Nursing Shortage????

[neurorn6]

Now I realize that we all work in differents areas of this country as well other parts of the globe. And I realize that the east coast and west coast are more heavily populated. But this is my question, Is there a nursing shortage or a shortage of experienced nurses? This is why I ask, living in the NE, around PA,NJ, and NY, we were always short staffed. Several nursing programs of all size. Out west, CO, NM, UT the same. Hospitals short staffed in both urban and rural area. Now in the south, KY, TN area and several nursing programs, and little demand for nurses.

I'm really curious as to what you have seen and come across in your work places and in your travels.

Lately, in the area I currently live, there seems to be less experienced nurse working the floors and more new grads. I wonder if it has to do with hospitals wanting to pay less for warm bodies?

Anyway, just wondering what others have come across.

[TheCommuter, BSN, RN]

Just an observation, it is too small of a sample but so far most of the responses have been from Nurses working in right to work states. Although the part about location stable has merit.

I am originally from California, which is certainly not a right-to-work or at-will employment state. Since California is so large, there are several parts of the state that are experiencing major nursing gluts. The other regions of the state are going through wage-driven nursing shortages.

1. The San Francisco Bay area and the Sacramento Metropolitan area have extreme surpluses of nurses to the point that some new grads spend 3 to 6 months looking for work. These two regions attract nurses from other parts of California, nurses from other states, and foreign nurses due to the competitive pay rates and natural beauty of the area. Hence, the nursing glut in this area intensifies.

2. The greater Los Angeles area and San Diego are going through wage-driven shortages of nurses. Simply put, the southern California cost of living remains high for middle-income people such as nurses, teachers, police officers, social workers, etc. Although house prices and rentals are dropping in Southern California, they still remain too high for many nurses in this area to maintain a middle-class lifestyle with the wages they're being paid. The typical San Diego new-grad RN will start at $28 to $30 hourly, while the ones in Los Angeles will start in the low to mid $30s per hour.

[gonzo1, ASN, RN]

I completely forgot about pregnancies and child care, and of course all older nurses don't have health problems.

[Ruby Vee, BSN]

there are definitely more new (er) grads working out there than experienced nurses - percentage wise compared to years past.

i have noticed a trend over the years among nurses. it seems that each year's graduates are ready to quit sooner. the nurses that i know that have been nurses for 30 yrs were nurses for 20 yrs before they really got to the point that they were sick of it. nurses that have been nurses for 20 yrs took about 10 yrs to get sick of it. and now we are getting to where nurses are sick of it after only 2-3 yrs.

i don't know exact numbers of how many of the "newer" people that are burning out quickly went into nursing "for the money", but from my observations, the people who went into nursing for more altruistic reasons seem to have been able to hang on longer before getting burned out. i also did not see as many people getting into nursing mostly for the money back when i went to school. so i do believe that one's motives for wanting to be a nurse contribute heavily on how soon you want to call it quits.

there are definitely locales where there are no shortages of bodies because of people being reluctant to leave and area and the area being unable to support so many nurses.

the places that do have shortages of "bodies" are usually the places that have a large number of licensed nurses who are not working or are working in other fields. the last time that i checked the tx bon stats for the county i lived in (and this was about 5 yrs ago), 18% of licensed rns were not working as nurses. that number did not include lvns, of which there were also a large number of in that county.

regarding burnout -- i've noticed over the years (30 of them) that those folks who go into med/surg first for a couple of years then into er, icu, or or some other specialty area seem to last longer without burning out. the new grads i've known who go directly into the icu burn out really quickly -- often in less than two years. there seems to be no shortage of folks counseling new grads to "follow your heart" or "go where you want to be," but i'm not sure that's the best advice either for the new grad or for the icu that hires them.

[lpnflorida]

I remember a time when requirements were at least 2 years working on the medsurg floors before specializing. I also happen to think that increased a nurses satisfaction in the long run. It allowed them time to become comfortable with the basics first. A time to more fully develop their leadership skills.

That is no longer a requirement. Perhaps , at some point the pendulum will swing back.

I recognize the trend now in ICU , ER is to grow their own so to speak. It was the explanation I heard about the hiring/preference for new grads.

[neurorn6]

I think there are several keys to this issue as mentioned in several of the posts. Those of us who went into healthcare before our salaries put us into the middle class, went into for reasons other then money. Most of us have personal reason for that decision. In the past most hospitals wanted you to have at least 1-3 years med/surg experience before moving on to the speciality units. Personally, I think that was the right thing. This is what I did and for me it was the best thing I could have done. I think that this is when nurses learn their "nurse's gut". You know, when you can look at someone and sense something isn't right. For those of you who remember the first nurse shortage and how salaries increased and their were people going into nursing and then burning out in less then 5 years. I see that happening now. Hospitals in several parts of the country just see warm bodies. I personally think that it can be dangerous to put new nurses in to critical areas. Both for the patient and the nurse. I remember coming out of nursing school, scared to death that I would make a mistake. Now, I have met new grads who look at us "experienced" nurses like we have no idea what we are doing. I love the expression "my instructor said". Hospitals look at those of us who have been there for several years like we are breaking the bank. We may make a little more then new grads but in most profession you pay more for experience.

One of the biggest issues is that as nurses, we don't stick together. In alot of ways we have allowed this to happen. I just left a facility in the south that actually promoted animosity between staff members. I could not believe the attitude that admin took. Nurses were actually frightened to voice their opinion of working conditions. But, people here are afraid to stand up for themselves. Here is a question, what has the ANA ever done to promote nurses bonding together. As far as I can see, nothing. Why hasn't there been a national nurse/pt ration passed.

Until we come together as a group nothing will change. I'm sorry to say that I am coming to believe that I truly feel it's because it is a dominantly female profession.

[Mudwoman]

I live in a rural area where there is a town of 35K about 35 miles away and a large city about 100 miles away. We have 3 hospitals. A large Catholic Non-profit, a medium For-profit and a small For-profit. The small hospital is closing due to lack of money and the other for-profit is under new management for the 3rd time in a year. Our hospital had a lay-off to cut costs. So, we are having to do more with less. Nursing is the best gig in town, so just quitting and going someplace else is not really an option for most of us. Most of the nurses did not get a raise this year because the bar was so high, it was almost impossible to meet the requirements of a raise. Morale is low.

Money is the new shortage. We are losing doctors too. Most of the people in this community that have medicare/medicaid don't have supplemental insurance and lots of people don't even have insurance period. The doc's are leaving and going to larger cities to make more money. We now have patients that have lost their primary care physicians and some of the doc's that are left aren't taking on new patients, so these patients can't find a doctor that will see them.

[RN1989]

I agree with Neuro - and I've gotten my head bit off a thousand times for saying it - many of nursing's problems have to do with it being a female dominated profession.

Women are easily persuaded, coaxed, and intimidated into doing what everyone else wants. They are accustomed to putting themselves last and everyone first - without thinking of the long term consequences. Nurses in the south are the worst for this. There is a distinct difference in what nurses in the south put up with compared to the way that nurses in the north where people come together for a common goal, whether it is a union or an association. Whenever I have been to national rallies, the majority of the nurses who go are nurses from states that have unions (nursing or otherwise) and they are not as afraid to voice their concerns and the truth.

I also agree with needing to get medsurg experience before going to a different specialty. Nurses are making more mistakes and feeling more pressure because they are expected to work in high-risk for lawsuit areas when they do not have enough experience.

There may have been a few battles won, but nurses are losing the war.

[lpnflorida]

RN1989, being someone who work in Florida,( not always considered the south) I do not necessarily agree that nurses in the so called south take more and speak up less. I have worked up north , in a union hospital and down south non union. Nurses still voice their opinions here , just as they did up north.

Perhaps I am nitpicking .

I do agree working in a predominately female field. One for which most tend to be looked at as a second income within a family. As opposed to one which is the main support of a family, has hindered the economics of nursing.

Having more men enter nursing has been a boon to us all in that regards. Isn't is sad that we females remain second class citizens though. We are the only ones who can change that. It has come along way since my birth. I expect to see more changes until I die someday.

[SweetTeaRN, BSN, RN]

I agree with almost everything said in the above posts. As a recent new grad, and a second degree nurse, these were all things I considered when coming into the field and choosing to go to the ER first. However, while I respect your opinions about how burnout is occurring more rapidly and how choosing to go into a specialty at first rather than med-surg is creating a problem, I urge you to look at the healthcare system. Compare the healthcare system from when you first went into nursing and then now. I guarantee you the atmosphere has changed a great deal. In today's system, it is much more difficult to be a caring individual within an unfeeling bureaucratic system. With the advent of HMOs, huge liabilities and legal issues, "Doc in a box," Medicare restrictions, and a growing aged population, it is very difficult to be the same kind of nurse that maybe once all of you were.

As a new grad, I am saying that it is somewhat unfair to expect the same ideals that were once upheld. While I strive to be the best nurse I can be, and that includes caring, compassion, and a commitment to my chosen field, there is a lot more adversity for me coming into the nursing profession than there was even 10 or 15 years ago. I think the burnout comes from the healthcare system and upper management. And you're completely right, the focus should be on training good nurses, then retaining them. And in most places, that emphasis just isn't there. And until it is, there will always be a "shortage."

[lpnflorida]

I found this article if you read down the page it discusses the nursing shortage as experienced over the last 70 years, it is not new. For that matter nursing burnout is not new either.

http://www.cinhc.org/documents/NursingWorkforcePaper.pdf