Listen up future Nurses. I have some news...

kgh31386, BSN, MSN, RN · Nov 8, 2010

My 2 cents on the issue. There's a shortage depending on where you are and how hard you look. The reason that this is extra dramatic in nursing is because well, a LOT of nursing students are VERY dramatic. You also have to realize that some students will flat refuse to work anywhere but their dream job. I know some classmates who didn't look anywhere but L&D and a couple of them got it, but the others are housewives now(they got married the month after graduation and haven't thought 2 thoughts about looking for jobs). And then there's the excuse of, "they only want experienced nursing". This creates some hostility towards those who have experience and you know what, it's no one's fault. Just look harder, find a job, and be happy. I guarantee you there are some med/surg pr LTC jobs out there that people on this very thread have seen, but looked right past. So many people say "I graduated nursing school, I'm not gonna wipe poop all day....I will only work ICU and NEVER med/surg". I saw more poop in the ICU than I did on any med/surg floor, but that's another story.

allnurses Guide · Nov 8, 2010

I wonder why you said "not so anymore" Has there not been bad economies before? Are there other mitigating factors that make an experienced nurse like you to say that? I think there are many reasons why I agree with you But if you might elaborate..........

Certainly there have been bad economies before! But a peak year nursing shortage around 1980 was so bad that we were pretty well insulated from the recessions of the seventies and early eighties. At around that time, if I wanted to work it was pretty much like an all-you-can-eat cafe. There were so many classified ads for nurse jobs that the Los Angeles Times created a newspaper within a newspaper with the large header NURSING JOB OPPORTUNITIES. Therein you would find all the large facilities taking out full page ads with enticements such as cruises, sign-on bonusses galore, tuition reimbursement and many other creative ideas by recruiters. I believe it was around this time that alternate shifts such as 4 10hr and 3 12hr/wk shifts began to appear as both a "flex-time" draw and staffing solution in one. It was nuts.

When a healthcare company was hit with the effects of a recession, they would lay off clerks, receptionists, techs etc before they would cut into the nursing workforce. I remember working for a company that merged with another in 1981. The new company actually had all of us fill out very detailed surveys of what we did for how long pretty much every minute of the day and then basically said "thank you for filling out the 15-page survey" now you, you, you and you are fired! Buh-bye! Not one nurse lost their job, 20% of "ancillary personnel" did.

I'm sure nursing programs started to sprout and crank out as many nurses as they could to meet the demand, and what we're seeing now might be the perfect storm of supply catching up with demand and simultaneous nastier than usual downturn in the economy. I can tell from reading these boards that (though not a regular trend throughout) it's tougher for a new nurse to find a job now as opposed to prior recessions by huge numbers. Like several hundred applicants for one job. Like a new grad spending $700 for a plane ticket to a far-off city just for an interview. Uprooting and moving to another state. I just don't see a fix for that occurring in the foreseeable future.

NJMEDguy48 · Nov 8, 2010

ok nursel56,

I enjoy your level headed response. A few more questions if I may. 25 years ago were there as many specialized techs as there are today that seem to fill some of the roles of nurses at a cheeper rate maybe because they do not have to be as well rounded? 1 yr tech school 15k vs 4yrs BSN med school at 50k. I am going to be careful as I can speak only for central NJ. There are tech schools everywhere (Just like computer schools of the 80-90's ) The truth is they are owned and operated by the same people! Yes really look at the corporations that own them. P & L is what it is about and they are making money! Amazing. You say hundreds are applying for 1 job in your area I wish we had a human resource person from each state on here to tell us the truth. How come schools here in NJ have years waiting lists to get into RN programs for nursing. They say lack of teachers. I am wondering about that. If they paid the professors the same rate or more as a nurse with all the students trying to fill the class these institutions and boards of directors (AH HA POLITICAL HACKS) that run them could still make money. This still perplexes me. At an affordable community college here in NJ you can get your RN. in central NJ very affordably. (compared to 4 yr college.) The hitch...... They (2 yr community college) make you take all pre reqs before you can apply for program. I just read on a current post here in all nurses they have over 1100 persons whom met all those pre req stipulations for 90 yes 90 spots at my county college(Ocean county). How much did the college make on all those 1010 that did not get into the nursing school? Will they go for other fields that offer little hope of growth and prospect in the new america? What other jobs can the new america offer? What other fields? I do not know... I have more to say and ask but I just wonder your thoughts, as an experienced health care professional

KeepnItReal · Nov 10, 2010

Maybe you should investigate every city, every state, and every hospital before you start saying the sky is falling. Like everyone else who has posted, there is no issue with job prospects where I live. Local hospitals have many openings posted, solicit new grads at informational job fairs at our school, and offer advance sign-on bonuses to those who are willing to sign a contract. I've already signed on with the hospital where I have clinicals, and it was offered to me in my first semester.
For those who don't go to the hospital setting, extended care facilities have been sending cards in the mail asking for applicants. Mental health facilities have openings. Every class, every semester, has placed the new grads within 3 months of passing NCLEX. I honestly don't know how a new RN can't find a job unless they just have little employment history?

Calm down, don't take it so personally

2ndyearstudent, CNA · Nov 10, 2010

I just don't see a fix for that occurring in the foreseeable future.

Just watch. They said the same thing in 1990.

allnurses Guide · Nov 10, 2010

Just watch. They said the same thing in 1990.

Thanks for the advice, but it will be highly unlikely that my observation of a local market in a particular profession for 35 years will end up to be far less accurate than your experience in 1990 in a different profession. Just out of curiosity, when do you expect the same conditions to recur for new grads that were present in 1980? How will that differ from what you think the situation was in 1990?

allnurses Guide · Nov 10, 2010

NJMEDguy--- I'm really not qualified to answer your questions about why nursing schools still have long waiting lists, the issue of profit and loss for schools or really what the big picture will be like going forward. I hear it said quite often that there is a lack of trained faculty - creating a bottleneck. The reasons for that - I don't know. Here is an interesting position paper from the American Academy of Colleges of Nursing (AACN) about the nursing shortage. They contend that the nursing shortage is still at crisis levels and call the present situation "an easing of the shortage". Not sure they would find a lot of agreement with that from nurses who are unable to get their first jobs for months on end, though. Included the fact sheet for Faculty Shortage, too.

AACN - Media - Nursing Shortage Fact Sheet

AACN - Media - Nursing Faculty Shortage Fact Sheet

NJMEDguy48 · Nov 10, 2010

Awesome Thanks.... Finally was able to talk to 2 human resource persons of 2 of NJ largest hospital systems. Yes they have nursing jobs! But few mostly from retirement. They have tons of qualified nurses though applying for the jobs. They finally can pick and choose. They are no longer offering bonusses and lowered the starting salary for a new position for the first time since she has been in HR (over 15). Her statement to me was If you had a business and wanted to lower one of the highest costs of operation LABOR would you not want to create an environment of perceived shortage to get the most applicants to help reign the costs..... Not sure it is that simple BUT I really believe that still good laborious jobs are getting harder to come by and more students will apply for them. Before I read the articles u suggest. I think the many ways we are becoming educated and share information globally will absolutely have an effect on health care and all careers in general Look at how we learn today off site campuses, on line, private votech settings.

BeenThereDoneThat74, MSN, RN · Nov 10, 2010

Maybe you should investigate every city, every state, and every hospital before you start saying the sky is falling. Like everyone else who has posted, there is no issue with job prospects where I live. Local hospitals have many openings posted, solicit new grads at informational job fairs at our school, and offer advance sign-on bonuses to those who are willing to sign a contract. I've already signed on with the hospital where I have clinicals, and it was offered to me in my first semester.
For those who don't go to the hospital setting, extended care facilities have been sending cards in the mail asking for applicants. Mental health facilities have openings. Every class, every semester, has placed the new grads within 3 months of passing NCLEX. I honestly don't know how a new RN can't find a job unless they just have little employment history?

Generally speaking, there is a shortage. Not all grads are getting hospital jobs within 3 months of employment. We could argue this until we are blue in the face. I happen to live in a major metropolitan area, where this is going on.

elkpark · Nov 10, 2010

How come schools here in NJ have years waiting lists to get into RN programs for nursing. They say lack of teachers. I am wondering about that. If they paid the professors the same rate or more as a nurse with all the students trying to fill the class these institutions and boards of directors (AH HA POLITICAL HACKS) that run them could still make money. This still perplexes me.

Part of the reason there are so many applicants at most (all?) RN programs is that the media has been beating the drum for many years now about what a great career nursing is, how great the pay is, the great "flexibility," the huge demand, etc., etc., etc. As more and more occupations have found many of their jobs outsourced or slammed by the economy, more and more people have decided that nursing is one of the last "sure things" employment-wise. How many times have you seen TV coverage of a local manufacturing plant closing and part of the story being that the former employees are going to turn out alright, though, because the state employment counselors have arranged for them all to go to nursing school?? (I live in a state that used to have kazillions of textile and furniture manufacturing jobs, most of which are gone now, and, if I've seen that story on TV once in the last 10 years, I've seen it two hundred times -- each time another manufacturing plant closes ...)

Lack of qualified nursing instructors is part of the problem, and lots of people talk about increasing salaries to lure more nurses into teaching, but it's not that simple -- colleges and universities have pay scales based on people's qualifications, experience, etc., just like hospitals do, and colleges and universities can't just start paying the nursing faculty twice what they're paying all the other faculty; apart from it blowing their budget all to heck, that's not fair, and they'd have a mutiny by the faculty in all the other departments. Also, numbers of nursing faculty are only part of the problem.

Another big issue is availability of clinical facilities. Over the last decade or so, at the same time established nursing programs have expanded the numbers of students they can admit each year and new programs have sprung up like mushrooms after a spring rain, hospitals in various areas have been merging into "healthcare systems" and consolidating services in order to save money and provide more cost-effective services. So, at the same time there are more and more nursing students all the time who need to have clinical hours in all the major areas of nursing practice, there are fewer and fewer specialty hospital units, clinics, etc., available for those students to use for clinicals. And hospitals don't get paid anything for making their facilities available to nursing programs for clinicals (although I've heard rumors that a few hospitals are starting to charge nursing programs) -- basically, they are being asked to take on a whole lot of extra risk/liability for no compensation. Fewer hospitals are willing to do that these days, esp. when they have little or no interest in attracting students to their facilities when they graduate and get licensed (and some hospitals feel like they've had bad experiences with nursing students from particular schools and "ban" particular schools). In any city or large town these days, it's becoming a real challenge to find appropriate clinical facilities and opportunities for nursing students -- even if there are plenty of instructors. The last time I taught in a BSN program, the medium-sized city in which my school was located had two BSN programs, a diploma program, and six or seven ADN programs all in the immediate area, all competing for clinical opportunities at the same few facilities. There were plenty of general med-surg opportunities for students, but arranging clinicals for specialty areas like pediatrics, OB, psych, and critical care was a nightmare each semester -- all the schools were competing for the same few sites. The schools had to pretty much take whatever the hospitals and other agencies were willing to offer them, and some of the clinical sites and schedules were v. poor learning opportunities for the students. In my state, in order to maintain your BON approval, you have to be able to demonstrate to the BON that you have not only enough qualfied nursing faculty for the number of students in your program, but also appropriate clinical facilities/opportunities for the students. And the same is true if you want to increase the size of your program -- you not only have to show the BON that you have enough faculty to accommodate the larger number of students, but also that you can accommodate the larger number of students in clinical.

NJMEDguy48 · Nov 10, 2010

Great info ELK.... Question I have. Seems to me not only do you as an educator provide reasons at your level why there are educating issues (hence nursing employment issues real or perceived). Many other persons at all different levels of health care state similar concerns. Let's be honest we are getting closer to socialized medicine (if we are not there already). I as a previous business owner say we are in a Global economy where everything is being shared. Are there countries that "train" Nurses cheaper and more efficiently than America?... In my book RNing is a vocation just like Electrician... Somehow there needs to be a more efficient way to train Nurses. If I was a hospital and competing for the almighty dollar as president of the corporation would I not want that for my shareholders? Efficiency at all levels to compete. (YES I know we are talking about human patients) So let's say more efficeint and better service providers. After all at the lowest level that is what the nurse and the facility you work for is providing a "service". The health care facililities spend millions on advertising. It is Krazy... Bill Boards of Robotics, Pictures/Banners of JHACO awards. Hospitals that are built to be museums as apposed to the efficient Venues they should be. Why? To coerce the patient to come to there facility as apposed to going to one in another town that might offer the same or better service at a cheaper more affordable cost that would be better for all taxpayers of america...... Here in Central NJ we have 2 systems that are growing by leaps and bounds in the number of facilities they are taking over by "mergeing" and "partnering" with the individual hospitals' Hence increasing the number of consumers um no patients they are seeing and billing. They will in the name of $ merge services. To become more efficeint. I am almost depressing myself as I am making choices in my life to enter this field of Health care. But to be honest I not only want to provide a "Touch" of hope for one, I really would like to provide the best quality of care in the most efficient manner for a better america and world...... Many facets of american health care I think need fixing And I think what has happened to many of our manufacturing and servicing companies are the precursor of what is going to and in fact is happening to health care. In the name of the almighty dollar we shall need to be prepared and embrace the technology and I think we have just tipped the iceberg to a changed American health care system. OK I am tired right now back to reading but my simple point is ... The medical system is a service business one that at this moment pays very well. For many reasons it is the target as one of the greatest jobs in the world (It may be as I have been privy to parts of the inside of it and the many rewards inc Wages, bens, perks, security and emotional it offers are awesome) More than any other time in history I believe qualified persons are going to be competing for those rewards to include female, male, domestic and foriegn of all ages after all we are now in a global society.... Oh and by the way as our ability to pay for all the seniors retiring and about to retire honestly we are not at this stage of our economic position as a country not able to afford to service them as we do now without either providing them less service or becoming more efficient in providing great health care. or guess what the result might be? I do not want to think about that...

healthcarestudent · Nov 11, 2010

thatthekey, what state are you with demand for nurses???

thanks