Survey: Would there be a nursing shortage if...

jwl300 · Mar 4, 2003

I believe there would still be a nursing shortage if pay and benefits were improved. This is because of the way nurses treat each other. I am a second career nurse, and sometimes suffer from "permanent jaw drop" because of the way some "professionals" behave. They are petty, territorial, and far from the concept of those who are supposedly in a caring line of work.

llg, PhD, RN · Mar 4, 2003

A few thoughts keep recurring in my mind as I read this thread.

1. I recently did a little survey among some friends in which I asked the question, "If nursing salaries were raised to the point at which working 1 day per week yielded a net income of $100,000.00 per year ... 2 days per week yielded $200,000.00 per year, etc. ......... Would you increase your hours or decrease them?" Everyone said that they would decrease their hours worked. No one said they would increase their hours.

That is consistent with what my hospital has found whenever they raise wages. Yes, it attracts a few more nurses and retains some, but it loses a lot of available nursing hours as the staff finds they can now earn their desired income by working less hours.

2. Back when I was in nursing school (1970's) no one I knew (women, at least) planned to work full time at the bedside until they were in their 60's. Almost everyone planned to work full time for only a few years, then switch to part time after marriage and children. There was also a lot of talk about being a staff nurse for only a few years, then moving on to less physically demanding nursing roles or roles with better working hours.

Again, this fact is consistent with what we are seeing now. As the baby boomer generation has aged, they want part time work, not full time work. Yes, some working conditions are appalling and need to be changed. But this generation of nurses would be cutting back their hours now and/or leaving bedside nursing regardless of the working conditions and/or pay. That was their plan in the first place.

Neither better pay nor better working conditins will entice these nurses back. I have a lot of friends in this category. If I had a husband with a good income, I'd probably be one of them. So, those who point to the number of nurses who are not working as proof that there is no real nursing shortage and that we would have plenty of nurses if only the pay and working conditins were improved may be wrong. They are ignoring the societal demographics and studies that show that part of this shortage is due to the natural retirement and semi-retirement of the baby boomers who no longer want or need to work full time.

3. Other physically demanding jobs (e.g. police officers, firefighters, military, etc.) have a planned retirement structure that kicks in after about 20 - 30 years of service. For someone who entered those professions in their early 20's, that means retirement comes in the 40's or 50's. It has always been recognized that the physicality and stress levels of those jobs require a retirement at that age. Bedside nursing is also physically demanding and stressful -- and yet there is not the same assumption made about the difficulties of working as a bedside nurse after age 50 that there is in other, similar professions.

When you add all these things up ... a lot of pieces fall into place.

I'd be interested in your thoughts on these things, Brian -- and those of anyone else who has thought seriously about these things.

llg

Brownms46 · Mar 4, 2003

I do agree in part with some of what you have posted here. And you have bought up some interesting, and well thought out points

here. Yes bedside nursing is a demanding field, both physically and mentally. But there are many fields that when the work is rewarding, and personally satisfying...and people enjoy what they're doing...they find it easy to continue doing it.

I have been traveling for quite a while now. And I have talked with nurses across the country for the last 11yrs that I have been traveling. I have talked with young and older nurses. I find the same complaints from most of them. The working conditions. Younger nurses wonder how many of the older nurses lasted this long in this profession, and older nurses...wonder what has been of the profession they loved so much.

I recently met a young nurse who had been recruited from the NW to the SW, immediately after graduating from school. She had moved away from home, and was excited about being a new BSN grad. But when she arrived at the unit she was supposed to work in...she was tore apart by the more experienced nurses. She lost confidence in herself and her ability to learn.

She left that hospital, and moved on to another, which also was going to pay her more money. She was again excited about the propects of working there. She found similar problems and bad working conditions there also. When last I saw her, she was comptempating leaving that hospital too. She was totally discouraged about being a nurse, and was questioning whether there was any good experiences to be found in nursing.

I'm over 50 and I still enjoy working on the floors..just not the way the work is now. When I started I loved working and had no problems working OT, and never feared for my pts., and or my license. Fear and stress now are a more constant companion when nursing in recent years. Maybe my memory is faulty, but I don't remember it being this way when I started out.

I run into a lot of workaholic nurses, and not everyone in my age bracket wants to work less..just because of their age. Many say they want it the way it was...when they didn't have to take care of so many pts. Especially in the ICUs, where one or two pts. were the norms...not three or four!. Pts. are more acutely ill now than they we saw on the floors when I started. What you see on med-surg floors now...used to be in the critical care units.

We used to have staffing by acurity level..and now it's just by the numbers. Nursing has changed...but not for the better IMO. And many nurses no longer wish to put up with how it has changed. That is IMO why there is no shortage of nurses who would be willing to work...if the conditions of the work were better.

grandma rn38 · Mar 4, 2003

i think if nurses wages where raised it would bring in more nurses that would be there for the money and not for the real thing nursing. i have work at the bigger hospital and made more money, and i was dump on all the time, after being there as a new nurse for 3m i was in charge. my 12hour shift was a 16-18 hour shift. i would get home close my eyes and come back. i now work in a smaller hospital and make alot less money but i'm doing real nursing which makes me happy. please don't get me wrong i think nurses should be payed very well for the work, and stress. but there has to be a calling for nursing not a dollar sign.

llg, PhD, RN · Mar 4, 2003

To Brownms46: Thanks for your thoughtful response to my post. I realize that there are still many people our age (I am 47.) who are still nursing at the bedside. I also realize that in some places, the conditions are deplorable and need to change.

I just get discouraged when some people think that it is ONLY the pay and conditions that are causing the shortage. These people say that "there is no shortage" or that "there would be no shortage if only the pay and conditions were improved." They assume that everyone with an RN license would return to work in nursing if only things were better. I am trying to say that it really is more complicated than that. Many of the baby boomers would not return to bedside nursing regardless of any change in pay or working conditins that might occur. There plan for their lives did not include bedside nursing at this point in their lives to begin with.

At my children's hospital, the ICU ratio is still 1 or 2 pts per nurse and the general care areas are 3 or 4 patients per nurse (with a nursing assitant for every 2 RN's) and we STILL have a shortage. While nothing and nowhere is perfect, we have done almost all of those things that people have asked for ... retention bonuses, flexible scheduling, competitive pay, etc. and there is still a shortage.

Anyone who thinks the answer is as simple as "more money" and "hire more staff" is being too simplistic.

Thanks again,

llg

igloorn93 · Mar 4, 2003

I don't think that most nurses go into nursing because of the pay. I think they go into it because of a 'higher calling'. That being said, once there, they see the working conditions, quality of care, long hours, little pay, work most holidays, long hours difficulty in arranging child care around 12 hour shifts, and many leave because of some of these reasons. If they could come up with some better benifits and yeah, increase in pay, and a lighter work load, I think we would see more nurses staying, and encouraging students to pursue a career in nursing.

dana d · Mar 4, 2003

Unbearable is right. That's the key. Money or benefits will not keep them. I know numberous nurses with a 2 year degree that have continued on and acquired a completely different 4 year degree. Mostly because of lack of support from the hospitals, physicians and nurses themselves. Who wants to work nights, weekends and holidays for less wages. Go back to school and get a teaching degree. You will have off weekends, holidays, and about 3 months in the summer. That's hard to beat. In my area, nurses and teachers make about the same, depending on how many years experience. But worse yet - Physicians on call at an area hospital receive $100. an hour, nurses, receive $5. an hour for call pay. Is there something wrong with this picture?

RN4jewels · Mar 4, 2003

I THINK MORE MONEY AND BENES WOULD HELP AND IF THE BALL WERE TO START ROLLING PERHAPS MORE WOULD CHOSE NURSING. THERE ARE SO MANY OPTIONS OUT THERE WHO WOULD CHOSE TO PUT UP WITH THIS PROFESSION WHEN THEY CAN MAKE SO MUCH MORE WITH LESS EFFORT. IN WISCONSIN OUR FLOOR IS PILOTING THE WISCONSIN NURSING REDESIGN PROGRAM. THOSE CHAIRING THIS ARE INFURIATING. THEY ALMOST INSULT US FOR WORKING PART TIME. I AM SO TIRED AFTER RUNNING THE FLOOR I NEED TO RECUPERATE BETWEEN SHIFTS TOO. THEY SHORT STAFF AND CLAIM "THERE IS A NURSING SHORTAGE, THAT IS WHAT KEEPS US UNDERSTAFFED" MY ***!!!!!!!!!!!!!! IS WHAT I TELL THEM. IT IS A COMPLEX ISSUE, BUT I AM MOST TIRED AND DISGUSTED WITH BEING A DOORMAT. WE ARE AT FAULT FOR ANYTHING THAT GOES WRONG. I AM A PERFECTIONIST AND GIVEN THAT EVEN I KNOW THERE IS NO SUCH THING AS PERFECTION. I WANT MORE MONEY, BETTER BENES AND A VOICE THAT IS RESPECTED IN THE ORGANIZATION. I REALLY THINK WE NEED TO PULL TOGETHER AND FIGURE OUT A WAY TO TAKE BACK SOME CONTROL. WE ARE NOT BAD TO WANT MONEY, I WOULDN'T CARE ABOUT MONEY IF THE NEXT GUY DIDN'T. I REFUSE TO BE AFRAID OF WANTING MONEY ANYMORE AND I DON'T CARE WHO TRIES TO IMPLY I AM NOT IN NURSING TO BE A GOOD CARE PROVIDER, THEY JUST DON'T WANT TO GIVE UP WHAT I WANT. LETS NOT FEAR OUR WORTH!!!!!

niteshiftnurse · Mar 4, 2003

The money would help, but not everyone is cut out to be a nurse. I am a nurse because it has been something I have wanted to do for over 30 years!!!!!!. Is the money good???,not really, unless you work lots of overtime. I love what I do and love making a difference in my patients stay.

GoodEnuf · Mar 4, 2003

Money and benes might help in retention and increase morale to those nurses already there. I doubt it will have any significant impact if poor working conditions remain and if nurses continue to be disrespected. Money and benes alone won't work, but are helpful. :idea:

Brownms46 · Mar 5, 2003

llg...You are very welcome..:). And you know I have been thinking all day about your post. And now after reading your second post...I must admit that I have heard nurses say that...they felt they didn't want to work the bedside any longer, as they have paid their dues. Yes there are those who wish to contribute to the well being of others, but have a life too.

I agree that the "shortage" is a complex situation. Brought on by many things. But I do feel there would be more "staff nurses"...if there more hospitals were as forward thinking as yours...and probably a few others.

Today I find almost daily new nurses asking about travel nursing. Why? Because they hear about the money, the independence and the ability to control their lives. Somewhere along the lines...they discovered that they didn't want to even begin to work as staff. Maybe it was the conditions they saw as students, that caused them to seek another way to pursue their careers.

Maybe they saw nurses mistreated by MDs, or saw the work loads that nurses endure at many facilities. Or maybe they saw the limited ability of nurses to have any real voice in how care is delivered in many of even the best facilities.

I don't know...but maybe the "shortage" is because those in charge of education programs...were short sighted in closing programs...or just not ensuing that others continued. There should be no reason for there not being enough nursing programs to allow entry into this profession.

Years ago...and even now...there are long waiting lists for new students. There is such a hassle with the whole process that it probably has turned away some excellent prospects. I just wonder who many did we lose?? How many fresh new faces did we miss...because they had to wait for a slot?? And in the waiting found another avenue to release their desire to serve humanity.

I wish I knew the answer to why there aren't enough nurses to help us care for those who are hurting, and in need of competent, and safe care. But I think if there aren't some answers soon...we will be back to caring for our love ones at home. Because in too many places..they aren't getting the care they should.

I salute your hospital in doing what it takes to provide safe pt/nurse ratios, and other incentives for nurse. As you have to start somewhere. Thank you for an enlightening discussion. :cool:

MrsK1223 · Mar 5, 2003

I have to say that I chose nursing as a career...just like anyone else chooses a career and of course money comes into play...some it means a lot and others it doesn't. If this was a male dominated profession, the fact that money is being brought into it wouldn't be so taboo. Before becoming a nurse I kept hearing how well nurses were paid and sure that attracted me. I am not altruistic....I'm here to make a living and it just happens to be one that involves treating the ill and the healthy. Doctors do it and they're not ashamed to admit that the money isn't somewhat of a motivator. I'm not Mother Theresa but I'm not a robot carrying out tasks either for the $$$$. I have a service to offer for exchange for money, it's called business. It's done all over the world, 24/7 365 days a year. We are supposed to be professionals and professionals should be paid well for their professional services and there is nothing wrong for wanting and expecting a professionals salary or pay. I don't think offering nurses money is the cureall of course to the shortage but it is a factor in the big picture in nursing. Until we stop acting like martyrs and accepting to do the work 7 times us for the pay of 1/2 of one of us or less then it will not change. I've known waitresses to make more than I do, in fact I've known many non degree workers make more money without the risk of killing or harming one or more people in a single day, risk of lawsuits, facing huge health risks on a minute by minute basis, being verbally and physically assulted, lifting and tugging hundreds of pounds, standing for hours and hours on end, working shift after shift with no food or bathroom breaks, must i go on. Sure maybe not everyone goes thru all of this and if you don't you're just lucky. I'm a fairly new nurse and it will take some major changes in the way nurses are treated before i will make this my life long career. If I knew how to change it or contribute to change I will or would do it. I know I won't be more than I am, one person doing her job but I won't even try to be the the 20 arms and legs administration and nursing managers want me to be to save them a few dollars.

Other factors that encourage the shortage is a pure lack of control over your life...it seems the hospitals want to own you, at least in my area. You can't be there for your kids either due to being at work more than at home or when you are home you are comatosed from exhaustion. My mother is a perfect example what the last 15 or so yrs in nursing have done to her...she's had to have both her feet broken and reset due to stress fractures from years of pushing 300lb patients and standing on her feet 16 or more hours a day and my mother is 5 foot and about 100lbs. It's taken her that long to just now make $21/hr. When you have two children to raise and this is the only income and there are no other choices around that pay even that well...where do you go? She put up with what she did to survive and thats what nurses do, at least in my area is just survive. The last time I heard the poverty cut off is around 29,000 (dont' quote me) and I make a little over that...hmmmmm doesn't quite seem worth it does it? Oh, please don't flame me...i'm in a mood. :devil: