Nursing Shortage!! It's real and it bites (new grads, can't find a job? Read this post!)

[klone]

I had no idea, when I took a job as a nurse manager of an inpatient unit at a rural hospital that's 4 hours away from the nearest large city, that a huge portion of my job stress would come from the fact that we DO NOT HAVE ENOUGH NURSES!!

Every unit at our facility has job openings. We have dozens of travelers. My department basically has just enough nurses to cover core staffing. What that means is - if there's a sick call, or a PTO request, or a medical leave of absence, we're short.

Thank Dog that my unit is awesome and they are a team and a family and are invested in the unit, because when we're short, the nurses pull together and volunteer to take OT and work 16 hour shifts.

The point of this post...if you're a new grad, and you can't find a job because the market is so competitive and every place is wanting a BSN...consider relocating! Look for those facilities that are in rural communities, or small towns that are >2 hours away from the nearest metro area that probably has multiple schools and a steady stream of new grad nurses to fill positions.

Coming from Denver, I had no idea that there really were places in the US that had shortages, but it's true, and it sucks. For patients, for communities, and for the nurses who are working short-staffed or working 60-hour work weeks because, well, we have no other options.

[JKL33]

klone said:

When someone submits an application, it goes directly to my in-box as well as HR's. I am first contact with the applicant, not HR.

And I can only speak to my facility of course, but what Rocknurse is describing is very much NOT the case. Oregon has strict staffing laws. We cannot compel people to work OT. And travelers are VERY expensive. There is no incentive to the department or the facility to NOT hire permanent nurses to fill open positions.

If it's on the HR website as an open position, then it's already gone through the approval process. HR does not post it until it's approved.

And no, it's not part of a larger hospital network. It's just an independent community hospital.

Interesting. Well I'm glad to hear that's the case for your sake. I haven't applied for anything new in a long while but last time around the manager got my name and ended up contacting me separately because apparently they frequently dealt with HR-related bumps in the road. But this was part of a large system.

I'm surprised/sad to hear it's that bad in an independent community hospital - I associate the problem you speak of with experienced people jumping ship when places like yours are taken over by Toyota...I mean larger systems. Do you use per diems? I know an excellent nurse who became indispensable as a per diem in your specialty and the type of setting you're talking about; it just happened to work out well for everyone.

[klone, MSN, RN]

JKL33 said:

Do you use per diems? I know an excellent nurse who became indispensable as a per diem in your specialty and the type of setting you're talking about; it just happened to work out well for everyone.

We do. We just don't have any that are interested in working night shift.

[hppygr8ful, ASN, RN, EMT-I]

klone said:

When someone submits an application, it goes directly to my in-box as well as HR's. I am first contact with the applicant, not HR.

And I can only speak to my facility of course, but what Rocknurse is describing is very much NOT the case. Oregon has strict staffing laws. We cannot compel people to work OT. And travelers are VERY expensive. There is no incentive to the department or the facility to NOT hire permanent nurses to fill open positions.

If it's on the HR website as an open position, then it's already gone through the approval process. HR does not post it until it's approved.

And no, it's not part of a larger hospital network. It's just an independent community hospital.

I used to live in Oregon and might return there someday - I love the rural life and small town communities. What part of Oregon are you in if I may ask. If you don't want to give it away you could PM me.

Hppy

[Workitinurfava, BSN, RN]

Approved could also mean, they are waiting from someone to take a low, deplorable rate of pay and they just haven't found anyone desperate enough for the job yet.

[Kooky Korky, BSN, RN]

I believe there is no shortage. There are just the shenanigans already mentioned by PP's. And maybe too little advertising, too low pay, night shifts, this sort of thing.

Good luck to the managers needing staff.

[klone, MSN, RN]

Kooky Korky said:

I believe there is no shortage. There are just the shenanigans already mentioned by PP's. And maybe too little advertising, too low pay, night shifts, this sort of thing.

Good luck to the managers needing staff.

Yes, in many places there IS a nursing shortage. And frankly, it pisses me off that people say otherwise. Until you've been to these communities, you have no idea. You can believe whatever you want, but that doesn't make it so.

Hospital that employs 400 nurses. Not to mention the SNFs, home health agencies, community health departments, clinics, hospices, and other various places that employ nurses. Local community college graduates 30 nurses a year. No other nursing schools in a 2-hour radius. You do the math.

[NurseSpeedy, ADN, LPN, RN]

Workitinurfava said:

Approved could also mean, they are waiting from someone to take a low, deplorable rate of pay and they just haven't found anyone desperate enough for the job yet.

I wonder if this is the case. Years ago when there was a TRUE shortage (showing my age). My husband and I were thinking about moving to an area where we could get more house for our money (a LOT more). I was working pool for a community hospital in a well populated beach area making really good money (over 2x core staff pay) with tons of OT available. I checked around where we were looking...their PRN(no pool) only made $3 over base-$12 less per hour than what I was making a little over an hour's drive (non rush hour traffic) away. If we were to move, I would have made the commute daily. In the end we couldn't sell our place since we bought it just before the bubble burst. I will say that I probably would have regretted the move. The area was not anything like what I was used to and quite a culture shock. Teeth were scarce wherever we stopped for gas, food, etc, saw a lot of rebel flags on cars, and I would probably need a cooler in the car for each publix trip. I'm not saying all rural areas are that way. It's just one extreme or the other in the general area I live.

[Heylove, BSN, RN, EMT-B]

As a new grad, I applied to a very small rural hospital in my tiny town. Everybody knows everybody (patients, nurses, administration, everybody!) and as nice as that sounds, as an outsider from out of state, I really didn't have a chance...even if I would have put a little more effort into my interview. They are connected to a large system, and now I work at another hospital within their same system, but have to drive one hour away. I am much happier because I love my unit and I really don't think I would have been happy at a small rural hospital where I was told "EVS shows up to our codes because we are so small." Um....no thanks.

[SpankedInPittsburgh, DNP, RN]

I think the OP describes two problems here both of which I've had some experience with.

First, understaffing on a unit. Where I work this is common. Units are very often understaffed for a myriad of reasons to include; use of sick time, open positions not filled, unrealistic staffing levels whereas if one nurse calls off then we are "short.... Personally, I think the worst thing a nurse can do in this situation is "pitch in" and help. If the need is being filled by individual nurses it gives no impetus for the institution to deal with a problem. Why hire more nurses and train them, pay their benefits and guarantee them work if you already have a trained staff in place that will pick up the slack. I do OT when it suits me. If the unit is short then that's a management problem that they should deal with. My job is to provide excellent care to my patients while I'm at work & theirs is to keep the lights on and the unit staffed.

The nursing shortage does have a lot to do with geography. I live in a University town that produces thousands of new nurses and hundreds of new NPs every year. In addition folks born here usually stay here. This being the case it is very much a buyers market for new nurses. Recently our two major hirers of nurses have started hiring only new BSNs & DNPs to fill positions. They will still hire experienced nurses with Associates Degrees for nursing positions and experienced MSNs for NP positions. Why did they do this? Because they can. There are more qualified nursing applicants than jobs. I was at a job fair yesterday as a requirement for one of my DNP courses. I work for the VA and already have a job because they paid for my education but I wasn't supposed to miss class. New DNPs can get a job in my market but the salaries are very disappointing. However, if they move they can earn much, much more money. One of my classmates accepted a job in a rural part of Colorado and he is earning almost twice as much as grads who choose to stay here. This is not a new phenomenon to the rest of the working world. Simply put, you go where the money and the jobs are. I owe my local VA 3 years at my appointed position & they are paying me incredibly well considering the market I'm in based upon our union contract and my longevity in my Hospital. However, other VA locales pay more and our pension is based on our highest 3 years earnings. You can bet for my last three years I'm going to be looking to move to a very high paying different location so I can collect a higher pension for years to come. Sound mercenary? It is. It's a job & its business

[OldDude]

I'm sure the issue is regional...but here's what I see in my area. Our nearby city has a population of a little over 300,000. There are 4 large acute hospitals and a ton of other inpatient, sub acute, rehab, yadda yadda facilities. There is a BSN nursing program and an ADN community college nursing program that churn out graduates every year. I have lived in this are all my life and, since I became a nurse, I've come to know a lot of other nurses...the overriding complaint, year after year, from those working the floors, is they are chronically short staffed. So, based on the availability of GNs, located in the same town, it just doesn't make sense that there is a nursing shortage - in my area.

[SpankedInPittsburgh, DNP, RN]

OldDude, they aren't hiring enough Nurses by design. 7-8 Nurses pitching in and doing OT on an as needed basis with bare-boned staffing is a poop-ton cheaper than hiring say 10 nurses on a unit. The bean-counters rule!!!

[klone, MSN, RN]

SpankedInPittsburgh said:

OldDude, they aren't hiring enough Nurses by design. 7-8 Nurses pitching in and doing OT on an as needed basis with bare-boned staffing is a poop-ton cheaper than hiring say 10 nurses on a unit. The bean-counters rule!!!

No no no!! I feel like nobody's listening to what I'm saying. They're just repeating their own version of what they believe to be true.

Spanked, I'm not saying what you're describing never happens. But that is simply not the reality in many places.

You say facilities would rather pay OT to staff than hire more nurses. Hire more nurses from WHERE?? Where are these nurses we're CHOOSING not to hire because we'd rather work our current staff until they're sick, exhausted, or burnt to a crisp?

This is what I'm trying to tell you - there ARE no nurses applying for these jobs because there are no nurses. Every new grad is snatched up, but there are not enough to take the place of those who are retiring or moving out of the community.