Abundant Opportunities

chuckster, ADN, BSN, RN, EMT-B · Apr 14, 2011

From the article "Abundant Opportunities":

In May of 2009, the BLS reported 42,820 registered nurses were employed in the Philadelphia area with an hourly mean wage of $34.34 and an annual mean wage of $71,430.

The author positioned these statistics directly after a paragraph that detailed overall wage growth in the counties surrounding Philadelphia (but omitted the city itself, probably because there was no growth to speak of). The implication is that nursing jobs and wages in the Philadelphia area are also seeing robust growth. This unfortunately is not the case and the author does readers a disservice by not providing more data. Looking at the same BLS numbers for 2008, we see that there were 42,740 RN's in the region with mean wages of $68,280. While this indeed represents growth, at a total increase of 80 jobs or under .2%, even the word "anemic" is inadequate. There are 32 programs (diploma, ADN & BSN) turning out several thousand new RN's (I'm working on trying to get the actual number) each year here in the Philadelphia area - all competing in a job market that's growing at .2% per year. Small wonder that new grads (myself included) are finding it difficult to get a nursing postion. What's even worse is that the 2009 number of 42,820 RN's represents a very significant overall decrease in the number of employed nurses in the region over the very recent past. The BLS data show that as recently as 2005, there were 56,670 RN's employed in the Philadelphia area - a decrease of nearly 14,000 jobs reprsenting an almost 25% decline over only 4 years.

While the main thrust of the article is the "abundant opportunities" in and around Philly for nurses with advanced training and degrees, a significant part is devoted to portraying the Phila area nursing job market as healthy and growing. This in turn entices more students to the area's 32 nursing programs and virtually ensures an oversupply of RN's in the immediate future. I truly feel sorry for those who will spend a great deal of time and effort getting their nursing degrees and passing the NCLEX, incurring some very signficant debt in the process only to find at the end, the job market is nothing like the rosy potrayals in articles like this one.

Turd Ferguson · Apr 15, 2011

This, my friend, is the blight of our times

martymoose, BSN, RN · Apr 15, 2011

holy crap- 32 nursing programs!!!! i thought where I was that 5 programs with 2x /yr grads was saturating!!!

good observation.

as I've learned in statistics- they can be bent in any way to suit a purpose

TickyRN · Apr 15, 2011

WOW 32 nursing programs is a lot, they need start shuttting some down.

PMFB-RN, RN · Apr 15, 2011

You know I am starting to think that there is a group of bitter, resentful MSN & doctorate prepared RNs who haven't touched a patient in decades who are very upset about the benefits & wages bedside nurse get. Maybe it's because back in the day, during their very brief bedside career, they couldn't make it on the wages of that time and felt forced to pursue advanced degrees to make ends meet. Now they see what nurses are getting paid and feel bitter and cheated about it. Now they are setting out to create a vast oversupply of RN by lying about what a great job with great pay it is, thus attracting tens of thousands of new nurses. These new people are attending greatly expanded nursing programs, or maybe newly created programs designed to meet the falsely created "nursing shortage". The idea is to so over saturate the market that wages drop tot he point that bedside nurses can not support their families and will be forced to seek advanced degrees. Misery loves company.

merlee · Apr 15, 2011

Chuckster - - you need to write an Op-Ed presenting the statistics you have shown here.

PMFB-RN - - Advanced degreed nurses rarely made more than bedside nurses, but worked far better hours. Many MSNs that I knew frequently picked up weekend shifts just to make ends meet!

CCRNDiva, BSN, RN · Apr 15, 2011

Chuckster, I have to agree with you. I live in the midwest and we have 4 colleges churning out nursing students (with another program opening this year) within 15 miles of each other in a 2 hospital community with a population less than 200,000. 2 of those schools offer accelerated BSN programs and one prepares both BSN and ADN nurses. Many of these grads are not able to find a job upon graduation.

With this overabundance of nursing programs, hospitals here have been able to keep wages down. I haven't had a raise in 3 yrs and my night shift differential was decreased by 2% this year. We are frequently reminded that if we don't want our job there is a plethora of new grads who are willing to take them.

I don't know why the nursing agencies continue to approve the addition of these programs in small cities. I've read so many articles like these that entice people to pursue nursing when the truth is hospitals are not hiring and if they are they prefer to hire those with experience.

chuckster, ADN, BSN, RN, EMT-B · Apr 15, 2011

i've got to do a bit more fact-checking and then some editing, but here is the draft of what i plan to send to advance for nurses. it's far too long (among other things) to get published but it will make me feel better.

i was disappointed to see yet another article in a nursing publication paint an overly rosy picture of the nursing workforce and continue to perpetuate the belief (some might say, canard) that there is a general shortage of registered nurses. that unfortunately is precisely what the regional snapshot - philadelphia article in the mid-atlantic/lower great lakes edition of advance for nurses does.
the title of the article, "abundant opportunities" seems to be a conscious effort to paint a happy face on a portrait of nursing opportunities in the philadelphia area. to be fair, a careful reader of the article will eventually discern that the major theme of the piece is that the "abundant opportunities" of the title really apply only to nurses with the proper academic credentials, job experience and specialty training. yet i am certain that this will be lost among most readers - especially those contemplating entering nursing - since sprinkled liberally throughout the article are misleading bits of data that appear to indicate that the overall demand for well-remunerated registered nurses is not only high, but also growing.
indeed, the opening paragraph of the article recycles the much-repeated statement from the 2008 bureau of labor statistics projection that nursing employment will rise much faster than average. of course, when the average rate of job growth is extremely low, as is presently the case in the us, a "much faster than average" growth rate may not even approach the historical average growth rate. the article continues with other bls information and states that during the period from 2009 through 2018 "more than 581,500 new rn positions" will be created "increasing the rn workforce by more than 20%". such statements with no contextual information approach being meaningless and are often very misleading. no information is presented in the article describing how the increase will take shape (e. g., fewer jobs in the first 5 years followed by large increases over the remaining years or great early growth with a slowdown in later years), which renders that particular data set much less useful than it otherwise might be. for argument's sake however, let's assume that the total of 581,500 new rn positions created evenly over the 10 year period referenced with an average annual increase of about 58,150. with approximately 2.6 million rn positions presently (as cited in the opening sentence of the article), this increase represents approximately 2% growth in the workforce in each year. given that the same bls report an rn workforce that will experience "much greater than average" growth with that growth estimated at 2% annually, one wonders what percentage qualifies as "average" growth.
the next section, entitled "regional salary trends" is perhaps the worst offender in terms of being misleading however. the second paragraph of this section begins by stating: "in what was the greatest increase among pennsylvania's largest counties, the average weekly wage in delaware county rose 2.4 percent from the first quarter of 2009 to the first quarter of 2010." the article continued and stated that: "chester county and montgomery county followed with a rise of 1.3 percent and 1.2 percent respectively" (note: i find it curious that no mention is made of wage growth in the city of philadelphia, which has larger population than any of the surrounding counties that were cited). the following paragraph then stated that "in may 2009, the bls reported 42,820 registered nurses were employed in the philadelphia area with an hourly mean wage of $34.34 and an annual mean wage of $71,430." given the juxtaposition of the information, it is easy for the reader to conclude that not only are nursing wages growing rapidly in the philadelphia area but that there is also robust growth in rn positions in the region.
let's start by examining the issue of wages. has there been an increase in 2009 nursing wages in philadelphia over 2008? the short answer is yes and it does indeed represent a significant gain, with hourly mean rn wages rising $1.51 and annual mean wages $3,150 over 2008 levels. that's good news but still needs some context, which is unfortunately not supplied. how for example, do philadelphia rn wages stack up against other areas? philadelphia wages are significantly higher than some areas such as south dakota ($25.73/hr; $53,520 annually) but considerably behind other areas such as san jose/sunnyvale, california ($52.92and $110,080). the philadelphia area also lags significantly behind the adjacent states of nj and md where mean hourly rn wages are $36.05 and $36.70 with mean annual wages of $74,990 and $76,330 respectively. while philadelphia area rn mean wages lag those of the neighboring states, they are significantly greater than the mean national rn wages ($31.99 and $66,530). we really need other information such as cost of living data to make truly meaningful comparisons but we can safely say that philadelphia area rn wages compare favorably nationally but unfavorably to those in the surrounding states. the point is that this is not the conclusion one would draw relying only the information presented in the article.
it is with respect to rn jobs that the article is most misleading however. as we saw above, the bls reports 42,820 rn's employed in the philadelphia for 2009. does this represent an increase in the number of jobs over 2008? the answer again is yes - but just barely. in 2008, the bls data show rn employment in the philadelphia at 42,740 which means an increase of 80 jobs over the 12 month period, or about 2 tenths of a percent (.2%). while that level of growth is to say the least, unimpressive, it at least represents some growth. what was ignored in the article is that the 2009 number of 42,820 rn's represents a very significant overall decrease in rn employment since 2004. looking at the bls data for 2004, we see that there were 56,670 rn's employed, so the 2009 level really represents a decreaseof nearly 14,000 jobs over a five year period - a nearly 25% decline. put another way, if rn employment is expected to rise 20% from 2009 to 2018 as the bls expects, we are unlikely to see nursing employment in the philadelphia area reach the 2004 job levels until sometime well after 2018. the on-line bls data is available only through 1997, in which 45,550 rn's were employed in the greater philadelphia area, still well above the 2009 level.
what i am most upset about however, is the impact that this article, along with many others out there, have on those contemplating a future in nursing. while it is clear once you start looking at the statistics in context, that future rn's in the philadelphia area are in for some rough times, the casual reader of "abundant opportunities" is almost certain to come to the opposite conclusion. as the author of the article would (or certainly should) know, there are 32 rn programs (diploma, adn & bsn) here in the philadelphia area. while i do not know the actual number of new rn's these programs generate each year, even if each program averages only 50 (which i suspect is far lower than the actual number) that means each summer, there are 1,600 additional new rn's released into the workforce in the philadelphia area. we saw earlier that between 2008 and 2009, there was a net increase of 80 rn jobs in the philadelphia area. is it really surprising that so many new rn's are finding it impossible to find work in philly? because articles like "abundant opportunities" present such an overly optimistic view of nursing employment, students continue to be drawn to the region's nursing programs which quite rationally, continue to try and increase their rolls. the end result of course is a worsening of an already bad situation.
frankly, i am not certain what the solution should be and i'm certainly not advocating that nursing schools be forced to limit the number of students they accept and graduate. what i am advocating though is that writers stop churning out pieces that are inadequately researched or lack context and that editors do their jobs and actually vet the articles considered for publication. an article such as "abundant opportunities" will undoubtedly help attract more students to nursing. as we've seen, an oversupply of rn's in the immediate future is virtually assured here in the philadelphia area and i believe that we do a grave disservice in enticing increasing numbers of impressionable folks to spend a huge amount of time, effort and most importantly money in the process of getting nursing degrees and passing the nclex only to find out when they are through that they face long odds of finding work in their chosen profession. let's stop artificially inflating demand where the supply has already well outstripped demand and let adam smith's "invisible hand" intervene early enough to rectify the problem with as few economic casualties as possible.

want2banrn · Apr 15, 2011

i've got to do a bit more fact-checking and then some editing, but here is the draft of what i plan to send to advance for nurses. it's far too long (among other things) to get published but it will make me feel better.

props if for nothing else, invoking adam smith.

Home Health Columnist / Guide · Apr 16, 2011

see sticked thread at top pa forum:

start here: pa nursing info schools, scholarships, nclex, nsg board, jobs, cna info

please check your facts again re # pa nursing programs in 5-county philly area...

can pull info from board approved nursing programs:

registered nursing programs

practical nursing programs

can use # nclex test takers/school to determine# new grads in area:

pa nclex exam pass rates of prelicensure programs: rn programs pn programs

total 7,100 rns took nclex from 10/09-9/2010 , down 150 from previous year.

will look at your article with fresh eyes in am.

chuckster, ADN, BSN, RN, EMT-B · Apr 16, 2011

Please check your facts again re # PA nursing programs in 5-county Philly area...

Had a chance to double check the PA BOM website and found that I miscounted. The actual number is 30 which counts all programs within the 215 and 610 area codes - a roughly 50 mile radius from Philadelphia (but only the PA side of the Delaware river). It also includes the 2 schools on provisional approval status. If we eliminate the schools outside of the 3 contiguous PA counties (Phila plus Delco, Montco & Chester), the number drops to 24. I did not include any of the programs in South Jersey, which is actually part of the Phila SMSA and so probably should be counted. If we add these, I think the number goes back up to 28, but I haven't had a chance to check the NJ BON website to get a more accurate count.

No matter which number we pick - 24, 28 or 30 - there are a lot of nursing programs in an area that presently supports fewer than 43,000 RN positions.

Hospital diploma programs

1 - Abington Memorial (Montco)

2 - Aria (Phila)

3 - Northeastern (Phila)

4 -Reading Hospital (Lehigh)

5 - Roxborough (Phila)

6 -St Joseph's (Phila)

Associate degree programs

7 - Bucks Co CC

8 - CC Phila

9 - Delco CC

10 - Gwynedd-Mercy Col (Montco)

11 - Harcum College (Montco)

12 - Thomas Jefferson (Phila)

13 - Lehigh-Carbon CC

14 - Monto CC

15 - Northhampton CC (Lehigh)

16 - Reading Area CC

BSN programs

17 - Alvernia U (Reading)

18 - Cedarcrest Colege (Allentown)

19 - Drexel U (Phila)

20 - Eastern U (Montco)

21 - Holy Family U (Phila)

22 - Immaculata (Montco)

23 - Thoma Jefferson (Phila)

24 - La Salle U (Phila)

25 - Moravian/St Luke's (Bethlehem)

26 - Neumann U (Delco)

27 - Temple U (Phila)

28 - U Penn (Phila)

29 - Villanova (Montco)

30 - W Chester U (Chester)