expects hospitals to teach new grads on the job ... I also had a very clear idea of what to expect in a full-time, entry-level nursing job, which I don't believe grads these days do!

    And I'm not speaking as some retro battle-axe longing for the good ol' days -- I've completed a BSN and MSN since then, and have taught nursing full-time in an ADN program, guest-lectured in BSN programs, and provided clinical supervision for undergraduate and graduate students. I'm progressive as all get-out, and I want to see my profession flourish. I realize that it was mostly luck that I happened to stumble into a very good diploma program, and that there were plenty of poor-quality ones out there. But my diploma program not only did a better job than the BSN-completion program I eventually attended of teaching us about critical thinking, professionalism, legal/ethical issues, prioritizing, management, and all that other good stuff, it also did a superb job of teaching us what we needed to know to be able to through a shift on a floor!

    I know it's very un-PC to say this out loud, but I think there are serious problems with the overall state of nursing education these days. I'm shocked at how little new grads know and are able to do when they graduate, compared to what a new nursing grad used to know and be able to do. I'm not blaming or criticizing the students for this -- they can only learn what they're taught. 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 ...
    The solution to the problem is a BSN as entry into practice, and to require all new grads to go through a paid, clinical internship for at least 6 months, it not a year before turning them loose after graduation. I don't necessarily think that it is a factor in not expereincig ther real world of the staff nurse, as it is an unwillingness on the part of the hospitals to provide enougn support for the new grads. Us older nurses have been chased out of the profession, or injured, and are not there to provide the support that we once did.

    It should be modeled after the internship porgrams for physicians, with nursing rounds, etc, on the patients, a training portion, designated mentors that actually WANT TO BE PRECEPTORS and have the personality for it. Physical Therapists and Occupational Therapists have an intership that the go through. I am sorry to say that if a profession that has so little impact on patient mortality and morbidity can require a DOCTORATE AS ENTRY INTO PRACTICE AND AN INTERNSHIP BEFORE BEING CUT LOOSE ON THE UNSUSPECTING PUBLIC, NURSING SHOULD AS WELL HAVE A FOUR YEAR COLLEGE DEGREE AND AN INTERNSHIP FOR LICENSURE.

    There also has to be a radical change in the curriculum. The nursing curriculum is not the problem, but most programs do not teach entreneupership, s the PTs and OTs do. Thsi is something that needs to be taught for nurses to appreciate what their professional skills are worth in the markeplace. As is stands now, our professional services are rolled in with the housekeeping, laundry, and the complementary roll of toilet paper and box of "industrial strength" of kleenex. That is why nurses are willing to accept such dismally low pay, and benefits for our much needed and necessary professional services. Here in Spokane, an agency, which shall go un named, if offerings RNs the princely sum of $15.00 and hour for flu shots clinics, and $22 an hour for nursing home shifts. Don't spend it all in one place. And there probably nurses breaking down there doors to do these clinics and agency shifts, for what I consider to be HS drop out wages. I told them I would work as an Independant Contractor, and they turned me down. Go figure.

    Anyway, there are radical changes that are needed to be made if nursing is to survive as an autonomous profession. The odds are stacked against us, by the hospitals, insurance companies, the public, and our fellow nurses who fight any change in the status quo.
  9. by   lindarn
    Quote from lindarn
    The solution to the problem is a BSN as entry into practice, and to require all new grads to go through a paid, clinical internship for at least 6 months, it not a year before turning them loose after graduation. I don't necessarily think that it is a factor in not expereincig ther real world of the staff nurse, as it is an unwillingness on the part of the hospitals to provide enougn support for the new grads. Us older nurses have been chased out of the profession, or injured, and are not there to provide the support that we once did.

    It should be modeled after the internship porgrams for physicians, with nursing rounds, etc, on the patients, a training portion, designated mentors that actually WANT TO BE PRECEPTORS and have the personality for it. Physical Therapists and Occupational Therapists have an intership that the go through. I am sorry to say that if a profession that has so little impact on patient mortality and morbidity can require a DOCTORATE AS ENTRY INTO PRACTICE AND AN INTERNSHIP BEFORE BEING CUT LOOSE ON THE UNSUSPECTING PUBLIC, NURSING SHOULD AS WELL HAVE A FOUR YEAR COLLEGE DEGREE AND AN INTERNSHIP FOR LICENSURE.

    There also has to be a radical change in the curriculum. The nursing curriculum is not the problem, but most programs do not teach entreneupership, s the PTs and OTs do. Thsi is something that needs to be taught for nurses to appreciate what their professional skills are worth in the markeplace. As is stands now, our professional services are rolled in with the housekeeping, laundry, and the complementary roll of toilet paper and box of "industrial strength" of kleenex. That is why nurses are willing to accept such dismally low pay, and benefits for our much needed and necessary professional services. Here in Spokane, an agency, which shall go un named, if offerings RNs the princely sum of $15.00 and hour for flu shots clinics, and $22 an hour for nursing home shifts. Don't spend it all in one place. And there probably nurses breaking down there doors to do these clinics and agency shifts, for what I consider to be HS drop out wages. I told them I would work as an Independant Contractor, and they turned me down. Go figure.

    Anyway, there are radical changes that are needed to be made if nursing is to survive as an autonomous profession. The odds are stacked against us, by the hospitals, insurance companies, the public, and our fellow nurses who fight any change in the status quo.
    Sorry, I hit the send button before I signed my post.

    Lindarn, RN, BSN, CCRN
    Spokane, Washington
  10. by   fergus51
    Quote from EvePooh
    I'm still a student nurse, and I totally agree that we are not well prepared for the reality. On the other hand, it might be quite difficult for students to take full load of patients because all of our work or charting have to be checked by our instructor and she/he is responsibile for. So if an instructor have 6 students and each student only takes 2 patients, the instructor already gets 12. Also, due to the liability issue and the patients nowadays know more about their rights, there are procedures that students can't do, or a patient can refuse a student to do it. So we might not have as many opportunities as students 20 years ago. It is a complicated problem that I have no idea how to solve. But they are only some of my thoughts.

    Eve
    We took full patient loads during our preceptorships (when we worked with an RN one on one). The instructors didn't have to follow us around since we had one nurse all to ourselves. This was less than 10 years ago, and my niece graduated from the same program less than 3 years ago. She did the same thing. I think it's too important to not be done.
  11. by   papawjohn
    Hey Y'all

    These are tough questions. The Masters level entry for Physical Rx'ists is a challenge to us as a profession. But it seems to me that less and less Physical Therapy is actually done BY Physical Therapists. They write orders and Nurses, Occupational Rx'ists or PT Techs actually do the PT. Is this a good model for Nursing? Nah, 'course not.

    The BSN and a year of Internship as an entry to practice would 'raise the profession' but would "create" so few nurses it would be almost impossible to be a 'professional nurse' and still actually be at the Pt's bedside. I've spent over 1/2 my career working at University affiliated Hosps and naturally have seen lots of BSN newbies. There is a large subset that obviously are not psychologically ready to deal with the deep doo-doo (figurative and literal) that nursing necessarily involves. I remember in particular one new BSN caring for a particularly nasty UpperGI Bleed.Yu could see on her face like the CNN 'crawler'--"I've GOT to go to GRAD SCHOOL-I've GOT to go to GRAD SCHOOL-I've GOT to go to GRAD SCHOOL."

    My thought is that more and more nurses are actually needed now and even more than that will be needed and that raising the educational level to BSN is going to put LESS EDUCATED "techs" at the bedside.

    What do y'all think of the refrain one hears from nurses: "I love my profession but I HATE MY JOB"? I think if Hosp Administrations had even a small clue--there would be more of us at the Pt's bedside and more of us seeking higher certifications.

    That puts our "profession" at the mercy of congenitally stupid Admin types which is not very satisfying--but as a practical matter, seems to be true.

    Following along interested
    Papaw John
  12. by   HuggyPuglet
    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!

    Yes, overworked + sicker patients + more responsibility is not a good mix for job satisfaction. Most of us got into the profession because we are by nature caring people with a giving nature.

    Our job satisfaction hinges on our being able to help those in our care. But the realities of most nursing positions and the patient census we are given each shift gives us no true way to be helpful or caring. Usually we are running between too many patients, doing too many procedures, passing too many medications and charting endlessly but we never seem to get the opportunity to truly know the people we are helping.

    I've seen many a patient referred to by their room number, not their name.

    The results of our work seem only to manifest themselves in discharges and transfers. I'm not saying that you can't get satisfaction from nursing - heavens if there was none, most of us would be doing something else. But the shortages make patient censuses rise thru the roof with only a finite number of nurses to do the job.

    And yet we continue to fight between ourselves over who has the better degree, who went to the better school, who is in good with administration and who isn't. This has to stop before we all self-destruct.... we have to work together before we tear ourselves apart.
  13. by   bluesky
    I had a full load during my preceptorship and that didn't prepare me for the days I felt like quitting... because all those days were caused by crappy way we nurses treat each other.
  14. by   Hellllllo Nurse
    I beleive the solution lies in better working conditions and lower, safer and reasonable pt loads for nurses.

    I don't think new nurses are leaving because they are poorly prepared, or that their education was inadequate, I think that's a seperate issue.
    I don't think getting a BSN, or being a diploma nurse is an issue here.

    From the results of the study, and my own personal experience, I think it's all about the working conditions.

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