I truly do not believe there is a nursing shortage as described in the literature. The simple premise of supply and demand would indicate if there was a 'perceived' need for more nurses: Low supply + high demand= higher wages. We do not see that in the hospital setting. Salaries are usually fixed based on years experience and (for the most part) non-negotiable. Furthermore, current salaries do not indicate that nursing is an 'in demand' profession. Put that together with management constantly using the 'nursing shortage' excuse to justify high patient loads to their current staff; but, when you have someone interested in a position in your unit, the response is that the "budget doesn't allow me to hire addtional staff" (I have heard this at more than one hospital). There may be a mild shortage because of those not willing to work under the current conditions, not the massive one being exploited.
My personal thoughts on this is that this supposed nursing shortage is being used as excuse to try and create a glut of nurses. Once there are too many, wages can go down, higher paid older staff will be laid off and many will be fighting for the few available jobs. I don't think that actual staff numbers, per hospital, will increase-just the number of available nurses seeking a job and be willing to be overworked and underpaid (while feeling grateful they have a job, in the first place). This has happened in many professions over the past 30 (or so) years. History is the best teacher. It about time we learn from the lessons history can teach us!
In my opinion, bedside nursing and NP roles are so vastly different in nature that I sometimes have hard time grasping the relationship between the two!
Bedside nursing is where the worst "shortage" is, including long term care. But as others have noted, many places that are short also aren't hiring or don't change the work conditions enough to recruit and retain staff.
So there's a half-hearted campaign to train more nurses. Interestingly, though, many of the new nursing programs are these accelerated programs that appeal to those interested in going directly to advanced practice, essentially bypassing bedside nursing. It almost seems contradictory.
But, NPs (and PAs) are more in demand because they are more cost effective than doctors and so there's a push for the quicker training up of NPs. I'd be curious to see the economics behind schools' decisions to offer accel programs and direct-entry advanced practice options versus opening more RN/BSN slots.
I truly do not believe there is a nursing shortage as described in the literature. The simple premise of supply and demand would indicate if there was a 'perceived' need for more nurses: Low supply + high demand= higher wages. We do not see that in the hospital setting. Salaries are usually fixed based on years experience and (for the most part) non-negotiable. Furthermore, current salaries do not indicate that nursing is an 'in demand' profession. Put that together with management constantly using the 'nursing shortage' excuse to justify high patient loads to their current staff; but, when you have someone interested in a position in your unit, the response is that the "budget doesn't allow me to hire addtional staff" (I have heard this at more than one hospital). There may be a mild shortage because of those not willing to work under the current conditions, not the massive one being exploited.
My personal thoughts on this is that this supposed nursing shortage is being used as excuse to try and create a glut of nurses. Once there are too many, wages can go down, higher paid older staff will be laid off and many will be fighting for the few available jobs. I don't think that actual staff numbers, per hospital, will increase-just the number of available nurses seeking a job and be willing to be overworked and underpaid (while feeling grateful they have a job, in the first place). This has happened in many professions over the past 30 (or so) years. History is the best teacher. It about time we learn from the lessons history can teach us!
Well folks, I have figured out what professions have a shortage. PT and OT. Why do I say that? In this weeks paper, hospitals here in Eastern Washington are offering $10,000 bonuses to each of these EXPERIENCED HEALTH CARE PROFESSIONALS!!
Why is that? Because there is no glut of PTs and OTs. And why is that? Because their professional organizations work at keeping the number of therapists low with high educational standards. That's why.
When was the last time you heard of an experienced nurse being offered ANY BONUS, let alone a $10,000 bonus. Usually, we are shown the door.
There was also an ad for nurses. But there was no mention of any bonus. Why? Because they know that in six months another crop of new grads from ABC Community College will be graduating and looking for jobs. Do the math.
There are new grads that will be graduating from the BSN program in four years, but that is too long to wait. Hospitals need nurses NOW. Nevermind that there are hundreds of unemployed, experienced, nurses in the area who have left the bedside that could fill their empty slots. But they would want too much money. New grads are paid ten dollars and hour less, and have not injured their back and necks yet. And are not too interested in retirement plans.
In this weeks paper, hospitals here in Eastern Washington are offering $10,000 bonuses to each of these EXPERIENCED HEALTH CARE PROFESSIONALS!!
Why is that? Because there is no glut of PTs and OTs. And why is that? Because their professional organizations work at keeping the number of therapists low with high educational standards. That's why.
When was the last time you heard of an experienced nurse being offered ANY BONUS, let alone a $10,000 bonus. Usually, we are shown the door.
Can someone connect the dots?
Or maybe it's that there aren't that many experienced OTs and PTs willing to work at those hospitals due to the conditions or pay. Perhaps experienced OTs and PTs have better options - such as working with a private practice. That's an option for PTs in some places; I don't know about OTs.
I imagine that PTs are hired to more supervisory roles than direct patient care as PT techs would be more cost effective. Thus, an inexperienced new grad wouldn't be nearly as valuable to a hospital as an experienced PT. However, notice that they use a bonus to recruit... wouldn't higher salary be more effective? But on paper that's more expensive in the long run. And with a bonus, they usually demand at contract to work a certain number of year or to forfeit the bonus. A place that's good to it's employees won't need to lock their employees into contracts to get them to stay.
And yes, I've seen plenty of hospitals offering bonuses to nurses. And to nurses who recommend someone who is then hired to the facility. More so in the last few years than just this last year. Often those offers haven't specified experienced or new grad. In some places, the new grads hire on for a salary that matches experienced nurses (which doesn't endear those newbies to the experienced nurses). And new hires are also expensive in that they require longer orientations and may be more likely to leave within a year than an experienced nurse (I'm guessing here - I don't have numbers one way or another on that ).
In general, having bonuses offered doesn't necessarily mean good things for a profession. As in nursing, it could mean that working conditions are such that even those qualified for such positions are choosing to avoid them and the facilities are resorting to bonuses to try to lure more staff back - as opposed to spending the much greater amounts of money to create a better work environment (eg hiring two people instead of giving a bonus to one to do the work of two people).
About the 'supply and demand' of nursing.....i have an example.
I worked in a LTC right after graduating nsg school. When I left this job, I worked night shift Thu-Sun. I chose these hours since I had a baby....they were the most family friendly since they were my DH's day's off.
This place had horrible management, like many of them do. For other reasons, I was on the DON's 'sh1t list. She was constantly nitpicking, bullying people if they went into overtime, ect. i made $23/hr. She absolutely HATED agency nurses. We often times worked short of CNA's b/c we couldnt call agency....she was definately most interested in making $ for the corporation than for pt. care or safety.
Anyway, my ex-coworkers told me that when I quit, they did not fill my shifts for several weeks - they had to hire agency nurses. (Who wants to work weekend/NOCS?? - even the agency RN's are at a premium for these shifts) When they did fill the position, it was with a nurse who came in and named her price at $32/hr-stating she wouldn't work for anything less and they gave it to her.
The way I see it, I was pretty valuable in that I was working (what many nurses consider) the most undesirable shifts at a significantly lower wage. If the DON would have been smart, she would have realized this....instead she had threatened to fire me upon occasion. The only way my replacement got the wage that she wanted was b/c she was filling a position that no one else wanted.....low supply and high demand.
Specializes in Med./Surg., Diabetes, Med. ICU, home hea.
I won't speak for everywhere in the U.S., but in my area of California, there is NO shortage... other than a few areas that are typically hard to staff for, i.e., telemetry, per diem E.R., etc. While the HYPE of "shortage" is prominent, just look at the want adds/recruitment sites in the Sacramento area. Two years ago, the listings were long and varied. Today, they are few.
Hospitals in this area have even started to eliminate "full time" positions and are near doubling the cost of health care benefits yearly. This, I believe, is in direct responce to "ratios" (vindictive business plan).
Re-entry programs are becoming HARD to find/utilize as a working adult (I know, I've been looking...).
Physicians' offices staff few, if any, RN's, opting for "Med techs." An urgent care I recently utilized, infrequently staffed an RN.
Times they are a changin' in this part of California; it will be interesting, and probably frightening, to see what will unfold in the next few years.
"Re-entry programs are becoming HARD to find/utilize as a working adult (I know, I've been looking...).
Licensed in 1980 after my BSN-RN, I continued to work 14 years! I befell to a MEDICAL DISABILITY and now 13 years later, I studied and took my NCLEX-RN, PASSED on June 29th, and have yet to be able to land a job... YES cucsus is low, YES, I was unable to be LICENSED before all the NEW GRADS- but, yes there are UNFILLED positions!!! I keep applying, and have TERRIFFIC INTERVIEWS, have actually been told I "will be hired, a per diem rate, set # of hours" only to be called the next week and told, wait another month or so, that the census is too low to hire me... another criticism has been my VOID of working history over the past 13 years (remember my disability)and my lapse of direct CLINICAL exposure) but, I have scoured the ENTIRE state, Florida, for re-entry, of refresher clinical courses, programs, and there are NONE! How does an experienced RN with excellent critical thinking and maturity and bedside management and skil get bak into an entry level job?? I fear it's a combination of my age, the lapse in work/recent experience, and mostly, that they can't see all the benefit I bring, they only see my (short-term baggage) all the job openings I see now are in specialty areas, all require current ACLS and specialty designations, even if I opt to more education, that doesn't fill my lapse in the work history, nor beef my clinical into todays new proceedures and electronic charting... how does one re-enter nursing, when No-one is willing to hire you?
There is no shortage of RN's, only a shortage of RN's willing to work in bad settings for low pay and poor benefits.
That's exactly it, a straight supply-and-demand situation with the moneybags who control the pay thereby keeping staffing levels to the lowest, cheapest level possible. I have no idea why this always shows up as a "controversy." There is no "controversy" where the industry is concerned because with the success of the "shortage" smoke screen, no one's been successfully sued for typical low staffing. And guess who perpetuates the lie for them so they rarely have to break cover and do it themselves? We do!
in short, the perception of many engineers is similar to that stated above: "there's no shortage of engineers, only a shortage of subject-matter experts who will work 60-hour weeks for $60,000 per week and no benefits."
for $3,120,000 a year i'll pay for myown benefits! :monkeydance:
loricatus
1,446 Posts
I truly do not believe there is a nursing shortage as described in the literature. The simple premise of supply and demand would indicate if there was a 'perceived' need for more nurses: Low supply + high demand= higher wages. We do not see that in the hospital setting. Salaries are usually fixed based on years experience and (for the most part) non-negotiable. Furthermore, current salaries do not indicate that nursing is an 'in demand' profession. Put that together with management constantly using the 'nursing shortage' excuse to justify high patient loads to their current staff; but, when you have someone interested in a position in your unit, the response is that the "budget doesn't allow me to hire addtional staff" (I have heard this at more than one hospital). There may be a mild shortage because of those not willing to work under the current conditions, not the massive one being exploited.
My personal thoughts on this is that this supposed nursing shortage is being used as excuse to try and create a glut of nurses. Once there are too many, wages can go down, higher paid older staff will be laid off and many will be fighting for the few available jobs. I don't think that actual staff numbers, per hospital, will increase-just the number of available nurses seeking a job and be willing to be overworked and underpaid (while feeling grateful they have a job, in the first place). This has happened in many professions over the past 30 (or so) years. History is the best teacher. It about time we learn from the lessons history can teach us!