Is there still a nursing shortage?

elkpark · May 1, 2017

Definitely a shortage in my area. My hospital's been offering "high vacancy incentive" for any nurse in any department in the entire hospital to pick up overtime in 12 week blocks because the hospital itself has greater than 30% of RN positions unfilled. Pretty much every night every unit has nurses over the ratios they're supposed to have, even the supposedly more desired specialties.
150 RN openings at my hospital alone and I suspect that they are underposting listings... there are nine listings for my unit currently, but those are a mix of days and nights. Nights could probably use at least ten more people and days are regularly even shorter-staffed than nights - nine listings is nowhere close to sufficient to bring us to full staffing.
Anyway, long story short, there are definitely areas of the country with a critical shortage, where we don't even have enough NEW GRADS to fill positions, let alone experienced nurses.
For kicks and giggles, here's what our staffing matrix looks like for a week closer to the end of May before the float pool staff get worked in. This includes regular staff plus current travelers. And yes, those negatives are the number of nurses below 18 per shift currently on the schedule, as the highlighting of one of the -10 days shows.

There is a big difference between an overall shortage of nurses, and hospitals choosing not to employ sufficient numbers of nurses to staff the hospital generously. Is the hospital recruiting and hiring nurses, or do they have open positions for which no one is applying? Are qualified applicants applying and getting turned away? (And is there some reason why nurses wouldn't want to work for your hospital, vs. a true shortage of applicants?) I know plenty of hospitals that are running the nurses into the ground through high ratios and overtime, but it's not because there is any shortage of nurses in that area; it's because the hospital isn't willing to pay what it would cost to have enough nursing staff to avoid the overwork and overtime.

calivianya, BSN, RN · May 1, 2017

You have given no evidence of a shortage of nurses in your area. Where are the numbers of licensed nurses in your area?
Open positions and short staffing are management choices and in no way reflect the number of available nurses, but rather the number of nurses willing to work for the pay and working conditions being offered.

Valid point! I don't know about the number of nurses in my state vs. the number of total openings (is there any easy way to find total openings beyond looking through every single nursing employer in the state?), but I do know that my hospital has excellent benefits, and the latest market adjustment pushed us higher than the neighboring hospitals for pay.

Thanks for the info. Do you mind sharing what area in the country you are in? I heard Midlands have this type of shortage. My mom is head of nurses where she works in CT, and says she always has vacancies, interviewing new grads (who are the ones who claim to have trouble finding a job) and she says that they are super picky about it and never end up taking the jobs even when offered. So sometimes it's hard to believe there is no shortage, when people that complain don't take the jobs they are offered because for example they didn't get the hospital position.

Central NC. I know most of our hires are new grads that my unit is the only job they bothered applying for, because they weren't worried about having to find another position. This is different from even four years ago when I started out, where a lot of my new grad cohort had to apply for multiple jobs and/or settle for something other than their "dream" job.

There is a big difference between an overall shortage of nurses, and hospitals choosing not to employ sufficient numbers of nurses to staff the hospital generously. Is the hospital recruiting and hiring nurses, or do they have open positions for which no one is applying? Are qualified applicants applying and getting turned away? (And is there some reason why nurses wouldn't want to work for your hospital, vs. a true shortage of applicants?) I know plenty of hospitals that are running the nurses into the ground through high ratios and overtime, but it's not because there is any shortage of nurses in that area; it's because the hospital isn't willing to pay what it would cost to have enough nursing staff to avoid the overwork and overtime.

Actively recruiting. They are currently running an incentive which triples the current referral bonus if a current employee can find someone with experience to work here. They are also offering sign on bonuses... which is nothing special, because the major competition hospital systems are also offering sign on bonuses. We can't find anyone with experience to apply... We're beyond the point where it's cheaper just to work existing staff harder, just from the sheer number of travelers - getting crisis pay rates - we have to keep the doors open.

I asked the travelers what they are making, and some of them make weekly what I make in four weeks. If that's their take home pay, I hate to think of what the hospitals are paying their agencies. There's no way that's cheaper than hiring more full time employees, even taking benefits into consideration.

I'm not aware of reasons not to work for my employer. My current job is the best I've had as a nurse... but that's not saying much since I've only had four jobs.

BSN16 · May 1, 2017

I think that there are areas that are very saturated with nurses...and areas that are not. with that being said the areas that there arent a lot of nurses are more undesirable areas in the midwest that many people dont want to move to. These areas also do not offer very competitive pay like the coast states do. previously worked in a city in iowa with a couple hospitals. These are the kind of hospitals that hire new grads into ER,ICU,OB positions because they are so short.

Medwynn · May 1, 2017

It's tough. When I first became a nurse, we had so many new grads from California spilling over into Nevada. The new grads could not find a job unless you wanted to work at a SNF. After a year at our hospital, the California grads moved back into their state and got their "dream" job. The hospitals around here always have open positions. Almost half of the cardiac ICU staff is travelers. We have a shortage here in our area.

Here.I.Stand, BSN, RN · May 1, 2017

Definitely a shortage in my area. My hospital's been offering "high vacancy incentive" for any nurse in any department in the entire hospital to pick up overtime in 12 week blocks because the hospital itself has greater than 30% of RN positions unfilled. Pretty much every night every unit has nurses over the ratios they're supposed to have, even the supposedly more desired specialties.
150 RN openings at my hospital alone and I suspect that they are underposting listings... there are nine listings for my unit currently, but those are a mix of days and nights. Nights could probably use at least ten more people and days are regularly even shorter-staffed than nights - nine listings is nowhere close to sufficient to bring us to full staffing.
Anyway, long story short, there are definitely areas of the country with a critical shortage, where we don't even have enough NEW GRADS to fill positions, let alone experienced nurses.
For kicks and giggles, here's what our staffing matrix looks like for a week closer to the end of May before the float pool staff get worked in. This includes regular staff plus current travelers. And yes, those negatives are the number of nurses below 18 per shift currently on the schedule, as the highlighting of one of the -10 days shows.

Based on some things you've said about your workplace culture, I'm not surprised.

beckyboo1, BSN, RN · May 1, 2017

Call it what you will but in this area, we call it a shortage. If you want to find a job as an RN, come to Columbia MO area where there are $10,000 sign on bonuses being offered.

PMFB-RN, RN · May 2, 2017

Call it what you will but in this area, we call it a shortage. If you want to find a job as an RN, come to Columbia MO area where there are $10,000 sign on bonuses being offered.

Obviously that is absolutely no indication there is a shortage of nurses. To know if you have a shortage you need to know how many nurses are available vs the number need.

While they may be offering $10K sign on bonuses. I'm willing to bet that the hourly rate is low, working conditions are sub par, and benefits inadequate, or all three.

In all cases I'm aware of, plentiful jobs and short staffing is a management choice.

PMFB-RN, RN · May 2, 2017

It's tough. When I first became a nurse, we had so many new grads from California spilling over into Nevada. The new grads could not find a job unless you wanted to work at a SNF. After a year at our hospital, the California grads moved back into their state and got their "dream" job. The hospitals around here always have open positions. Almost half of the cardiac ICU staff is travelers. We have a shortage here in our area.

How many nurses available vs how many needed? Without that date you can't determine if there is a shortage.

PMFB-RN, RN · May 2, 2017

Valid point! I don't know about the number of nurses in my state vs. the number of total openings (is there any easy way to find total openings beyond looking through every single nursing employer in the state?), but I do know that my hospital has excellent benefits, and the latest market adjustment pushed us higher than the neighboring hospitals for pay.
I'm not aware of reasons not to work for my employer. My current job is the best I've had as a nurse... but that's not saying much since I've only had four jobs.

I'm curious about the "excellent" benefits you mentioned. To describe them as "excellent" they would have to include low premium, high quality health insurance with little to no deductible, reasonably priced dental insurance, a generous 401K matching to at LEAST 6%, At least 8 hours/pay period of PTO or vacation/sick leave, as well as a non-contributory pension plan at a MINIMUM.

I am also curious about the pay and working conditions. Are hours guaranteed? Is there mandatory over time? Is floating unusual and handled fairly? Do you have a strong union? Clinical ladder? Merit based raises? Are your staffing ratios safe and standardized?

As for pay, I would consider anything less than starting pay for new grads of $25/hour in the Midwest & south, and $30/hour on the coasts to be LOW. Here in the upper Midwest new grads are paid $31.50/hour before night and weekend differentials. Nurses who have 5-10 years experience will make in the low 6 figures without OT, and highly experienced nurses up to $140k/year or so.

DoGoodThenGo · May 2, 2017

Guess it comes down to who you want to believe.

North Dakota hospitals are hiring international nurses because they say the shortage is real, acute and growing.

Now if you've seen the film "Fargo" and or know anything about North Dakota it is clear the climate (winter months) isn't for everyone. Nor is that part of the USA (NYC or San Francisco it ain't) again up everyone's street.

Nursing faces critical job shortage | North Dakota News | bismarcktribune.com

PMFB-RN, RN · May 2, 2017

Guess it comes down to who you want to believe.
North Dakota hospitals are hiring international nurses because they say the shortage is real, acute and growing.
Now if you've seen the film "Fargo" and or know anything about North Dakota it is clear the climate (winter months) isn't for everyone. Nor is that part of the USA (NYC or San Francisco it ain't) again up everyone's street.
Nursing faces critical job shortage | North Dakota News | bismarcktribune.com

Maybe there is a shortage of nurses in North Dakota, maybe not. That state borders this one and I know that the economy is BOOMING there and there are jobs all over the place. I also know that the regular pay offered by hospitals in ND is very low. My hospital in Minnesota is full of nurses from North Dakota who came here for the much higher pay and better benefits offered in MN vs ND (a right to work state).

I just looked online and Altru health system in Grand Forks ND is offering starting pay of around $25/hour for hospital nurses, and $16/hour for clinic nurses. I also noticed that TOP pay is listed at $33/hour there, vs $50/hour here in my hospital for staff RNs.

Trinity hospital in Minot lists starting pay for hospital nurses of $22/hour.

So it would seem to me that North Dakota is driving away it's nurses with low pay being offered. Is there really a nursing shortage in North Dakota? Or are nurses voting with their feet and rejecting being paid inadequately?

jaderook01, BSN, RN · May 2, 2017

Seems like some people on here have had trouble finding their first jobs, some find them before they even graduated. News and articles frequently state there is...I'm very confused! What is everyone's personal experience finding a job or what have you heard?

This is just me talking without looking at facts to back up anything. So- pure opinion- in other words. There is a shortage. However, hospitals are getting rid of middle management nursing positions and capping floors instead of hiring new folks, even though they still may have nursing positions posted. It's about saving money instead of safe nurse/patient ratios. Sometimes it's all about the hospital looking good on paper for potential mergers. It's also about a shortage of nursing instructors. We make more money working in hospitals at the bedside than we would in teaching more nurses. Until colleges and universities start paying their instructors well enough- they will never be able to meet the actual nursing demand.