Nursing Shortage

[zack1110]

"The nursing shortage lies--local major hospital corporations are not hiring nurses, despite continuing to falsely post job openings"

Knoxville, Tennessee

December 1, 2013

After deciding to go to school to become a Registered Nurse, many had the hopes and promises of never being unemployed or ever having to worry about finding a job. So many figured this would be a good investment in their future--but it may be time to reconsider that idea.

For as long as I can remember, and most definitely for as long as I had aspired to be a nurse, I had been hearing the term 'nursing shortage' tossed around by the multiple media streams as well as from other healthcare professionals. It was brought up everywhere. If you looked for example, in the newspaper, you would find ads boasting huge sign on bonuses for Registered Nurses with excellent wages and benefits-- some even paid continuing education opportunities.

Many people began to jump on the bandwagon to obtaining their nursing degrees. With many opting to do BSN programs, there were also many ADN programs that offered nursing education and the 'RN' title after only 2 years of study. This made it appealing to a lot of already employed individuals looking for a stable, steady career change. All kinds of nursing programs began to spring up, with as many as 6-10 nursing programs per city or region. Most of these programs here in Knoxville are producing roughly 60-100 nurses every 2 or 4 years depending on the program, but with a job outlook growth projected at "faster than average" and the "shortage of nurses", it seems like a no brainer! With quotes like this plastered all over the American Nurse's Association's website, where could you possibly go wrong?

The Shortage Isn't Stopping Soon
You've likely heard about the "nursing shortage" for years now, and perhaps you think it's been resolved. However, registered nurses are still at the top of the list when it comes to employment growth (BLS, 2010).

What we have failed to see as a society is the impact of market saturation. With so many local nursing programs producing a steady supply of new graduates, it's not difficult to see that eventually the supply is going to exceed demand in any given geographical region, as it has already done here in Knoxville. But this isn't the only contributing factor in and of itself. This is just one of the complicating factors in a multiple faceted, bigger issue.

At the same time we saw such an increase in the amount of nurses that were being turned out into the job market, we also began to see some political changes within the healthcare industry itself, in particularly with the hospitals. Many of the smaller market hospitals began to merge or be 'bought out' by larger corporations, such as Covenant Health and Tennova Healthcare Systems. These larger corporations have ended up owning many smaller hospitals and dominate the job market in the Knoxville area. This is a great investment for the corporations, but can be pure disaster for the nurse seeking employment.

If those two strikes aren't enough to put nurses behind the eight ball, then add in the fact that many jobs that used to be held only by Registered Nurses are now being filled by Licensed Practical Nurses, Certified Nursing Assistants, and Medical Assistants. This is in part due to an increase in the availability of educational programs for these careers. Also, the job descriptions have changed which allow these individuals to do more than the previously could, thus eliminating the need for RN's. This also eliminates the need for a company to pay RN wages for the same tasks that can be done by a CNA or LPN.

This leads to another problem that is wreaking havoc on nursing job opportunities--the greediness of these large corporations. The idea of "doing more with less" has caught on BIG with employers. In jobs, such as retail, this only hurts the employee by working them to a personal limit and exhaustion. In the employer's eye, if they can get one person to do the work of three people, then why would they want to pay three people? This idea has really taken a hold on the nursing industry as well. The employers however, have neglected to see the real problem with this. When you implement this ideology, not only do you work the employee beyond his or her limits, but you also endanger the lives of patients. I have found this to be the case first hand, working for Covenant Health. This is especially true on medical surgical units and critical care units. It is not uncommon for one nurse to carry the load of 7-8 patients per shift on a medical surgical unit and 3 patients at a time in a critical care unit. This patient to nurse ratio has increase drastically over the past few years and is simply unsafe practice. I can remember having traveling nurses come to our facility, see our nurse to patient ratio and make comments about how 'unsafe" they felt working with that load. The employers are slowly increasing the workload per person until they find a "breaking point", which usually consists of a patient harm event and/or a subsequent lawsuit involving patient harm. Unfortunately, patients must be injured or harmed before the issue is viewed in any other light aside from a "bottom line" or "money" issue. Despite bringing these issues up in staff development meeting numerous times, it was always "blown off" as not important. These large corporations are able to get away with such treatment of their employees because of the very thing they are creating--the saturation of nurses and the fact that they dominate the market. If you have nurses that are seeking jobs so desperately, then they are willing to "put up" with harsher working conditions and lower wages in spite of having a "job". At the same time, the reason for those harsher working conditions is greediness from the employers by not hiring additional nurses to spread the workload out and make conditions safer for everyone. It's a vicious cycle and until the healthcare corporations such as Covenant and Tennova realize this, they may be facing more patient dissatisfaction and lawsuits than they bargained for.

Interestingly enough, employers do a great job of "masking" the fact that they aren't hiring new nurses too. Just go to any large hospital website and view the job opening boards. You would be amazed at the amount of "open" positions that are posted there. I have heard from numerous nurses, that even after applying for upwards of 30 positions, they have yet to receive one call for an interview. I have experienced the same thing first hand. After speaking with one local Human Resources agent, it was apparent that their facility had only hired five RN's over the past 5 months, despite countless pages of open job postings. I have spoken with several managers who have informed me that hiring is just 'dead' and there are no plans to hire additional nurses, especially before the beginning of the year at the earliest. In addition, you never see those attractive 'sign on' bonuses that once were a commonplace among nursing positions.

If these large hospital corporations are not going to hire new nurses, and we have in fact seen the end of the 'nursing shortage era", then they at least need to stop feeding the public a constant stream of lies by continuing to post job openings daily. This is a very misleading and dirty way to do business in the community.

[roser13, ASN, RN]

Yes, we are all quite aware. You do realize that you're preaching to the choir?

[mvm2]

I as a CNA taking over RN duties? UMMM NO I DON'T THINK SO. And I won't be taking over LPN jobs either. I think you NURSES are safe from me taking over your jobs anytime soon;)

I think whoever wrote this article is a little off as well. With what everyone is saying here at AN it seems to me that hospitals want MORE education out of their nurses not less. That is why every nurse is scambling to get their BSN right?

Also it states..... "the job descriptions have changed which allow these individuals to do more than the previously could, thus eliminating the need for RN’s."

Really? I just took my CNA course just last year and I don't remember learning anything about meds or how to put in a IV. So how can CNAs take over a nurses position

[Palliative Care, DNP]

I'm sorry but I had to stop reading due to all of the typos. It was driving me insane. On topic we are all aware there is no nursing shortage in many areas. If people are willing to relocate then there are opportunities.

[applewhitern, BSN, RN]

If you were writing this for school, then you need to use paragraphs; it is too difficult to read as it is written.

[Anna Flaxis, BSN, RN]

You guys are so mean with your uneccessary comments!

[zack1110]

I never said nurses would be 'replaced' by CNAs or MAs. Trust me, CNAs are a great asset. I worked in CCU for 2 years and my CNAs helped me so much and were some of my best friends! No need to get all defensive on me. What I am referring to is more in the 'clinic' setting or doctor's offices. In the past, when you went to the doctor, an RN came in to do your triage (BP, P, Temp, took your history, ect.). I am not saying that CNAs are 'taking over', just making the point that a doctor's office is NOT going to hire and pay an RN to do these things now as they used to years ago, which means that's one less job opportunity for the RN that used to be available.

[zack1110]

I always love to see how 'defensive' people become on these forums. You would think I wrote this article specifically about them and they take it so personal. This is the same reason politicians can't get anything accomplished in Washington, they can't get past taking issues 'personally' and just have a civil discussion. It's sad.

[zack1110]

For those of you who are critiquing my formatting and spelling, I have revised the typos and fixed the formatting. (Bet you didn't think I would care enough to go the extra step did you?) I will have to proofread some of your posts sometime for you too. :)

By the way, I am not a student.

“The nursing shortage lies—local major hospital corporations are not hiring nurses, despite continuing to falsely post job openings”

Knoxville, Tennessee

December 1, 2013

After becoming a Registered Nurse, I thought I had the hopes and promises of never being unemployed or ever having to worry about finding a job. I figured this would be a good investment in my future—but it may be time to reconsider that idea.

For as long as I can remember, and most definitely as long as I have dreamed of being a nurse, I have heard the term ‘nursing shortage’ being touted by multiple media streams, as well as from other healthcare professionals. When I looked, for example, in the newspaper, I would find pages of ads boasting huge sign on bonuses for Registered Nurses with excellent wages and benefits— some even offered paid continuing education opportunities.

It seemed as though many other people began to jump on the bandwagon to obtaining their nursing degrees as well. With many individuals opting to do BSN programs, there are also many ADN programs that offer nursing education and the ‘RN’ title in a two-year curriculum. This option was appealing to many already employed individuals looking for a steady and stable career change. All sorts of nursing programs started to spring up, with as many as 6-10 nursing programs per city or region. Most of these programs here in Knoxville are producing roughly 60-100 nurses every 2 or 4 years depending on the program. With a job outlook growth projected at “faster than average” and the “shortage of nurses”, it seems like a no brainer! Plus, with quotes like this plastered all over the American Nurse’s Association’s website, where could you possibly go wrong?

The Shortage Isn’t Stopping Soon
You’ve likely heard about the “nursing shortage” for years now, and perhaps you think it’s been resolved. However, registered nurses are still at the top of the list when it comes to employment growth (BLS, 2010).

What we as a society have failed to see is the impact of market saturation. With so many local nursing programs producing a steady supply of new graduates, it’s not difficult to see that eventually the supply is going to exceed the demand in any given geographical region, just as it has already done here in Knoxville. But this isn’t the only contributing factor in and of itself but rather only one of the complicating factors in a multiple faceted, bigger issue.

At the same time as we are seeing such an increase in the amount of nurses being turned out into the job market, we are also seeing some political changes within the healthcare industry itself, particularly within the hospitals. Many of the smaller market hospitals are merging or being ‘bought out’ by larger corporations, such as Covenant Health and Tennova Healthcare Systems here in east Tennessee. These larger corporations end up owning many smaller hospitals and dominate the job market. This is a great investment for the corporations, but can be pure disaster for the nurse seeking employment.

If those two strikes aren’t enough to put nurses behind the eight ball, then add in the fact that many jobs once held exclusively by Registered Nurses are now being filled by Licensed Practical Nurses, Certified Nursing Assistants, and Medical Assistants. This is particularly the case in clinical areas such as doctor’s offices and urgent care centers. Certain aspects of the job descriptions for “nursing support staff” have overlapped which allow these individuals to do more than they previously could, thus eliminating the requirement for an RN to do certain tasks. This also eliminates the need for a company to pay RN wages for the same tasks that can be done by a CNA or LPN.

This leads to another problem that is wreaking havoc on nursing job opportunities—the greediness of these large corporations. The idea of ‘doing more with less’ has caught on BIG with employers. In jobs, such as retail, this only hurts the employee by working them to their personal limit and udder exhaustion. In the employer’s eye, if they can get one person to do the work of three people, then why would they want to pay three people? This idea has really taken a hold on the nursing industry as well. The employers however, have neglected to see the real problem with this. When you implement this ideology in healthcare, not only do you work the employee beyond his or her limits, but you also endanger the lives of patients.

I have found this to be the case first hand, working for Covenant Health. This is especially true on medical surgical units and critical care units. It is not uncommon for one nurse to carry the load of 7-8 patients per shift on a medical surgical unit and 3 patients at a time in a critical care unit. This patient-to-nurse ratio has increase drastically over the past few years and is simply unsafe practice. I remember several traveling nurses who came to our facility, saw our nurse-to-patient ratios and made comments about how ‘unsafe” they felt working in those conditions.

The employers are slowly increasing the workload per person until they find a “breaking point”, which usually consists of a patient harm event and/or a subsequent lawsuit involving patient harm. Unfortunately, patients must be injured or harmed before the issue is viewed in any other light aside from a “bottom line” or “money” issue. Despite bringing these issues up in staff development meeting numerous times, it is always “blown off” as not important. These large corporations are able to get away with such treatment of their employees because of the very thing they are creating—the unemployed saturation of nurses and the fact that they dominate the market. If you have nurses that are seeking jobs so desperately, then they are willing to “put up” with harsher working conditions and lower wages in spite of having a “job”. At the same time, the reason for those harsher working conditions is greediness from the employers by not hiring additional nurses to spread the workload out and make conditions safer for patients. It’s a vicious cycle and until the big hospital corporations such as Covenant and Tennova realize this, they may be facing more patient dissatisfaction and lawsuits than they bargained for.

Interestingly enough, employers do a great job of “masking” the fact that they aren’t hiring new nurses too. Just go to any large hospital website and view their job opening board. I am amazed at the amount of “open” positions that are posted there. I have heard from numerous nurses that even after applying for upwards of 30 positions, they have yet to receive one call for an interview. I have experienced the same thing first hand. After speaking with one local Human Resources agent, I was told that their facility had only hired five RN’s over the past 5 months, despite countless pages of open job postings. I have spoken with several managers who have informed me that hiring is just ‘dead’ and there are no plans to hire additional nurses, especially before the beginning of the year. In addition, you never see those attractive ‘sign on’ bonuses that once were a commonplace among nursing positions.

If these large hospital corporations are not going to hire new nurses, and we have in fact seen the end of the ‘nursing shortage era”, then at least stop feeding the public a constant stream of lies by continuing to post job openings daily. This is a very misleading and dirty way to do business in the community.

[roser13, ASN, RN]

"If these large hospital corporations are not going to hire new nurses, and we have in fact seen the end of the ‘nursing shortage era”, then at least stop feeding the public a constant stream of lies by continuing to post job openings daily. This is a very misleading and dirty way to do business in the community."

I still don't get the point of your post.....

To whom is it addressed? Certainly not nurses.

"I always love to see how 'defensive' people become on these forums. You would think I wrote this article specifically about them and they take it so personal."

Who's getting defensive?? Criticism of your "article" does not necessarily equal a reader taking it "so personal" [sic]. It may just mean there are flaws in your logic, topic or presentation.

And Stargazer, I don't see any unnecessary or mean posts. Anyone who posts on an open forum must expect relevant critique.

[zack1110]

Well roser13, if that is how you feel, then why don't I just critique you a little…you seem to be able to dish it, so you should have no trouble taking some yourself...

If you aren't smart enough to get the 'point" of my post, then I am sorry, as it is quite obvious that this is a post regarding why I feel like there are 'less' RN jobs available now than there were before and it points out some of the issues that I feel like are contributing to that. I didn't know that posts on here had to be directed specifically to "nurses" and if you can find that requirement, I'd love to see it.

Looking at some of your posts, you sure are good at writing about the exact same thing, the "nursing shortage" over and over again. So, in your words, I guess you are "preaching to the choir" but it sure didn't stop you from posting multiple times about it!

[zack1110]

On another note, when you are here reading other people's post and you feel like it doesn't pertain to you, then why even bother to comment? Obviously now you state that you don't know what my point is or whom its addressed to….although your first comment suggests that you understood just fine, in fact, enough to leave a passive aggressive comment like:

Yes, we are all quite aware. You do realize that you're preaching to the choir?

​