Is the nursing profession causing its own RN shortage?

[RNDave]

With all the RN's going to NP school, is the profession significantly contributing to the RN shortage? Between retirement and RN's in line to become NP's it seems our unit is on a constant hunt for staff.

[fnp2b369]

Very well said, PyridiumP! No school in the nation has the legal authority to determine the total number of clinical hours of its students. The state BON's have the sole authority to set the minimum of clinical hours necessary to graduate from a school of nursing and be eligible to sit for the NCLEX. AND, all RN students, be they diploma (I've heard a few programs still exist), ADN or BSN earn the same number of clinical hours. Remember, to the BON, a nurse, is a nurse, is a nurse. They are not allowed to set different standards or grant special privledges to NCLEX candidates with different degrees.

I have been an LVN, an ADN and a BSN, and now I'm a grad student working on my NP. When I'm done with my masters I intend to go on and earn my doctorate in nursing. Having said all that I can honestly say that yes, all new grads start off wide-eyed and scared, regardless of their degree. And, the more education one earns, the more opportunity for financial gain, as well as professional respect. Having started at the bottom of the ladder and worked my way up I feel that the minimum entry for practice should absolutely be the BSN. Med/Surg units are rapidly becoming a thing of the past and patients are expected to be ill and recuperate at home. To optimize that dynamic the RN needs basic courses in community health and epidemiology, which most ADN's get little to no exposure to. I went to a very high-ranked ADN program with NCLEX pass rates in the high 90's but we had ZERO exposure to community health principles and practices-I had to learn all that in my BSN program. I have about 25 years to work before I retire. I'm hopeful that by that time RN's can somehow manage to get it together and unite as educated professionals under a single entry of practice. Until then all the squabbling over which degree is superior only makes it easier for management to impose their bs on us all. Remember, if we're too busy fighting each other we're too busy to fight management for what we and our patients deserve. It's a principle as old as the pyramids... Peace í ½í¸Š

[NedRN]

Add those those conundrums, is the issue that there are insufficient numbers of nurses to mentor the new grads. New grads, especially from the BSN colleges/universities do not have the clinical skills necessary to "hit the ground running," unless they have been ADNs, diploma grads or LPNs with several years of clinical experience prior to entering the BSN programs.

lets be clear that *no* new grad is more than minimally competent to hit the ground running. New direct entry ADN grads are no more competent than new grad direct entry BSN grads. They all have the same amount of clinical time as students, this is regulated by their accrediting agencies and boards of nursing. Inconvenient fact in this argument but there it is.

Actually, if CHESSIE's statement was changed to diploma students hitting the ground instead of ADNs, it would have been accurate. The old diploma programs were hospital based and hands on training (what might be called on the job training today). They were even quartered in the hospital or an adjacent building with a curfew. Training included a didactic portion of course, but most of time spent was practical training by staff nurses or just working (free labor for the hospital). They rotated through every nursing job in the hospital and did not need additional orientation when they started doing the same job for a salary (not much more value than room and board was during the diploma program).

Of course, those programs are long gone in most countries, even in holdouts like Great Britain. Academics believe research shows that academically trained nurses do better than practically trained nurses after the first year and then outperform the diploma nurses. The same is true of BSN over ADN, hard as that is to believe with basically just one semester of total credits separating the two programs. I guess it just proves that further education is always valuable even just a couple of classes.

[OCNRN63, RN]

I am sorry but i really have difficulties finding in my own posts any mentions of "all bedside nurses".

I did mention that doing the same entry-level job for 35 years cannot be named a good career, although it may be satisfactory for someone. I think it is pretty much correct about nursing as about anything else. Staying for 35 years near conveyor belt doing the same operation was considered a career when Henry Ford started his automotive business. Nowadays, it is still a job and respected as such, but it hardly be named a "career".

I did not mean that all bedside nurses are mindless task machines (as a matter of fact, I am working bedside). But, as kalivianya mentioned and as one can easily see from this very forum many posts, in many places they are treated just as such. Add to that anti-intellectualism and bullying culture which are often flourishing in the very same type of places, and also lack of power in decision making and inability to practice the skills and knowledge they posess, and you will better understand at least one reason why so many nurses go back to school.

I am sorry if my posts hurt anyone's feelings.

You're still saying the same thing, only qualifying it with a non-apology apology ("I'm sorry if my posts hurt anyone's feelings").

Had I not been sidelined by a serious illness, I would have stayed at my job till I retired. I had a job I liked, great co-workers, good pay for my area, and good hours for the most part. I had no desire to go into debt at my age to be a NP; I didn't even really want to be one. I had no desire to be a manager, either.

So if wanting to stay at my job till retirement made m a "drone," then I'll take that. I'm sure my patients were happy to have us there for them. Actually, that's just your opinion that staying at a job for 35 years is not a career. I loved working with those nurses who had seen all sorts of treatments come and go; who had seen historic changes in caring for certain populations; who knew all the tricks/hacks to make the day go smoother.

It's interesting that the subtext of your post was a jab directed at older/seasoned nurses.

[chemdawg, MSN]

I have been in nursing for 5 years. As a recent grad from Texas we were relocated to Washington State where it took 4 months of persistent hard work and prayer to land a residency. The majority of the hospitals within an hour drive either did not have a program for new grads or picked from over 200 applicants those that had connections from school, family or friends. The hospital that I did obtain a new grad job at had a thorough and challenging program that included passing the PBDS. During my three years there I saw many new RN's that would relocate long enough to get the first year under their belt and then obtain a job back home. Turnover was and still is high and it makes it difficult for the core staff each season. I have wondered how great it would be for longevity to weed those out only wanting to use it as a stepping stone. Or even for the receiving hospitals of these trained nurses to compensate those hospitals that are willing to invest in new grads.

[PMFB-RN, RN]

I have been in nursing for 5 years. As a recent grad from Texas we were relocated to Washington State where it took 4 months of persistent hard work and prayer to land a residency. The majority of the hospitals within an hour drive either did not have a program for new grads or picked from over 200 applicants those that had connections from school, family or friends. The hospital that I did obtain a new grad job at had a thorough and challenging program that included passing the PBDS. During my three years there I saw many new RN's that would relocate long enough to get the first year under their belt and then obtain a job back home. Turnover was and still is high and it makes it difficult for the core staff each season. I have wondered how great it would be for longevity to weed those out only wanting to use it as a stepping stone. Or even for the receiving hospitals of these trained nurses to compensate those hospitals that are willing to invest in new grads.

Did you have to sign a contract to get the residency?

[Bepsi]

I don't know if there is a national shortage but locally yes we do. There is a local nursing school putting out new students every semester. The problem is that they stay locally long enough to get experience then move on to the big city. Our hospitals have ratios and pay competitive rate but it is a small town with not a lot of extracurricular draw. Nurses need to look outside their area to find jobs in hospitals if they are not finding one locally. I don't see the problem in my area improving any time soon. The hospital setting will always be difficult but finding the nurses with fortitude to work it is hard.

[PMFB-RN, RN]

I don't know if there is a national shortage but locally yes we do. There is a local nursing school putting out new students every semester. The problem is that they stay locally long enough to get experience then move on to the big city. Our hospitals have ratios and pay competitive rate but it is a small town with not a lot of extracurricular draw. Nurses need to look outside their area to find jobs in hospitals if they are not finding one locally. I don't see the problem in my area improving any time soon. The hospital setting will always be difficult but finding the nurses with fortitude to work it is hard.

Because a lot of nurse leave after they get some experience in now way indicates there is a shortage of nurse. Just a shortage of nurses who want to live in the area.

[lynnlu]

EXACTLY!! " RN SHORTAGE" is a myth unit managers tell the staff in order to justify the bare minimun staffing ratio's that save on budget and put money in the admin's pocket. i know PLENTY of RN's looking for staff jobs at any given time. psh. please.

[dec2007]

EXACTLY!! " RN SHORTAGE" is a myth unit managers tell the staff in order to justify the bare minimun staffing ratio's that save on budget and put money in the admin's pocket. i know PLENTY of RN's looking for staff jobs at any given time. psh. please.

I think some areas are different than others. We've been doing mandatory overtime for the last six months.

[NurseDiane]

It benefits the nurse & the hospital. High turnover means that the hospital doesn't have to worry about paying retirement benefits or raises for ladder/tier rising up through the ranks.

It's all about money.

[dec2007]

It benefits the nurse & the hospital. High turnover means that the hospital doesn't have to worry about paying retirement benefits or raises for ladder/tier rising up through the ranks.

It's all about money.

How does that benefit the nurse? I guess if you're a work-a-holic it would, but if

you're a nurse happy with what you hired on for, mandatory overtime isn't all that nice.

[chacha82, ADN, BSN]

Not the profession for me but the nature of work in some places. High acuity, slammed with admissions, demanding family members. Increasing requirements on documentation and no time to do it. Expectation for ICU level monitoring and care on a medical floor. Interruptions for trivial reasons in the middle of critical tasks. Not enough CNAs to help with personal care, or CNAs who might as well not be there because they don't help. Demands to attend training on precious days off. The worst is when I'm titrating meds or trying to figure something out (usually looking at multiple IV meds) and patients or family members are barking orders at me. It's distracting and rude. I get that they are upset about their situation, but I'm still a new nurse and don't do tasks on autopilot.