Nursing shortage? Read this and respond please

[CEN35]

In the recent months our hospital appears to have trouble hiring new nurses, and/or keeping nurses in the hospital. This seems most prvalent on the evening and night shifts. A few thoughts enter my mind right from the start.

#1 - Are there a lack of new grads entering into hospitals?

#2 - Are experienced nurses getting out of the hospital to work with corporate companies, legal nursing, insurance companies, etc?

#3 - Is it d/t pay scales, and shift differentials. I know that in the past shift differentials have decreased. They have decreased to the point, where many nurses working nightshift had their yearly raises (let's say .43 cents an hour), but then the differential was reduced by .50 cents a year for 4-5 years. So they lost .07 cents a year. Currently there is no differential between the evening shift and night shift.

So what is it like at your hospitals? Do they have problems hiring, or keeping the positions filled there? Is there a shortage in your area or part of the country? Any thoughts on this would be appreciated.

Rick RN CEN

[pickledpepperRN]

Originally posted by CEN35:

Thank you all for your replies and input so far. I have two questions though? What is a CNA?

One other note, someone mentioned unity? Prrofessionalism etc. One thing for sure, when you look at the medical community, the physicians have the AMA. That's it? What do we have? TheONA, the ANA, the NLN etc. That's one problem r/t nursing unity and professionalism, not to mention the griping, and arguing about BSN vs ADN, what a crock! There needs to be a lot done, before we can get to the same level of proffesionsalism as physicians.

Rick RN CEN

Hi:

A CNA in California is a certified nursing assistant with 150 hours training. CNA is also the CALIFORNIA NURSES ASSOCIATION.

What if nurses applying for a job in a hospital asked for reasonable working conditions in writing? I'm talking about adequate staffing with plans for admissions, lunch breaks, equipment and medications available when the patients need them, orientation and training for each unit the nurse will be required to work, respect for the work we do as shown by believing our assessment of the need for more staff, and backup for nurses who insist on being treated with polite respect by all including doctors.

WELL? How about all of us who dread going to work who would love nursing if we could truly care for our patients applying for jobs with these requests?

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[saphie]

This is just my opinion for what it's worth but there is seems to be a lot of talk about the horrible nursing conditions. Like doctors who don't give you the time of day. I totally agree that there are some like that, heaven knows I've been yelled at when I have stood up for a patient. On the other hand, I have had doctors come and talk to me about their patients and ask my input. Welcome my questions without making me feel dumb. I believe that there is a nursing shortage and that it is only going to get worse. In my class there was some people in my year that were rather disgruntled with some earlier year students because they were in nursing because it was a "easy" degree. Our class started when there were no jobs in nursing. I guess the point I'm trying to make is that the majority of time nurses spend complaining about our job, what about focusing on the positive. No one will want to enter if all they here is negativity. I would love to see the proffessional associations do public campaigns on what nursing is and why we do it. Perhaps with more public support we wouldn't be in the bind that we are now going into. Anyway, food for thought.

[pickledpepperRN]

I agree that complaining is a waste of time. We need to ACT. Get together with fellow nurses at homes or for a meal. Instead of complaining brainstorm ACTIONS. Start small OR check out the link in my profile.

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[dianee]

Hi Rick,

I believe that the real problem today is that there is shortage of specialty nurses. Often (because of poor working conditions)the med/surg nurses are so burned out out after their first couple of years they look for jobs outside of the hospital setting. I'm lucky to have great job that I love, but I also had the luxury of being able to get an advanced degree, that gives me A LOT more flexibility. Would I want my daughter to be nurse? Well, from my perspective, if she is going to have to go to college for 5 years, take classes like Organic Chemistry, statistics etc. why not go to medical school? We have undervalued ourselves so much that now we have a shortage. Let's get over the timeless "What degree do you have?" debate and start helping and supporting each other. Di-

[Patricia Smith]

Dear Rick: Your responses are all within reason. I live in Phoenix (112 degrees today) and along with the shortage of a cool breeze, is also the shortage of nurses. Being a nurse now for 20 plus years I have been through some of the ups and downs our profession has endured. Our shortage (as far as I can see) started approximately 5 years ago. Nurses were plentiful; with management having the "like it or leave it" mentality. The progression of HMO's on the scene and hospitals hiring Managment firms (bean counters) to run hospitals more efficiently. They paid these firms hundreds of thousands of dollars--which could have been used for nursing salaries, or nursing programs, but they weren't. We were asked to document how many minutes of each day was actually spent "hands-on" patient care and how many minutes were used charting, drawing blood or handling equipment. These non-nursing duties were then given to non-nursing personel and our patient ratio's increased. We also were asked to "re-apply" for our nursing positions! The nurses who were phased-out or accepted early retirement were never to return to the nursing profession. Other young people who saw the increasing ratio's and responsibility actively sought "other" gainful employment. This was a period nursing was never to recover from. There is not a day goes by I don't see nurses crying in the hallway due to the stress and amounts of never ending patients being admitted to an already over-loaded floor, and unappreciative management. If there are nurses out there looking for work, Phoenix may be the place. Our starting pay is low ($l6.15 hr) I have nurses who have worked in the same system for 20 years and are still only making 20.40 so if money is the reason you are in it--stay where you are! I can't imagine doing anything else for a living...it is in my blood. I am obviously in the mid 40's range but will hang on.....I have one daughter who is a nurse, and my younger one who is definitely headed that way! I feel that I can make a difference every day--when that changes, so will I. Another big issue is support of one another--if we had that, we could have had the start of a union here five years ago--it died because every one was afraid of losing their jobs that were already in jeopardy due to the "re-application" to our positions. We are left with the aftermath--We are the backbone of every hospital in America! If only we used that backbone to stand tall, and stand together--it is only then that we will be able to "level out the playing field" and get the tools we need to lighten our loads! Good luck to you all--my prayers are with you!

[vicki]

Dear Patricia, I couldn't agree more. Most of us are nurses because we love what we do and feel like we can make a difference. There are a lot of bad working conditions out there, but there are also a lot of nurses in positions that they love. There will never be a solution to all the problems, But I do beleive that if all nurses would stand together, especially on the really big issues, that we could make a difference in salaries and working conditions. It makes no difference if you are LPN, RN with ADN,BSN or Masters. Nurses should support each other. Until we support each other and stand together no one will ever take us serious on these issues.

[This message has been edited by vicki (edited July 31, 2000).]

[oramar]

Originally posted by Patricia Smith:

Dear Rick: Your responses are all within reason. I live in Phoenix (112 degrees today) and along with the shortage of a cool breeze, is also the shortage of nurses. Being a nurse now for 20 plus years I have been through some of the ups and downs our profession has endured. Our shortage (as far as I can see) started approximately 5 years ago. Nurses were plentiful; with management having the "like it or leave it" mentality. The progression of HMO's on the scene and hospitals hiring Managment firms (bean counters) to run hospitals more efficiently. They paid these firms hundreds of thousands of dollars--which could have been used for nursing salaries, or nursing programs, but they weren't. We were asked to document how many minutes of each day was actually spent "hands-on" patient care and how many minutes were used charting, drawing blood or handling equipment. These non-nursing duties were then given to non-nursing personel and our patient ratio's increased. We also were asked to "re-apply" for our nursing positions! The nurses who were phased-out or accepted early retirement were never to return to the nursing profession. Other young people who saw the increasing ratio's and responsibility actively sought "other" gainful employment. This was a period nursing was never to recover from. There is not a day goes by I don't see nurses crying in the hallway due to the stress and amounts of never ending patients being admitted to an already over-loaded floor, and unappreciative management. If there are nurses out there looking for work, Phoenix may be the place. Our starting pay is low ($l6.15 hr) I have nurses who have worked in the same system for 20 years and are still only making 20.40 so if money is the reason you are in it--stay where you are! I can't imagine doing anything else for a living...it is in my blood. I am obviously in the mid 40's range but will hang on.....I have one daughter who is a nurse, and my younger one who is definitely headed that way! I feel that I can make a difference every day--when that changes, so will I. Another big issue is support of one another--if we had that, we could have had the start of a union here five years ago--it died because every one was afraid of losing their jobs that were already in jeopardy due to the "re-application" to our positions. We are left with the aftermath--We are the backbone of every hospital in America! If only we used that backbone to stand tall, and stand together--it is only then that we will be able to "level out the playing field" and get the tools we need to lighten our loads! Good luck to you all--my prayers are with you!

Dear Pat, God bless you, every word you said in your post is true. I know you continue to take good care of your patients no matter what kind of indignities are heaped on you. I remember when I had to reapply for my position, I did not realize then but it was the beginning of the end for me. I felt as if I had been given a deadly insult, the rage I felt was suppressed and went inward and made me physically and mentally sick. Much to my shame I quit caring, I see you have perservered and I salute you for it.

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[sparrow]

Hospitals are so busy cutting costs and the first place they cut are the most expensive staff members.

We hire new grads, regardless of how long it takes to orient them and how long it takes for them to be confident enough to fly on their own. The only problem is, after they are experienced, they take every thing I've taught them about real nursing and organization and go to the nearest big city to make twice as much as I do after 25 years in nursing. I've been pushing the hospital to make them sign a contract stating they will stay at least 3 years, but then they say "employement will not be "at will", meaning the employee can't be dismissed without lots of documentation. Most stay about a year, then we start all over again with a whole new batch. Maybe if new nurses would relize how expensive it is to orient and train new help and how so many hospitals are getting burned with new grads leaving so soon, they might find their search for a job much easier. All they need to do is not leave after a year. I've been in nursing long enough and worked at enough places to realize that the grass in not always greener over the fence and money is not always as satisfying as it sould be because it sure does not replace the feeling of knowing you made a difference to one person that day - and that is how you make a difference, one person at a time.

[CEN35]

Thanks for all the replies

Rick

[normarae]

Originally posted by walkaway:

I've been an RN since '68 and I am most discouraged now. The only reason I can go to work these days is because I am a float pool nurse at the hospital where I work. It is a suburban 220 bed hospital and what keeps me afloat is the fact that I can pick and choose my hours and shifts. Of course, this is only possible because we do have too few nurses. Originally, float pool was constantly called by co-workers, because they wanted off. Now I am called each week by the staffing office to pick up needs and if I took them all I could do doubles about 5-6 days a week. This has been the situation for well over a year. Right now this month we have been running at 67-97% bed census. So the pace hasn't been real killing. Weekends when they are desparate they will throw in a bonus. These have ranged from $25 to $200 a shift. Of course we are not to tell any coworkers about our bonus. And I could go on and on. What really tears me is that my high school age son's girl friend is a nurse aide at a local nursing home. She has been there for 3 years and earns $6.15/hr. for 3-11 shift. The kids who work at the grocery store start at $7/hr in the evenings. She is taking the vo-tech high school medical program and she wants to go on to nursing school. I think it is in her heart but I keep telling her that she has to get pro active for nurses or she will end up as tired as me. My other desire with nursing is to join a travel agency and see some or most of these United States in the next few years. I sort of picked up a negative vibe on the posts that someone's hospital pays tons of big bucks to travel agency nurses. It will be the only way I can afford to travel as I have not been able to save any of my hard earned money.If I do travel nursing, I hope the nurses in far away places won't hate me.

I am just starting to review the comments on allnurse.com and I read with compassion the sadness in between the lines of your comment. In Florida the problem with finding a job for RN CNOR was hospitals were getting consults from "those experts" and were being told to downsize licensed/nl personnel. Managers were being pink slipped right and left. I heard there were RN jobs in the East coast of Fla and interviewed and was hired (or so I was told) for 3-11 OR at Lantana Fla. I relocated and went in for my physical - the other manager re-interviewed me and I was told no job. I applied for unemployment. Finally did 40 hr job search with assorted interviews - (I believe HR's were practicing their interview techniques) One OR mgr left me in her office and forgot me for over 2 hours and I left a note saying call me for another appointment. Apparently she was so busy doing the job of a shortage RN that she didn't come back. I finally got a part timewith promise of full time in a hospital in Palm Beach Gardens Fl. Looked promising. They had two traveler nurses - I noted the regular f/t people were sent home without pay or PTO if they had it. The travelers were sitting in the lounge when the cases were finished. AND getting paid. One day soon after the consult by expert, the traveler tech and the surgeon asked me to open a graft and then said it was the wrong one. I had showed the surgeon and the tech. I was terminated in my orientation period because of the cost of the graft. I think that was just an excuse to LIFO concept of OR's. On the way out I met a ICU travel nurse and she gave me the name of a travel recruiter - I had a full time job in OR with 13wk contract - in 3 days. The good thing with traveling is the regular staff (who are overworked and stressed) love you if you can learn where the closet is quickly - and you are no threat to them because you are leaving. If you can't cut the mustard, they still know you are leaving and again you are no threat to them. Inter personal jealousy and backstaffing among regular OR staff is increasing and traveling keeps you out of the politics. Hope this helps.

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[steveleskovec]

I am an RN of 11+ years. Like many here i got into the field for job security. (ha, ha) Currently I work for an agency as a nurse recruiter so i have a vested interest in this question myself. I did not take time to read all the replys. What i do have is information presented in the HEALTHCARE MONITOR, a newpparer publication which comes out in the north-east Ohio area every week. the July 17, 2000 edition had some statistics posted. They are as follows:

average age of nurses in Ohio is 47+, of all the licensed nurses 13% are age 18 - 35, 37% are over 50 and 50% are 35 - 50 years old. Enrollment in nursing schools is decreasing, couple that with the number of grad nurses failing the NCLEX is increasing. In the past, 30% of licensed nurses were not working but were able to be drawn back into nursing. Today,

I say go agency and write your own ticket. If we all have to deal with the worst situations (and i see it getting worse before better) we might as well make our own schedules and get paid a premium for it.

[iamme457]

I have been a nurse for 9 years. I have worked all of those 9 years in a hospital. One year on med/surg and 8 years in various critical care units. I am going to work as a supervisor in a nursing home for more pay better benefits and a whole lot more respect. I am also going to start horseshoeing again, that is what I was doing before I went to nursing school.

Many nurses are leaving nursing altogether, some are going into home care, to be drug reps or for insurance companies. Less staff, more hours, less pay, really sickening health benefits, who would want that for their enemies let alone themselves, hospital nursing is not the place to be for me.

Deanna