Nursing: The 10 Hardest Jobs To Fill In America - page 2

Source: Forbes Magazine, 06.03.09 The 10 Hardest Jobs To Fill In America If you're looking for work in any of these fields, you're in luck. Full Article: The reporter should have... Read More

  1. by   marie-francoise
    The article did not address the REAL reason for the nursing shortage (well, the nursing shortage that was, anyway). Although lack of educators and the aging population are factors, the real reason is that many nurses don't want to stay in nursing, or at least at the bedside, for terribly long. Working conditions I suspect are the REAL reason.
  2. by   NurseDiane
    Hi Everybody-----Brand New Here..............

    I have my own "theory" about this alleged nationwide "Nursing Shortage", seeing as how so many nurses can't find a job.

    I think the hospitals are getting some sort of subsidy monies from someplace while they cry "nursing shortage"......and the reason I say this is because I have seen hospitals that have dozens, if not HUNDREDS of nursing positions open, and I also know licensed, experienced nurses who have applied for them and they hear NOTHING back from the hospitals in regard to their application/resume. Now, why would a hospital not contact an experienced nurse who is more than qualified for a position? I have friends who have applied online (and that is what all the hospitals want you to do nowadays, so there is absolutely NO WAY of finding out if they even received your application and resume), and then tried to walk into the nurse recruitment office and been YELLED AT to get out!!! You can't even talk to a live person anymore. I think this way the hospital can show the state/fed how many applications they ARE NOT getting in response to their postings(which is a LIE) and cry for more money to employ agency nursess. What I think the hospitals are doing is crying to the state and/or possibly the national government and getting monies to hire per diems, agency nurses or travel nurses----but, meanwhile, they are not hiring the agency nurses nor are they hiring staff nurses, and they are doing something completely unrelated with these monies they are receiving( like hiring "Valet Parking" services). And therefore, they got money to hire agency nurses and hired no nurses at all.

    I live in New York, and currently, Englewood Hospital in New Jersey has its nurses on strike----however, they made sure to bring in "travel nurses" to cover their units. Now, as far as I am concerned, from an accounting point of view, is ASININE!!! I am quite sure that the amount that they are going to pay these travel nurses is more than what the nurses are asking for in their contract!!! One of their gripes is nurse-patient ratios, and the hospital says that it simply cannot afford to hire more nurses to have the nurse-patient ratios that are safe. So, my solution to this problem is DON'T ADMIT AS MANY PATIENTS!! Only admit as many patients to meet safe nurse-patient ratios instead of hiring more nurses. But, NOOOOOOOOOOOOO, they won't do that. There is no longer any concern for patient CARE----what is of prime concern is what the accounting sheet looks like at the end of the month. The only time anybody in upper level management becomes involved is when a someone is injured or God forbid dies because of a "mistake"----and then, do you think a hospital will stand behind a nurse? No way. And---the hospital will scramble for the staffing sheets to try and prove that they weren't understaffed that day, when in reality nurses were taking care of way too many patients to be able to do it safely and competently.

    The problem with hospitals now is that they are no longer being run by people who know what goes on every day in a hospital----doctors, nurses, physical therapists, respiratory therapists----, they are being run by people who have MBA's and who are running the hospital like other "businesses" that they have managed. Most of the time, the hospitals are so top-heavy with management, and their salaries are far more than a nurses' salary, which is a crying shame. Nurses are so grossly underpaid it is ridiculous. My 80-year old mother fell on the ice and fractured her elbow and shoulder in February, had a total shoulder replacement and was in the hospital for one week and then in a rehab facility for 2 weeks, and at the end of March got diagnosed with colon cancer and after her colon resection was in the hospital for a week. One of the nurses that took care of her was a retired New York City firefighter who had gone back to school for nursing and was a newly licensed nurse.......in conversations with him, he told me that he had no idea how hard a job nursing is, between needing to have the knowledge base and having time management and prioritization skills, not to mention the physical part of the job. He said that he always thought that nurses "walked on water" and wanted to be one of them, but he also said that the general population should know how hard nurses work because he said that if they really understood what it takes to be a nurse, that the public's opinion would change dramatically. And, this is coming from a NYC fireman!!! The care that my mother received was mediocre at best----I never heard a nurse explaining anything to her, teaching her about her condition or wound care or any of the meds she was on; her discharge instructions were never explained to her----they just left the discharge paper on her overbed table, and had I not asked them for the prescription for Percocet to go home with, we would have left the hospital without it!! If my mother was any other patient who did not have a nurse in the family, she would not have known any better than to ask for the prescription----and the only thing written on the instruction sheet was the doctor's name and his office phone number, that's it. And, we already have that!! And, I won't even get into the rehab facility----but let me to say that she developed a pressure sore on her elbow that isn't healed til this day, and it was never even recognized or treated. The visiting home nurse noticed it on her assessment the very first day she came over to see my mother.

    I have been a nurse for 20+ years, and have seen radical changes occur in healthcare and medicine, some for the better, and some for the worse. I was a nurse during the "good old days" when we got to know the patients, their families and their friends----now, it is a "get 'em in, get 'em out" mentality, time is money and rapid turnover is good---but make sure that all your charting is done!! Make sure that all the boxes are filled in; make sure the MAR's are correct; make sure you give report and don't forget anything; make sure all the pieces of paper are in the right place, even though with the advent of computers it was supposed to make paper and pen charting obsolete (now, you have to do both paper and pen charting as well and computer charting, and you are writing the same thing in 6 different places!!!) BUT, make sure you don't put in for overtime because you ran out of time to chart because nursing management will rake you over the coals and not pay you in the end. Let's not forget OVERTIME MANDATION either.

    If I had to do it all over again, I don't think I would do it all over again----I would choose something else in this day and age, something where I really LOVED going to work every day and truly loved what I did, instead of trying to appease hospital management. Health Care to me is a fake term----there is very little "care" in nursing anymore, and that's a sad thing. If you truly "cared", you'd never get out of the hospital. The "Magnet Nursing" thing to me is a complete joke----that standard should be followed by every nurse, every hospital and every health care facility in the country!! Just another "project" for nursing management to busy themselves with, to run around with their clipboards and make sure that there are "committees" and "groups" in the units, and to concern themselves with surveys and Press-Gainey scores. Nurses don't have enough time to do their work, never mind get "committees" together to meet during a work day!!

    As you can see, I am a jaded, experienced nurse. I can certainly hold my own in any patient care setting, and have mastered the "skills" needed to be a successful nurse. However, I am disheartened by the direction health care has gone and feel it is very unfortunate that patients have had to reduce their expectations for care when they enter a health care facility. I feel sorry for people who have to entrust their lives to hospitals that don't have a health care provider in their family or friends network. Big business has taken over health care---just take a look at the insurance companies, lower reinbursements, higher premiums and astronomical salaries to management who wouldn't know basic life support if it slapped them in the face.

    WOW---sorry for such a long post, originally supposed to comment on nursing being one of the hardest jobs to fill in America......LOL!!! But thanks for reading!!
  3. by   marie-francoise
    Quote from NurseDiane
    The problem with hospitals now is that they are no longer being run by people who know what goes on every day in a hospital----doctors, nurses, physical therapists, respiratory therapists----, they are being run by people who have MBA's and who are running the hospital like other "businesses" that they have managed. Most of the time, the hospitals are so top-heavy with management, and their salaries are far more than a nurses' salary, which is a crying shame.

    The "Magnet Nursing" thing to me is a complete joke----that standard should be followed by every nurse, every hospital and every health care facility in the country!! Just another "project" for nursing management to busy themselves with, to run around with their clipboards and make sure that there are "committees" and "groups" in the units, and to concern themselves with surveys and Press-Gainey scores. Nurses don't have enough time to do their work, never mind get "committees" together to meet during a work day!!

    Big business has taken over health care---just take a look at the insurance companies, lower reinbursements, higher premiums and astronomical salaries to management who wouldn't know basic life support if it slapped them in the face.
    Great post. You hit so many topics on the head. Yes, I have seen those MBA-types (nicely-suited young men w/clipboards and stiletto-heeled women) on the hospital units, and they seem SO out of place there, yet also seem to be the ones in power.

    I think your theory about hospitals' deliberately under-hiring nurses is correct. In many ways, it is a manufactured shortage. The resulting higher patient-nurse ratios produce working conditions that drive nurses away.
  4. by   Freedom42
    Please tell Forbes what you think about this article: readers@forbes.com.
  5. by   treetop2
    NurseDiane, you are so right. I hadn't thought about the hospitals probably receiving government $ or some other incentive for "shortages". I think you may be right. I spoke with an ex SNF administrator and he told me that the SNFs get lots of Baylor $ but don't have to pay it all out to Baylor nurses. So you can see how well-meaning programs are strategized to milk the system. Our company recently paid out bonuses because our state survey results were good. I'm an RN supervisor and I got the exact same bonus as the CNA's, about 90 bucks. The "department heads" and higher management (meaning no direct patient care) got into the thousands. Our company also pays out bonuses for "safety" (no employee accidents or safety claims). The management keeps that $ and spends it on whatever they want instead of giving to the employees as it is intended.
    Management is all politics these days, it's who you know and whose butt you kiss. Forget about knowledge, skills, or even honesty. And if they think you might qualify for their job they will sandbag you every chance they get.
  6. by   Teacher First
    NurseDiane, please do forward your reply to Forbes as Freedom42 suggested! It is great that we interact with one another in this forum, but it is the public who need to know what is going on. The average person out there has absolutely no clue regarding any of the issues you speak of, and perhaps does not really care until they are affected personally. Everyone is yelling about the healthcare situation in this country, but I wonder who "everyone" is. It seems that one of the biggest concerns is the cost associated with healthcare (better worded as diseasecare because we all know that in spite of wanting to teach and promote health, we end up taking care of dreadfully ill people!), and another is the lack of insurance. But I digress!
    I have been a nurse for over 32 years, and I have taught full-time for over 26. I always had a second job in the ICU and ER setting on week-ends to make up for the shortfall in pay. I have worked in some of the biggest hospitals in the country and a few of the smaller ones. I have run myself ragged some days or nights to provide care to patients of all types, and gone home so tired that I thought I would never be able to walk again!
    And just so you all know, teaching is one of the hardest jobs I ever have done. You have to love it, or you wouldn't do it because the salary is awful compared to the hospital. But just as it is miraculous to see a baby born or an MI patient recover successfully (or fill in the blank with any number of miracles you have witnessed), it is thrilling to see a student walk in off the street and in a few short semesters walk the walk and talk the talk! Just as exciting as a patient coming in a few weeks after discharge to thank you for caring for him or her, it is just as exciting to me to have a former student come to my office or send an email and thank me for making a difference in their life, or to share that they have now completed their MSN or NP. Yes, nursing is the hardest job I know of, but at the end of the day I went into it for all the right reasons, and I can't think of anything else I would rather do!
    One other thing I will relate, and then I will save it for another thread is that to teach effectively one must be qualified in a number of ways. It pains me a little to see responses in some of the threads that offer the advice in essence "If you can no longer do (whatever), go teach."
  7. by   pagandeva2000
    Quote from marie-francoise
    Great post. You hit so many topics on the head. Yes, I have seen those MBA-types (nicely-suited young men w/clipboards and stiletto-heeled women) on the hospital units, and they seem SO out of place there, yet also seem to be the ones in power.

    I think your theory about hospitals' deliberately under-hiring nurses is correct. In many ways, it is a manufactured shortage. The resulting higher patient-nurse ratios produce working conditions that drive nurses away.
    Agreed! And, yes, this Magnet Status is crapola on a cracker!:angryfire
  8. by   anoro
    Thanks Nurse Diane for your post! You are articulate & thorough, so the length of the post does not trouble me. I could have written your post myself! Line after line, your post explained my experience, allow me to add additional detail in response to the Forbes article.
    You wrote that management & administrators are manipulating staffing numbers. Oh yeah, how about the schedules that exist for the "record" that list adequate staff numbers, versus the real schedule where we know that Nurse X , who is "scheduled for work" will definitely Not be in for that shift ! I've seen that happen a few times to nurses, techs and aides. A co-worker (LPN) had that happen to her and I was left with several discharges to do, 3 admissions to take in, meds to give, & a new RN to orient (orientee's 1st day on the unit), and techs to "supervise"! I know the LPN, she is a committed professional. When we spoke that day via phone, she assured me & I believed her, she was approved by Admin. to be away at a class, therefore off that shift. This had been approved three days earlier to allow her to complete mandated training. The LPN, told me, again I believe her... that she was informed verbally and confirmed on a written schedule, that she was off on the upcoming Friday. Come Friday she was scheduled to be in for a shift! When I contacted the Administrator of Nursing, (the same person who approved the day off for training), the Admin. insulted my co-worker ( & friend) by accusing her of just not showing up!
    How about a Behavioral Health Tech.'s experience: Three weeks before a religious holiday, the man told us all, in front of his supervisor: "because I am per diem, I will not be in for my holiday, I go to services with my sons." The response I'll paraphrase as, "OK, you are per diem and don't need approval". For the next two weeks he was not on the schedule for that religious holiday. However, come the holiday, the man was scheduled to be working a 12 hour shift! I notified the Admin. & was told by the Admin. "Well, call him and see if you can get him in...." How ridiculous! I did call him, and wished him a happy holiday on his answering machine. Of course he was not answering the call, he was at religious services with his family... just as he had been telling us for three weeks!
    How often, in recent years, have I seen a schedule that is posted that we know is a phoney schedule and/or changed without notifying the staff involved? Give me a buck for each time, and I could take a fine vacation, or send it to my lawyer.
    Oh, my lawyer, right...let me explain. Speaking up gets one threatened by management, persist & get reported to your Board of Nursing. Yes, the threat was made and carried through. Though over one year has passed, the BON has not yet investigated the complaint! That's good news because the BON knows there is no danger to patients, & it is "not serious "(did not involve any patients), however it is bad, because I could not get full-time work in nursing after leaving that job, gladly). Full-time work in nursing is just what the lawyer recommended, to "prove" that I can safely practice, as if 25 years of experience, a clean record, and 16 pages of good to excellent references, copies of old job evaluations, and two letters for commendation, did not already document that! Should I have saved the candy, the thank-you notes from patients & their families that I have received all these years? How could I have saved the good-bye handshakes and sometimes the hugs, that I've received as proof of my worth as a RN ? What about the folks who thanked me for that last re-positioning, or the meds, or the back-rub just before they died? OK, the backrub was obviously a long time ago! (When did you last have time for that type of humane, comforting nursing act of caring?)
    When I read how Marie Francoise responded, then others, I knew you spoke for many of us. Essentially those of us who have experienced the "profession", ( I thought it was a profession, so I pursued advanced education) We have quite a different perspective from newcomers and well, the media image is the same old, (pick your choice) , doctor's handmaiden, "Angel of Mercy", or whore. No need to apologize for appearing jaded Nurse Diane, we as the long-term survivors, who either cannot leave or choose to stay & fight, we BECAME jaded. We became jaded in response to the environmental changes; business model, pace of the work, persistent disrespect & bullying. We became jaded advocating for our vulnerable patients, or fighting for our own loved ones when they, as patients, received sub-standard care that both distresses us & compels to protect our own. We are jaded by being embarrassed to have the dysfunction of our own profession, and the system within which we have practiced so long, exposed as incompetent and uncaring.
    Still, despite this, overall I have enjoyed providing professional nursing care in a variety of settings over many years. I am proud that I have been able to use my energy, heart, and education to financially support myself, and at times support loved ones, in a career that offers a liveable wage with diversity in jobs. My profession is valuable, life sustaining and enhances this world we live in. Overall my co-workers have been and remain, caring, committed people. It is painful to see Nursing dismantled for greed by people who are not qualified to evaluate the work we perform daily AND nightly. The insulting part of the greed perspective is that we are so often told it's really about " patient satisfaction". Do not insult my intelligence. Spend less on Press Gainey surveys and instead try safe staffing so we can do health ed.,discharge teaching, or provide nursing measures including the growing numbers of complementary therapies as nursing care. Oh, but that might mean less drugs, therefore less profit for big pharmaceutical companies.
    I appreciate the validation & support other nurses provide in this site. Yet the media and public really ought to be given a clue. So, I'll be responding directly to Forbes Magazine regarding their article. Please Nurse Diane, consider sharing your own thoughts outside of this forum. Thanks to all who responded above.
  9. by   anoro
    I love your expression, pagandeva2000. "Crapola on a cracker" for sure!
    thanks for LOL
  10. by   Patchouli
    [font=book antiqua]i feel very disillusioned. i just want to be a nurse. all the building up, the hype, the student nurse dinners, sigh... three weeks till i take boards. why bother?
  11. by   hollymckenziern
    I think part of it is many hospitals are using contract (traveling) nurses rather than opening full-time positions with all the benefits. Just a theory.
  12. by   anoro
    Hey Patchouli, Take your boards because you worked for the right to do so! Then keep your eyes WIDE open.
    The discussion has been about why there is a perceived, or shall I write, "advertised" nursing shortage & why this has remained so. Remember that for many of us, there were few alternatives to nursing available years back. Even now many people go into nursing thinking, 2 years is very little time to be in school, for what has been promoted as a high paying field where you can "always get a job'. Like anything else, the best jobs get snatched up fast. The big salaries are in urban teaching facilities with rotating shifts often & high stress levels. But I had a great time with other nurses and great mentors & that was in addition to great pay.
    There have been feasts and famines before and will be again. Good luck.
  13. by   jaflosa
    To be honest I did not know that nurses were having a hard time finding a job. I live in the Houston TX area and there are pages and pages of ads for nurses. The hospital almost fight over the new graduates and offers many incentives for recruitment and retention. I did not even apply for the last three jobs that I have had but was seeked out by the recruiter and thse were staff positions. I am very surprised and sorry to hear of the shortage in other areas of the country.

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