So is there really a nursing shortage?

Nurses General Nursing

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I've been a nurse (LPN) for several years, and a fairly new RN now in California. While in school, both ASN and now my BSN I kept hearing about the huge nursing shortage we're facing, and how much worse it's going to get, and I still hear it. Then I read posts from experienced nurses on here who state that there's no nursing shortage in most US cities.

So which one is true? I read about how the Baby Boomers will need many more nurses, and I also read how there aren't enough Gen X and Millennials to take over the Baby Boomer Nurses' jobs once they retire. I also read statistics by the ACA 2010 that state that we're facing a major nursing shortage and how many more nurses are needed, and in fact many agencies and companies have been bringing in foreign nurses to fill these so-called vacancies in nursing.

So what's the real truth? In my state of California I see lots of nursing jobs posted all the time, and I wonder if it's because of nurses retiring, quitting, new positions being created, or if it's truly a shortage of nurses at all times. What do you think? Is there a shortage? Do you see a shortage in your city / state?

So here's the deal with nursing.

Once you're in, you're in. If you have critical care experience, you can write your own ticket, because hospitals want transplantable nursing labor. In ten years every job will require an MSN, specialty certification, and five years of ICU experience....sigh

Specializes in Nursing Professional Development.

My region seems pretty much like what others are saying here.

We have plenty of new grads looking for beginner-level jobs ... most of whom have no desire to stay in the long enough to become worth the expense of training them for high level acute care. They just want 1 or 2 years of experience before moving on to something else. The constant training (and turnover) of new grads increases the stress of units considerably. (Typical med/surg nurse/patient ratio is 3:1, sometimes 4:1)

What we need are people who want to specialize in acute care and who can handle the stress that acute care involves -- and who will stay in acute care long enough to become proficient care givers and front-line leaders.

Specializes in LTC Management, Community Nursing, HHC.
I recently read an article in our local paper about the local hospital "feeling the pinch" of the "nursing shortage"

What they neglected to discuss were the two big layoffs, and the "restructuring" of job titles and programs in the past few years. Those actions led to very experienced, well seasoned, and highly trained nursing professionals, being laid off. Nope, not a word about that.

There is, IMHO, a shortage of administrators who are willing to pay the value of the nurses they had, and willing to staff at adequate levels.

Isn't that strange? How can they only discuss one angle, and completely leave out the part where they intentionally created layoffs? I wonder also if the layoffs could have been to get rid of higher earner RNs and bring in less experienced ones who'll be paid less?

Specializes in LTC Management, Community Nursing, HHC.
There is no nursing shortage, just a shortage of nurses willing to put up with the realities of being a floor nurse. The "Nursing Shortage" is one of the buzz phrases they use to sell seats in nursing programs.

You could be right, but I've also read articles that are not related to nursing schools where they discuss shortages and the measures being taken to overcome them. So that's a little more difficult to explain, in my opinion. And these are from legitimate organizations / research, not nursing schools, or independent writers giving their opinions.

Specializes in LTC Management, Community Nursing, HHC.
So here's the deal with nursing.

Once you're in, you're in. If you have critical care experience, you can write your own ticket, because hospitals want transplantable nursing labor. In ten years every job will require an MSN, specialty certification, and five years of ICU experience....sigh

I completely agree about hospitals wanting a transplantable nursing workforce in the near future. Some do even now. However I don't know about the MSN. Someone has to do the actual floor nurse work, and will all those nurses be paid enough to want to get an MSN? It's like the BSN now. They talked about "all nurses will have a BSN" for some time now, and although one of the ACA's goals was an 80% BSN workforce by the end of 2016, I don't believe they will achieve that.

Not too long ago there was so much talk about never needing LPNs / LVNs again, and California started getting LVNs out of the hospital setting back in 2006 - 2008 or so, and now they're hiring LVNs in the hospital again, along with RNs who don't have BSNs, which I think is a good thing. We seem to cycle through these "we need more qualified nurses" to "we can't pay them more money for their additional qualifications" to "we're OK with LVNs and RNs without BSNs" Hopefully it stays that way. I see the benefits of a highly qualified nursing workforce, but in my opinion we all don't have to be PhDs and Nurse Doctorates, or even MSNs.

Specializes in LTC Management, Community Nursing, HHC.
My region seems pretty much like what others are saying here.

We have plenty of new grads looking for beginner-level jobs ... most of whom have no desire to stay in the long enough to become worth the expense of training them for high level acute care. They just want 1 or 2 years of experience before moving on to something else. The constant training (and turnover) of new grads increases the stress of units considerably. (Typical med/surg nurse/patient ratio is 3:1, sometimes 4:1)

What we need are people who want to specialize in acute care and who can handle the stress that acute care involves -- and who will stay in acute care long enough to become proficient care givers and front-line leaders.

That makes perfect sense. I remember reading some research about Millennials being different from Baby Boomers and Gen X nurses in that Millennials want their time off, and a life, which Baby Boomers and Gen X nurses often apparently didn't "demand". The article as not disparaging of Millennial nurses, but just explaining why nursing should change to accommodate a new generation of nurses who want a good life outside of work as well as a good job. Which of course makes sense. So I can see the part about nurses being trained and then leaving fairly quickly, but I think employers may just have to get used to it because they too benefit from well-trained employees who may join them after leaving a previous job. Ultimately, I think it mostly comes down to money. If they were to pay well, I believe most nurses would stay.

It really depends on where you look and what city you are in. There are nursing jobs out there that's not in the hospital like SNF/LTC. It's not acute care experience, but it's still nursing experience that you can put on your resume. Newer grads tend to believe they will get their dream jobs working in the ER or ICU right away. Maybe, if you get an internship with a preceptor on that unit.

Specializes in ICU, trauma.

In my neck of the woods there is a catastrophic shortage of nurses. We are having to close rooms in many units simply because we can't keep enough staff. All depends where you're located

Specializes in Specializes in L/D, newborn, GYN, LTC, Dialysis.

Pockets of severe shortage, clearly. But nationwide, there is a shortage of jobs for the glut of new grads, starry eyed, thinking they would roll out the red carpet once they passed the NCLEX. Nursing schools are to blame; they put those ideas into their heads often.

If you want to live in rural areas, say of Kentucky or North Dakota, yea you will get a job, more than likely. You have to be willing to uproot your life and relocate if you want work, in many cases.

There is a shortage of experienced nurses willing to put up with the outright crap many hospitals and other places dish out, demanding more and more for less and less. Many are going to retire, many more cut back and move on. Sadly, many others FORCED out due to being "topped out" on pay with seniority and being asked to settle while watching a new grad hire on for 1 dollar an hour less. What a slap in the face.

But, I, on the other hand, applaud the Millennial generation. They are not willing to put up with the crap their elders traditionally have. They see what loyalty and faithful long-term employment will get you, nothing at all. They are not going to stay around when moving on will net more. They are smart; they are advancing their education sooner and moving on faster. Gotta hand it to em.

This will get really interesting when the Boomers really have all retired. I just hope there are competent, caring nurses left when we oldies in the Gen X and Boomer generation need them.

Whew.

Specializes in Nursing Professional Development.
That makes perfect sense. I remember reading some research about Millennials being different from Baby Boomers and Gen X nurses in that Millennials want their time off, and a life, which Baby Boomers and Gen X nurses often apparently didn't "demand". The article as not disparaging of Millennial nurses, but just explaining why nursing should change to accommodate a new generation of nurses who want a good life outside of work as well as a good job. Which of course makes sense. So I can see the part about nurses being trained and then leaving fairly quickly, but I think employers may just have to get used to it because they too benefit from well-trained employees who may join them after leaving a previous job. Ultimately, I think it mostly comes down to money. If they were to pay well, I believe most nurses would stay.

I used to think it was all about money ... and "we need to treat the nurses better and then they'll stay" ... but now I think that is not the whole story. I talk to students a lot and many of them say they just don't want the realities of acute care -- and no amount of money within reason is going to fix that. You can't have acute care without having staff present on the nights, weekends, and holidays. No amount of money can change that.

Yes, we need to treat (and pay) nurses better. But I work for a hospital that treats its nurses better than most places -- and we still have the same problems keeping new grads more than 2 years. Talking with the students, many have made their minds up before they have set foot in the hospital. That is not why they are going to nursing school. Their plan is to get 1-2 years of hospital experience, then leave -- regardless of what the hospital does.

So it makes less and less sense for the hospital to hire them. That's why we look for experienced nurses. Even if they don't stay long, at lease we didn't have to invest as much in their orientations.

The older I get, the more I realize that the answers are not as easy as they appeared to be when I was younger.

I am one of those dreaded millennials. I also work in the NE and probably have bias.

Young nurses no longer have any desire to remain in staff nursing positions because its simply undesirable long-term employment. Why would we want to work nights, holidays, or be on call when as our friends get promoted and get regular raises? Hospitals give out miniscule cost of living raises to nurses, but offer all kinds of performance-based incentives to everyone else. We can't change the system, we can only change our position in it.

We all see the nurses who have APRN, administrative, and faculty positions that have reasonable compensation and great lifestyles. The only separation between most these people and us is 40 credits of graduate work and a couple years of bedside experience.

Now the problem is that nursing, as a profession, got what it wanted. Hospitals wanted nurses to go to grad school- and so they did. The rub is that the jobs aren't there for everybody at higher levels. In major cities, tons of nurses have MBAs, MHAs, and MSNs; there just aren't enough higher level jobs that aren't NP or CRNA. The next bubble to burst in nursing is the grad degree bubble. There will be WAY too many RNs with advanced degrees and no advanced jobs for them. This is all the end product of nursing schools cherry-picking elite students, then hospitals expecting intelligent and motivated young people to be content with task-oriented staff nursing positions, while simultaneously encouraging certifications and advanced degrees.

Is there a nursing shortage? No

The shortage is the number of hospitals willing to hire or take a chance on new grads or "unskilled" RNs. So basically, they would rather be short staffed than to hire these folks.

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