A little HX please

chloecatrn · Jul 25, 2010

The shortage isn't a myth. Right now, hospitals don't have the money to pay new grads to be oriented. Orientation is an expensive process, and leaves them short a nurse on the floor for the up to 12 weeks -- longer in the ICUs and EDs -- while the new grad is brought up to speed. Additionally, the preceptor doesn't usually have a full patient assignment so that s/he can provide learning coaching and experiences, so the unit is really short 1.5 nurses during that time. Hospitals are getting more bang for their buck by hiring experienced nurses who don't require the intense orientation that new grads do. It's still cheaper to pay overtime than to pay to orient a new RN, unfortunately. (A study figures that when all is said and done, including attrition rates of new RNs who are hired and oriented and don't stay, orientation of a new nurse costs between $39,000 and $65,000. I have heard, but cannot find anything to substantiate the idea that ICU and ED nurses are more expensive to orient because of more advanced training necessary to work in those areas, i.e.: ACLS/PALS, trauma, sedation.)

There was a shortage prior to the recession. There still is one, it's just hidden in economic considerations and decisions by nursing directors and hospital CEOs, and there will be one when this recession is over. The magnitude of the post recession shortage, however, will be dependent upon the implications of the Obama healthcare bill for hospitals.

UVA Grad Nursing · Jul 25, 2010

Great question, and one with a very complex answer. In my opinion, much of the answer is in the simple economic principles of supply/demand.

News of the 'nursing shortage' hit the media nearly 10+ years ago. Much attention regarded that there were more people leaving nursing (retirement, family, personal issues) than those entering nursing [low supply and high demand]. Earlier in the 2000s, Schools of Nursing were encouraged to increase their enrollments and states approved dozens of new nursing programs (public, private, and for-profit). Some studies suggest that the number of new graduates have nearly doubled in the past 10 years. [increase supply]

Jobs however in recent years have not doubled in this time. Many RNs who had left the workforce (having a family, etc) have returned to nursing. [increase supply]. Retirements have also slowed and RNs are working more years (few want to retire in these uncertain years). End result is that there are more new grads ready to enter the workforce than there are jobs. A recent AACN study showed that 48 states are graduating more RNs than there are jobs (only Alaska and Nevada have more openings than graduates today). [high supply, low demand].

Added to these workforce issues are the costs of training a new graduate. The University HealthCare Consortium estimated that it costs an employer $77,000 to train a new graduate in their first year (covered time for training, reduced assignments while they are learning how to be a RN, costs of mentoring, etc). The cost to train an experienced nurse to a job is much, much less. Fewer elective procedures and a lower census means less money for many employers. And less money generally means that employers are more hesitant to take risks with new, green RNs. [low demand]

What does this mean for the future? Surely when the economy improves I expect more RNs to retire and leave the workforce. Employers in better financial situations will be able to hire some more new graduates (and devote the time and money to train/retain them). But I also expect there to be calls to scale back some of the growth in new RN programs.

nebrgirl · Jul 25, 2010

Thanks for the replies....it shed some light on the issue of "will things change" at least in my mind, because I know the recession no matter how bad it is can not last forever.

fiveofpeep · Jul 25, 2010

where I work, we are very very short but dont have the money to train. I think that is the general consensus.

there is a shortage of experienced nurses and a shortage of money to pay those who are not experienced.

anonymurse · Jul 25, 2010

My last term was to be a preceptorship on a specific unit. I nailed this down by interviewing for a job before my last term began. The job was conditional on my doing well in the preceptorship, which consisted of taking increasing numbers of my preceptor's pts while I learned the unit. There was no cost to the hospital and no loss of productivity (actually my tuition was paying for it). If I were a student again in this market, I'd definitely try to make the same arrangement.

kcochrane · Jul 25, 2010

Prior to this economy, there was a shortage. It wasn't because there were no qualified nurses, just they were not practicing. I believe the number I heard thrown around was 1/2 million nurses. Of course some of those are retired, some left to be SAHMs, some left because they had enough, etc. So when the economy tanked many came back to work. At one of our hospitals here, we didn't have new grad positions for a few months due to many per diem nurses going full time. They either had spouses that lost jobs or they lost their other job that had benefits.

Many people find nursing isn't for them after school or they get burnt out, or they just had enough. When there are other options, those people will leave the field and jobs will open up. Just my two cents.