Nursing shortage less than expected

  1. Nurse Shortage Less Severe Than Expected | 2015-09-23 | Hospital & Health Networks

    Well, whoever saw this coming? Older, experienced RNs are staying in the field longer, often due to financial/economic concerns. The depresses the demand for newer nurses. Add to that (not mentioned in the article) hospitals increasing thir ratios to reduce costs, and suddenly the shortage is mild to moderate.
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    About CountryMomma, ADN

    Joined: Nov '12; Posts: 667; Likes: 3,059
    Full-time Med-Surg RN (Secret Step Down Unit!); from US

    11 Comments

  3. by   loriangel14
    What a joke. What shortage?
  4. by   AJJKRN
    I still say that we have a shortage of experienced bedside nurses...most definately in my area for sure!
  5. by   DoGoodThenGo
    This "latest" Peter Buerhaus co-authored study has been out or whatever for awhile now it seems. It told what many on the ground already knew; in large parts of the USA there isn't a nursing shortage nor will there be one for some time to come. When facilities speak of any nursing shortage they are most likely referring to a lack of seasoned nurses with experience in this or that specialty.

    You'll notice they keep hedging bets by saying things like "we're not out of the woods yet...." or some such. Biggest fear is that word will get out and seep in that a nursing degree is not an automatic ticket to an "exciting and high paying career" in the healthcare industry. Should that happen and program enrollments plummet what happens then?

    Meanwhile back at the ranch no one has yet come up with a scheme to deal with hundreds of under or unemployed new grads in any given local area. Telling a newly licensed RN saddled with student loan debt and other bills to pay that the job market will "improve" in ten or twenty years isn't doing her or him any favors.
  6. by   nursel56
    Quote from DoGoodThenGo
    . . .Meanwhile back at the ranch no one has yet come up with a scheme to deal with hundreds of under or unemployed new grads in any given local area. Telling a newly licensed RN saddled with student loan debt and other bills to pay that the job market will "improve" in ten or twenty years isn't doing her or him any favors.
    This is what bothers me most of all. There are lots of (then) new grads from the 2010-2011 era when everyone still insisted what we saw "on the ground" here wasn't happening. Since they didn't "exist" officially with the forecasters back then, how many just gave up, returned to former jobs to pay the bills, defaulted on loans and wrecked their credit ratings, and drifted away?

    It's a waste of talent and education, and for the financial aid based at all on public funding, a waste of money. I wish there had been a mechanism to retain those new nurses somehow.

    Thanks for the thread, countrymomma!
  7. by   DoGoodThenGo
    Quote from nursel56
    This is what bothers me most of all. There are lots of (then) new grads from the 2010-2011 era when everyone still insisted what we saw "on the ground" here wasn't happening. Since they didn't "exist" officially with the forecasters back then, how many just gave up, returned to former jobs to pay the bills, defaulted on loans and wrecked their credit ratings, and drifted away?

    It's a waste of talent and education, and for the financial aid based at all on public funding, a waste of money. I wish there had been a mechanism to retain those new nurses somehow.

    Thanks for the thread, countrymomma!
    We've been down this path before, and yes, no one wants to touch the hot potato issue of paying the costs of orientating/residency for new grads. So left to their own devices hospitals (where this burden has traditionally been given) are coming up with their own arrangements.

    What funding does exist from the federal government for nurse education/training IIRC is largely tied to a model of nursing education that no longer really exists; diploma programs or at least the facility owning/running the thing.

    While have often advocated some sort of nurse residency program modeled after the post graduate physician matching program; in hindsight cannot see how it would work. Such a plan would be very expensive and nearly impossible to implement. If for nothing else it does not solve the problem of what happens after one or two years of post graduate residency. If the facility in question does not take on the RN where does she or he go?

    There is another way, but no one will touch that either; mandatory staffing ratios. Increased staffing wouldn't solve all new graduates problems, but it would take some of the edge off as places would be forced to hire and train new nurses.
  8. by   llg
    The other almost "untouchable" possible solution is the idea of a "training wage" for new grad residencies and/or the development of employer-sponsored "transition programs" based on an economic model that makes them feasible for an employer to provide.

    Back in the old days (when I was a new grad), I got 5 weeks of orientation to work in a level III NICU. Within 6 months, I was starting to orient to Charge Nurse responsibilities. That 5 weeks of orientation was worth it to the hospital because they were getting an RN who could take a full patient load after 2 months of employment, etc. So the economics of that 5-week investment paid off for the hospital.

    Times have changed -- but the economic model has not -- and it needs to. For a lot of reasons too numerous to spell out her, 5 weeks is no longer sufficient orientation for a new grad going into most practice environments, and certainly not an ICU. The investment now required for the 3-4 months of necessary preceptorships are far greater than they used to be. Unless there is a guarantee that the new grad will stay and work for them for at least 3-4 years, the financial investment simply doesn't pay off. Hospitals can't afford to provide those long, indepth orientations to people who will most likely move on to another job within 2-3 years.

    So we need to totally re-design those programs -- including the relationships they stand on and their financial model. That means considering some dramatic changes that will not be popular with everyone. For example, one possibility is that the new grads in the official transition program would be paid a "training wage" -- significantly less than a that of a staff nurse with minimal experience but taking a full assignment on her own. That would simply decrease the cost/risk for the hospital of hiring more new grads and getting in the training pipeline so that they could begin their "real staff nurse job" in 6 months or so IF (and only if) they passed the training program. Hospitals might even offer the course to nurses and charge them a fee for taking the course -- as an extension of their entry-level education: personally, I don't think that extreme is necessary -- but it is an option.

    Another possibility is for the government to subsidize residencies for nurses like they do for physicians. That would work, but it is not likely to happen to any large degree for political reasons. Yet another possibility is to lengthen the education provided to new nurses to include a semester of "apprenticeship" that would be run in conjunction with employers -- at minimal cost to the employer. All of these economic models would give new nurses a mechanism to transition from the student mode to one of productivity as a practicing nurse where he/she would be financially "worth" the investment for an employer.

    But that much change is hard to bring about. My hospital is like most hospitals. We don't need more new grads: we can hire more than we need. But we do need OR nurses, ED nurses, and ICU nurses desperately -- and those new grads won't be able to fill those positions until they get at least a year of experience. (even if that year is spent in those units as a trainee)
  9. by   DoGoodThenGo
    Wouldn't have to be at every hospital in the USA, but pick a select few in a local area and or state much like the physician post graduate program. Make these facilities designated "nurse residency" facilities and work out costs and how much the federal government's share would be.

    Program could mimic some of the orientations of old; several weeks spent rotating through various departments then the new grad chooses a specialty. She or he would then spend a period in that area learning what needs to be known and getting up to speed.

    Sadly considering the vast numbers of new grads in many areas there would have to be some sort of guidelines and or cutoff academic wise to week out those not likely to complete, well at least based upon prior academics. You'd of course have to have passed the boards and meet other requirements for employment.

    Unlike things for some in days of old the idea would not be to provide cheap grunt nursing labor. But rather an extension of a new nurse's education just with more focus on clinical aspects and the ability to bring it all together.

    Wage wise the probie perhaps could start at slightly below the prevailing wages for local nurses and work their way up. Again using medical post graduate as an example "interns" would be perhaps lower on the pay scale while "residents" at or near a staff nurse's wages.

    It really is a shame the USPH hospital system was disbanded. Those facilities could have been used as sort of a national nurse residency training ground. The VA system could prove another interesting avenue as it is already owned by the federal government.
  10. by   joanna73
    There will probably never be a true nursing shortage again. Instead, we will continue to face a nursing job shortage.

    Each semester, nurses continue graduating, yet where are the jobs? Yes, nurses are retiring, but in order to balance budgets they are not replaced.

    At my workplace, 5-6 nurses are retiring within the next 2 months and none of those positions will be filled. When we have sick calls, our casuals are not called. Instead, someone absorbs the work. This is all too common.
  11. by   MrNurse(x2)
    My wife has just ended a 22 month period of unemployment. She has 28 years of experience, she also was not counted as unemployed. The economy is so much worse than the news has us to believe. Annual income is down $8,000, and that isn't from the lowest income, those numbers come from where nurses live in the class structure. The best indicator of the economy? Nurse employment numbers.
  12. by   CFrancine
    I don't know if they are still doing it but back in 2013, my job started paying new nurses 75% pay during their orientation (that didn't include internal transfers, I'm not sure about seasoned external hires entering a new area). That also have a nurse residency program although I'm not 100% sure what that includes. I guess it's up to individual hospitals to make changes.
  13. by   runRNmom
    I live in California, which has mandatory staffing ratios, and one of the worst glut of new grad nurses with no job possibilities.

    I got my license in early 2013 and began applying to new grad programs (which typically had hundreds of applications for a handful of openings.) Same response each time: "more experienced" candidates were chosen for the new grad positions. I did some per diem LVN-level wellness clinic work. Then I finally got my only other interview and subsequent job offer for outpatient psych. I wanted no part of outpatient nor psych, yet that is what I took because it was an RN job.

    I did that for over a year, and to my surprise, I liked it. It was not my dream job, but I learned a lot. I just capped off a 3-month job search with an offer for inpatient geri med-psych. I accepted gladly. I actually still have one interview pending, with an actual new grad program. I couldn't even get an interview for a new grad program when I was an actual new grad. It took 18 months of experience as an RN to qualify for an interview for a new grad program, heh.

    My employed nursing school classmates either moved out of state, joined the military, or had the good sense to be trilingual former RTs-turned-RNs to qualify for new grad programs.

    Anyway. Long-winded way of saying staffing ratios clearly aren't working magic here.

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