Nursing: Not A Recession-Proof Career

The media, some institutions of higher learning, and many members of the public heartily believe that the nursing profession is immune to economic downturns. Contrary to popular beliefs, nursing is quite vulnerable when economic times change for the worse. The intended purpose of this article is to dispel the popular myth that nursing is recession-proof.

Nursing: Not A Recession-Proof Career

Contrary to widely held beliefs, nursing is certainly NOT the recession-proof career that many entities have seemingly made it out to be.

During the recession of the early 1990s, some nurses in certain regions of the United States had remained unemployed for six months or longer as they attempted to secure employment. Newly graduated nurses were hit the hardest, but many local employment markets were brutal toward the more experienced nurses, too. The severe nursing glut of the early 1990s had persisted well into the middle 1990s before easing sometime during the late 1990s.

During the Great Recession of the late 2000s, patients avoided having elective surgeries in droves because they were fearful of taking the time away from work that was needed for full recovery, which resulted in a low census on certain units in acute care hospitals. When the census is low at hospitals, fewer nurses are needed to keep these floors operational.

More people than usual become unemployed during sluggish economic times and, as a result, lose their health insurance benefits. Since healthcare is prohibitively expensive, uninsured people are definitely not inclined to seek it unless their health problems have progressed into unavoidable emergencies. In addition, the medical bills of uninsured patients tend to go unpaid, which means less cash flow for healthcare facilities. Numerous hospitals are providing plenty of charity care in this day and age.

Although it is an accurate statement that nursing jobs can never be outsourced, always remember that nurses can be "insourced" by recruiting foreign nurses to work at the most desperate hospitals in the U.S. In fact, a hospital in the desolate border town of Pecos, Texas, is currently willing to sponsor nurses from abroad. These nurses are less likely to whine about working evenings, nights, weekends, and holidays because they are earning more money in the U.S. than they ever would in their country of origin.

Masses of part-time nurses accept full-time positions during economic recessions to keep their households afloat when a breadwinner spouse loses his or her job without notice. Plenty of retired nurses have been reactivating their nursing licenses and since 2008, and are returning to the nursing workforce due to the escalating costs of food and fuel combined with the effects of retirement funds that have dwindled in value.

Another noteworthy issue is the aggressive expansion of nursing program slots over the past few years. Moreover, multiple new schools of nursing have opened their doors to willing applicants in recent years, especially at the private for-profit trade schools. These two factors have resulted in a recent increase in newly graduated nurses in local job markets. A significant number of these new nurses have grappled with unemployment and underemployment for more than one year because their local job markets cannot absorb them all.

The aforementioned ideas are just some food for thought. While these occurrences might not apply to your specific region or the part of the world where you live, these things are surely happening in many cities and towns across the United States.

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TheCommuter

About TheCommuter, BSN, RN

TheCommuter, BSN, RN, CRRN is a longtime physical rehabilitation nurse who has varied experiences upon which to draw for her articles. She was an LPN/LVN for more than four years prior to becoming a Registered Nurse.

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Specializes in Med Surg - Renal.

No career (no legal career anyway) is recession proof. Unless your career is being Mitt Romney's wife, which as we've seen in the news is a very difficult and challenging job requiring at least a couple Cadillacs.

"Insourcing" of RNs appears to be a myth. (We can dig up the old threads again if you want.) The reason desolate border towns are willing to sponsor nurses from abroad is because they are desolate border towns.

As the economy slowly recovers, the outlook for all jobs will improve. The economy cycles.

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Specializes in Case mgmt., rehab, (CRRN), LTC & psych.
"Insourcing" of RNs appears to be a myth. (We can dig up the old threads again if you want.) The reason desolate border towns are willing to sponsor nurses from abroad is because they are desolate border towns.
Retrogression has been in effect since 2006 for foreign nurses attempting to live and work in the U.S., so the "insourcing" of RNs from abroad has come to a screeching halt. However, prior to 2006, many U.S. hospitals were heavily recruiting and sponsoring foreign nurses.

A handful of the absolutely most desperate facilities are still willing to provide sponsorship for nurses from abroad. These hospitals tend to be located in places where most American-born people generally would not want to live.

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I have seen "in-sourcing" used extensively at my hospital in the SF Bay area. I work NOC shift, med-surg and many nights I'm the only native born English speaking nurse on the unit. I can go all night hearing Tagalog, Hindi, Urdu, Mandarin, and various African dialects being spoken, without a word of English.

And these nurses are HARD working nurses. They will work through breaks, off the clock (after end of shift), and put up with treatment by management and other staff which would have your average American nurse shouting HOSTILE WORK ENVIRONMENT, and calling for a lawyer. They are grateful for their jobs, and are 100% loyal to the hospital management which sponsored them into those jobs.

Welcome to the new Global (AT WILL) workplace, where you can be replaced by a cheaper, more flexible (aka subservient), nurse without any notice.

Would you like fries with that?

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Specializes in Case mgmt., rehab, (CRRN), LTC & psych.
I have seen "in-sourcing" used extensively at my hospital in the SF Bay area. I work NOC shift, med-surg and many nights I'm the only native born English speaking nurse on the unit. I can go all night hearing Tagalog, Hindi, Urdu, Mandarin, and various African dialects being spoken, without a word of English.

You're in California? I was born and raised there, and I can certainly attest to the fact that California has a staggeringly high number of nurses from foreign countries.

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I have seen "in-sourcing" used extensively at my hospital in the SF Bay area. I work NOC shift, med-surg and many nights I'm the only native born English speaking nurse on the unit. I can go all night hearing Tagalog, Hindi, Urdu, Mandarin, and various African dialects being spoken, without a word of English.

And these nurses are HARD working nurses. They will work through breaks, off the clock (after end of shift), and put up with treatment by management and other staff which would have your average American nurse shouting HOSTILE WORK ENVIRONMENT, and calling for a lawyer. They are grateful for their jobs, and are 100% loyal to the hospital management which sponsored them into those jobs.

Welcome to the new Global (AT WILL) workplace, where you can be replaced by a cheaper, more flexible (aka subservient), nurse without any notice.

Would you like fries with that?

There are a large amount in the Chicago area as well. I'd say especially in affluent communities - I've been told it has to do with that "servitude" aspect, as well as the ability to slave people "who know no different" easily.

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Specializes in ICU / PCU / Telemetry / Oncology.

I'm assuming the "work for 40 years at one job and retire at 65" era is now history. I don't know anyone around me who is planning to retire any earlier than 70. I personally plan to work until at least my mid-70's, God willing. There's no way I can retire anytime before then and live comfortably. Not that I plan to do floor nursing until then, but I will look into nursing opportunities that will simultaneously complement my life comfortably.

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Specializes in Trauma, ER, ICU, CCU, PACU, GI, Cardiology, OR.

enlightening article, & sad to say very true.

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Specializes in Med Surg - Renal.
You're in California? I was born and raised there, and I can certainly attest to the fact that California has a staggeringly high number of nurses from foreign countries.

I don't doubt it. I don't consider RNs who were trained in the United States as "insourced."

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The article doesn't consider countervailing trends, such as unemployed people tend to get medical care more (at least at first, while insurance is around) because they have more time on their hands. Plus, the aging of the population sets up a demand for services independent of the economic cycle. Still, a good eye-opening article.

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Specializes in Case mgmt., rehab, (CRRN), LTC & psych.
I don't doubt it. I don't consider RNs who were trained in the United States as "insourced."

Me, neither.

The foreign nurses that I've mentioned received their nursing education and training in countries such as the Philippines, India, and (on a far lesser scale) Great Britain.

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Contrary to widely held beliefs, nursing is certainly NOT the recession-proof career that many entities have seemingly made it out to be.

. . . More people than usual become unemployed during sluggish economic times and, as a result, lose their health insurance benefits. Since healthcare is prohibitively expensive, uninsured people are definitely not inclined to seek it unless their health problems have progressed into unavoidable emergencies. In addition, the medical bills of uninsured patients tend to go unpaid, which means less cash flow for healthcare facilities. Numerous hospitals are providing plenty of charity care in this day and age.

I suspect that this problem will be exacerbated when the SC rules key provisions of the ACA unconstitutional later this month, but that's just one man's opinion on the two topics.

. . . Masses of part-time nurses accept full-time positions during economic recessions to keep their households afloat when a breadwinner spouse loses his or her job without notice. Plenty of retired nurses have been reactivating their nursing licenses and since 2008, and are returning to the nursing workforce due to the escalating costs of food and fuel combined with the effects of retirement funds that have dwindled in value.
I don't know if this is the case in all parts of the country but in my part of the world, this is true is absolutely what's been happening. So much so that the overwhelming majority of employers hiring nurses now will not consider new grads. Nearly every job posting, including those in LTC, now state that they require a minimum of one year experience, with many demanding two years or more.

. . . Another noteworthy issue is the aggressive expansion of nursing program slots over the past few years. Moreover, multiple new schools of nursing have opened their doors to willing applicants in recent years, especially at the private for-profit trade schools. These two factors have resulted in a recent increase in newly graduated nurses in local job markets. A significant number of these new nurses have grappled with unemployment and underemployment for more than one year because their local job markets cannot absorb them all.
Again quite true in my area at least. Looking at just the 25 nursing programs in my home state metro area shows 25 active nursing programs (diploma, ADN and BSN) within a 50 mile radius (I live in a major metro area that actually borders three states, which would bring the total number of programs to over 35 but I don't have easy access to the other data needed for a valid comparison, so I'm artificially limiting things for this discussion). Looking at the NCLEX first-time passing numbers for these programs shows a gradual increase in new RN's over the past five years from about 1,800 to about 2,100. Looking at the BLS data shows that on average, there are roughly 200 new nursing positions created annually in the metro area over the same time span. While these figures are slightly misleading - not all of the 2,000 or so grads remain in the area after passing the NCLEX and the BLS data does not take into account nurses who retire or move and are replaced - at the macro level it certainly strongly hints that supply is greatly outstripping demand. While my region is probably not the norm across the entire country, I strongly suspect that this is also the case in many, if not most major US metro areas. The anecdotal evidence I've seen leads me to believe that this is the case for SoCal, the NYC metro area, WDC, and major AZ and FL metro areas.

The really bad part of all of this is that demand for seats in nursing programs seems to be continuing to rise. It's only rational for nursing programs to seek to satisfy that increasing demand, even though doing so worsens an already severe problem. My strong suspicion is - and again this only my opinion - that both nursing wages and benefits will see significant deterioration in the coming years. I believe that this is already underway but have not yet seen the data needed to support this assertion.

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