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Nursing crisis looms as baby boomers age

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by Brian Brian, ASN, RN (Member)

Brian has 16 years experience as a ASN, RN and specializes in CCU, Geriatrics, Critical Care, Tele.

13 Articles; 201,214 Profile Views; 3,695 Posts

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255 Posts; 4,586 Profile Views

I don't think it's a matter of nurses( bedside staff nurses specifically and the MOST affected in this mess) not being able to look out for themselves or speaking up, It's what is and has been done to us who HAVE done just that. diciplines, terminations, layoffs according to peck orders, get rid of the outspoken in most cases the older nurse squeeky wheels, the troublemakers(as we are viewed when we speak up) the only thing administration wants is a YES person, a bend over person, a 'you are soo right person': when it DEFIES common scense, patient safety, our license. There is No dialog between administration and the staff nurse. It's just do it.( work shorter staffed, longer hours, more patients, faster and faster where's the smile, lets see the teeth, keep the customer happy, don't ask for more money- there isn't anymore because administration's pockets need lining first/off the top, nope no more staff- 'DO THE BEST YOU CAN"!! but don't dare leave something out- because if you do- your GONE. even the newer nurses are leaving after 3-5 years depending on their physical stanina> staff meetings are full of press ganey numbers and profit margin reports- this is pure usless garbage!! this is an absolute indicator of where administration's focus is. often times in these staff meetings- the PATIENT is NOT mentioned ONCE. If only these staff meetings could be video taped and showed to rooms full of the general public- let the public decide what's wrong with nursing. WE, nurses are short of breath trying to tell these administrator jerks- and yes, they know what the problems and are SELECTIVELY refusing to listen- they don't want it changed- it's too profitable for them- that's what the public needs to see and hear. The public needs to know why they go to an ER and drop dead without being seem, why someone dies of medical and nursing errors- wrong heparin doses, the public needs to know the pace and patient loads each one of us are FORCED to take on or be terminated. The public needs to know the threatening and intimidating administrations pull on it's nursing staffs. The public needs to know what a nurse is responsible for= why they earn and have the RIGHT to earn a decent salary, the public needs to know how much the hospital CEO makes and needs an answer why the CEO's salary is what it is when nurses are caring for Joe public's family members short staffed and NOT smiling, stressed out, and frazzled but the CEO makes out good!! The public needs to know who the money mongers really are.( not the staff nurses) The public needs to know what happens to a nurse who reports medicare fraud, a poor practice . The public has the right to know- they are the ones affected by this- customers/patients/consumers??? are they not???

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255 Posts; 4,586 Profile Views

The public also needs to know that most of the experienced nurses are being chased out- where's the experience at these bedsides with complexly ill patients.

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KarenBuley has 31 years experience and specializes in obstetrics.

23 Posts; 2,236 Profile Views

Yes, as RNnbakes says, one problem contributing to the nursing shortage is attrition due to stress-related issues. This year we have another chance to lobby for passage of the Registered Nurse Safe Staffing Act, which would positively affect working conditions and help alleviate burnout. We need to rally together to pass this legislation, that has been introduced since at least 2003.

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29 Posts; 1,498 Profile Views

unfortunately employers can do what they want and we are at their mercy.

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Indus has 43 years experience and specializes in Cath Lab, ICU's, Pediatric Critical Care.

31 Posts; 2,594 Profile Views

There are so many good points here, I'm not sure where to start, so I'll just speak my mind. I'm a nurse with 38 years experience, and like lots of you out there with the same, we've seen lots of change.

1) Hospitals shouldn't be expecting new grads to be on their own coming out of these 'new' 16-18 week orientation programs they're running. An orientation should be tailored to the individual new grad and where she's working. A new grad or fairly new nurse can not be expected to function by his/her self in 16-18 weeks of mostly classroom lectures, esp. going into a critical care area. I recently mentored a new BS grad who was orienting in the CCU. When she was in the unit, her preceptor always had a 2 patient assignment, and the grad had 1-2 patients. How can you precept someone in that situation? A month before her orientation was to end, they told her if her evaluation was not good enough, she was going to be reassigned. Well, she didn't make it, nor did the other 2 new RN's with her, nor did the 3 new RN's in the previous orientation class. What happened to giving these new grads/RNs enough time? What happened to providing some extra help to these new nurses? (In 2000, while working in a Cath Lab, a new grad was hired and given 1 year to orient. She started taking call with another RN after 6 months, and after 1 year, was able to take call as the only RN on a team with 2 xray techs. This works!!!)

2) Why are these hospitals hiring foreign nurses for less pay to fill these positions? A quick cheap fix???? Why are they not screening them for comprehension of the English language and nursing proficiency? I've been frequently frustrated giving report to nurses who do not understand basic English, let alone nursing/medical words and phrases. How are they communicating information to and about their patients?

3) Why do hospitals still think that ICU nurses always have to have 2 patients? Patients today are sicker, more complicated, followed by more specialists, etc. When I started in ICU's in 1976 in the midwest, the ratio was 2 patients to 1 nurse!

4) I'm seeing the 'work the older nurses harder'....I'm also seeing pay scales changed so that older, more experienced nurses at the top of the pay scales are not receiving much, or any, raises because they are at the 'top of the scale'. So much for 'years of experience'!

I think we older nurses (however old you are!) need to mentor these new nurses coming out. We need to make them see past the lousy politics, long hours, not-so-great pay that this can be a good job to have. We need to teach them the right way to do things, and not to use short cuts because of staffing, etc. and possibly endanger patients and giving less than the best of care. These are the nurses that will be taking care of us baby boomers in the future whether there is a shortage or not!

Thanks for reading,

Counting the time to retirement!

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Jarnaes has 14 years experience and specializes in US Army.

320 Posts; 7,656 Profile Views

Thank you, Indus. Very well said.

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Quickbeam is a ASN, RN and specializes in Government.

1,009 Posts; 10,161 Profile Views

You can't get arrested in my midwestern state as a new grad, much less find a nursing job. I also see a lot of experienced RNs coming out of retirement to work after their/their husband's investments failed. Yet the schools here keep pumping out new nurses with promises of unlimited job prospects. The early 1990s keep coming to mind with surplus RNs, cut pay and hours.

I think the nursing crisis related to Boomers is that we're going to need to work forever so we won't be stepping aside for new grads. Lots of gray hair where I work, myself included.

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Lovely_RN has 6 years experience.

1,121 Posts; 9,647 Profile Views

I truly believe that the whining about the looming shortage is nothing more than a conspiracy to keep cranking out new grads and to open up more visas for foreign nurses. What is the goal of the conspiracy? To continue to flood the market with excess labor thereby driving wages down and keeping nurses in their place. Hard to stand up for your rights when hundreds of people want your job and will do it for half, 1/3, or even none of your current salary (don't you love the idea of non-paying new grad residencies?).

Hospitals are a business just like any other and if you don't believe it you're crazy. Nothing will change until people begin to die in great numbers and the settlements from lawsuits outstrips the cost of safe ratios.

In the meantime until that happens nurses will be worked like dogs to get more done with less. We will be manipulated into believing that we should do what we do for love and that to demand proper compensation and safe working conditions cheapens the profession because this is a vocation not a career (wink wink).

In addition...the facilities will try to pass on as much of the liability as they can to us.

Shortage my @** it's simply not true and I refuse to belive it.

When something is in short supply it beomes more valuable and valuable is the exact opposite of how the majority of nurses are treated.

It's like saying that 1+1=3....it's completely illogical.

Edited by Lovely_RN

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Quickbeam is a ASN, RN and specializes in Government.

1,009 Posts; 10,161 Profile Views

In addition...the facilities will try to pass on as much of the liability as they can to us.

OMG, I have to add this...I recently did a round of interviews looking for something better....and I had a series of interviews with the post office as an occupational health nurse. I have exactly the background they were looking for. When it got to financials, the manager said, (very offhand) "you do know about the liability issue?". Uh, no. Turns out they offered no benefits and I'd have to provide all the liability coverage for the job myself. They wanted an independent contractor who would take all the burden of lawsuits off their hands. I went screaming in the other direction.

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14,620 Posts; 103,258 Profile Views

OMG, I have to add this...I recently did a round of interviews looking for something better....and I had a series of interviews with the post office as an occupational health nurse. I have exactly the background they were looking for. When it got to financials, the manager said, (very offhand) "you do know about the liability issue?". Uh, no. Turns out they offered no benefits and I'd have to provide all the liability coverage for the job myself. They wanted an independent contractor who would take all the burden of lawsuits off their hands. I went screaming in the other direction.

I don't count on my employer to cover me (liability-wise) anyway, in any employment circumstance -- I always carry my own coverage. At least they're (the PO) being honest :) -- typical healthcare employers will tell you you're covered under their liability coverage, but cut you loose and throw you under the bus as soon as something bad happens.

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Ginger's Mom has 41 years experience as a MSN, RN.

1 Article; 3,179 Posts; 22,363 Profile Views

Due to retrogression foreign nurses have been limited in getting visas to the USA? How are hospitals working around this issue?

I agree when I read these articles I wonder what the agenda is behind them? Lower wages ? Make nurses feel unstable?

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14,620 Posts; 103,258 Profile Views

There are so many good points here, I'm not sure where to start, so I'll just speak my mind. I'm a nurse with 38 years experience, and like lots of you out there with the same, we've seen lots of change.

1) Hospitals shouldn't be expecting new grads to be on their own coming out of these 'new' 16-18 week orientation programs they're running. An orientation should be tailored to the individual new grad and where she's working. A new grad or fairly new nurse can not be expected to function by his/her self in 16-18 weeks of mostly classroom lectures, esp. going into a critical care area. I recently mentored a new BS grad who was orienting in the CCU. When she was in the unit, her preceptor always had a 2 patient assignment, and the grad had 1-2 patients. How can you precept someone in that situation? A month before her orientation was to end, they told her if her evaluation was not good enough, she was going to be reassigned. Well, she didn't make it, nor did the other 2 new RN's with her, nor did the 3 new RN's in the previous orientation class. What happened to giving these new grads/RNs enough time? What happened to providing some extra help to these new nurses?

While I agree completely with most of what you say, I am also an "old-time" RN, and I wonder what happened to not hiring new grads into critical care areas? In "the old days," that was not considered a realistic possibility; you moved into critical care after you developed some real expertise in general med-surg settings. I think employers are doing new grads a serious disservice by sticking them in these circumstances and setting them up to fail. This board is full of threads from new grads who have all had the same bad experience of being hired into an esoteric specialty or critical care area as a new grad and are now looking at leaving nursing, either because their manager told them they weren't working out toward the end of their (inadequate) orientation and let them go or because they simply burned out during the (inadequate) orientation period. New nurses are leaving nursing at a much higher rate than they ever have before; partly, I think because of the v. unrealistic expectations they develop (or are given) in nursing school, and partly because the larger healthcare community is chewing them up and spitting them out (and I'm referring to employers here, not actions of individual nurse co-workers).

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