Nursing Shortage!! It's real and it bites (new grads, can't find a job? Read this post!)

[klone]

I had no idea, when I took a job as a nurse manager of an inpatient unit at a rural hospital that's 4 hours away from the nearest large city, that a huge portion of my job stress would come from the fact that we DO NOT HAVE ENOUGH NURSES!!

Every unit at our facility has job openings. We have dozens of travelers. My department basically has just enough nurses to cover core staffing. What that means is - if there's a sick call, or a PTO request, or a medical leave of absence, we're short.

Thank Dog that my unit is awesome and they are a team and a family and are invested in the unit, because when we're short, the nurses pull together and volunteer to take OT and work 16 hour shifts.

The point of this post...if you're a new grad, and you can't find a job because the market is so competitive and every place is wanting a BSN...consider relocating! Look for those facilities that are in rural communities, or small towns that are >2 hours away from the nearest metro area that probably has multiple schools and a steady stream of new grad nurses to fill positions.

Coming from Denver, I had no idea that there really were places in the US that had shortages, but it's true, and it sucks. For patients, for communities, and for the nurses who are working short-staffed or working 60-hour work weeks because, well, we have no other options.

[scooterscamp123]

Can you tell us more about the area you're in? Do you mean rural as in a mountain or beach town with some recreation and available work to offer or rural as in food desert, poverty stricken, a lot of drug crime, etc? If it's closer to the latter I think the only way you can hire nurses and keep them is to offer a hiring bonus under the condition that they stay for a year, two years, whatever. That way you'll keep your nurses for a good while, fixing your staffing issue and your nurses will be more motivated to stay. I know it's more money up front but if you take that risk these nurses you hire might say, "Hey, I've learned a lot working here and I've created great work relationships and have become pretty proficient in my skill set. I think I want to stay." In my opinion even just one nurse who makes the decision to stay long term is more than worth the small financial cost the hospital will pay to keep them there. I don't know if you have the power to do this but if so you should at least try it. I know hospitals are all about saving money but as the saying goes, you pay for what you get. I hope everything works out!!

[klone, MSN, RN]

Those of you who have inquired about where I am, I have sent you a PM. I'm already highly identifiable by my posts, but I like to at least keep the illusion of anonymity.

[klone, MSN, RN]

scooterscamp123 said:

Can you tell us more about the area you're in? Do you mean rural as in a mountain or beach town with some recreation and available work to offer or rural as in food desert, poverty stricken, a lot of drug crime, etc?

More like the former than the latter.

[BrandonLPN, LPN]

The problem with those rural areas is that, too often, the pay is *much* lower than in the cities/suburbs. As an experienced LPN, I can expect to make about $27/hr in LTC in my midsized midwestern city. But only a couple hours drive away, they'd look at me as if I were insane if I demanded anything over $20/hr.

I realize cost of living is lower out there, but it isn't *that* much lower. Not nearly $10 less an hour lower.

A lot of these rural facilities can't retain whatever staff is locally available because their wages are so pitiful. Many nurses in my facility live out in the boonies and make the commute to the city precisely because of this.

[klone, MSN, RN]

BrandonLPN said:

The problem with those rural areas is that, too often, the pay is *much* lower than in the cities/suburbs. As an experienced LPN, I can expect to make about $27/hr in LTC in my midsized midwestern city. But only a couple hours drive away, they'd look at me as if I were insane if I demanded anything over $20/hr.

I realize cost of living is lower out there, but it isn't *that* much lower. Not nearly $10 less an hour lower.

A lot of these rural facilities can't retain whatever staff is locally available because their wages are so pitiful. Many nurses in my facility live out in the boonies and make the commute to the city precisely because of this.

I can't speak for SNFs and LTC places, but the hospital wages are within a couple dollars/hour of larger hospitals in the state. If you go to the union's website, it lists all the contracts they have with the various facilities and it lists the pay ladder.

[bsvoboda]

Thanks, I read your reply..if I could get a NICU position I would be elated, as I worked L&D and Nursery as medic in AF years ago and loved it, plus I was premie (700 gms). I know Postpartum and L&D are not a guy's domain as I was told in my clinicals. I cant PM due to not posting enough.. will check out hospital's site. Thanks!

[SpankedInPittsburgh, DNP, RN]

The Incredible Nurse said:

klone,

Relocating is very important when trying to secure that first RN job, or when looking for better cost of living for seasoned nurses. However, in order for any organization to be able to attract talent they need to put their wallets where their intentions are. It is no secret that the time of the martyr nurse is coming to a close, no longer do the new generations see nursing as a calling or a sacrifice that must be done for the greater good of humankind; instead they want to be able to pay their huge loans, and maybe even be able to afford rent, etc. So as the frame of mind have shifted, and now money is what talks, organizations need to catch up and pony up better pay rates if they want to attract and retain their nurses.

If your particular organization is having issues finding new staff because most new grads or seasoned nurses prefer to stay in more desirable areas, maybe is time to offer something that catches the eyes of those looking for new opportunities. Maybe offer a big student loan repayment in exchange for x years of service, or a juicy sign on bonus, or double what they are getting payed currently. Do this and you will see that many nurses, lacking houses or whatever, will make huge commutes to reach your facility; heck, double my pay and I will be in the next "red eye" flight to your town, ill rent a tent and a heater and camp in the nearest parking spot in your facility. All jokes aside, in order to get something, something must be given, so have your administrators loosen their belts, the great depression is over, the economy is booming, is about time they put some money into acquiring some staff.

Thank God the day of the martyr is drawing to a close. Its pathetic and self serving nonsense. Delivering high quality medical care is a business to all the players in the industry and has been for decades. Its time for nurses to stop pretending that they were sent by god to pick up the slack and suffering in silence to the powers that be while moaning constantly to everybody else that will listen about their lot in life. Adults are responsible for their destiny and happiness so if you are offered a bad deal go find a better one but don't whine about it until death. If an adult does that they deserve all the poop sandwiches that are fed to them

[OldDude]

SpankedInPittsburgh said:

Thank God the day of the martyr is drawing to a close. Its pathetic and self serving nonsense. Delivering high quality medical care is a business to all the players in the industry and has been for decades. Its time for nurses to stop pretending that they were sent by god to pick up the slack and suffering in silence to the powers that be while moaning constantly to everybody else that will listen about their lot in life. Adults are responsible for their destiny and happiness so if you are offered a bad deal go find a better one but don't whine about it until death. If an adult does that they deserve all the poop sandwiches that are fed to them

My dad rose to the ranks of "private 1st class" after being drafted into the army during WWII where he ended up on the tropical paradise of Guadalcanal. Until he drew his last breath I never heard him complain about anything; he did what he could and looked forward. One of his favorite sayings to me was, "do you want some cheese with that whine?" And I use it with my kids...thanks for the reality check Spanked!

[Miabrit]

Your post gives me hope. I wouldn't mind moving and living/working in a rural area serving others. Where is your location besides being in Oregon? I can PM yet.

[kbrn2002, ADN, RN]

Frustrating isn't it? I continue to believe that nursing shortages do actually exist, but in very limited areas. Like yours, OP. Just because an area is rural doesn't mean it's a low cost of living area. If available housing is limited, that most likely means that what is available is expensive. If you are looking to attract nurses to move to the community, the community has to be able to provide the amenities that make that move attractive. Affordable housing, a good school system, locally available goods at a reasonable price, entertainment and recreation options, affordable local taxes are just a few things people are going to look at before committing to a move.

[RNperdiem, RN]

I thought about your post a while and wondered what it would take to attract me to a rural hospital in an area far from anyone I know.

A lot of true rural areas (not outlying suburban areas or resort towns) have populations that skew elderly, downscale and racially homogenous. How would my family fit in? What would the schools be like for my kids? Would my husband be able to find work in his field?

In my state, a lot of the country hospitals have hit financial hard times and are closing. Health care seems to be migrating to the larger towns and serving larger regions. Maybe your hospital is lacking the money it would take to become more competitive in hiring.

Whoever mentioned tuition forgiveness as an incentive is on to something. I could see that attracting nurses.

[WinterSoldier]

Hi Klone! Have you tried reaching out to Central Oregon Community College in Bend? I know it's a few hours away, but, the local (and only) health care system here in Central Oregon is not particularly new-grad friendly so the graduates from COCC typically need to leave town for acute care positions. The local hospital seems to have a strong preference for experienced travelers. Would you mind PMing me your location? Thanks!