Nursing Shortage

Published

"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.

Also, CCU is a great area to get a lot of experience and training. Given that CCU is probably one of the more difficult places to work (as far as skills are concerned) I would think going to a med surg floor position, I would be viewed as more qualified than someone who didn't have any 'higher level' experience.

Not trying to be argumentative or anything, but many people find that moving from a critical care area to a general med-surg area is a lot more challenging than they expected, and you may find that you are not considered "more qualified" than others. Experience with caring for a v. small number of clients in critical condition does not necessarily translate smoothly into working med-surg, where time management skills and ability to juggle a larger number of clients simultaneously is more valuable than the "higher level" skills that aren't going to be used much in that setting anyway.

However, best wishes for your journey! I hope you'll find something you enjoy.

I know I looked at a Recovery Room position and they actually wanted someone with a year of critical care experience. Once again, its that line of crap that we are fed in school that you should "get all the experience you can because it will make you more valuable in the future". HAHA!

I know I looked at a Recovery Room position and they actually wanted someone with a year of critical care experience.

That makes sense, because PACU is considered (more or less) a critical care setting. I was commenting specifically on your reference to "a med surg floor position," not suggesting that CCU experience wouldn't be considered valuable anywhere else.

I've never had a problem with getting a job. Sorry that you are. I can just as well write a post about how I got my first job and many after that.

I've never had a problem with getting a job. Sorry that you are. I can just as well write a post about how I got my first job and many after that.

THANKFULLY and i stress "thankfully" i have yet to have a problem finding employment either. It saddens me to hear/read that alot of nurses are finding it hard to become or acquire employment. I hope all works well with everyone who is seeking employment in this job market.

Specializes in Complex pedi to LTC/SA & now a manager.
I know I looked at a Recovery Room position and they actually wanted someone with a year of critical care experience. Once again its that line of crap that we are fed in school that you should "get all the experience you can because it will make you more valuable in the future". HAHA![/quote']

I will say that when I did my clinical rotation in PACU the nurse manager stated that although the minimum requirement was 1 year critical care, the nurses hired/transferring into PACU(recovery room) had an average of 5-10 years of ICU/CCU experience.

You could definitely tell these nurses were sharp, confident, highly experienced and skilled. They caught subtle changes and intervened early preventing significant complications. Their experience and confidence in their skills definitely enabled them to not only care for their patients but effectively advocate on their behalf. Whether a typical day stay patient was "off" and really needed an admit or 23hr obs rather than discharge home. To ensuring a patient had effective pain management.

If you were the manager and you had 100 applications for 2 recovery room jobs. 25% could be eliminated off the bat as they didn't meet minimum job qualifications (new grad, inappropriate experience (such as a pedi clinic nurse with 6 months experience), not yet licensed, etc) Out of the 75% left, 50 are internal candidates. 10 have relevant certifications (CCRN, ACLS,PALS, TNCC) , 5-10 years ICU experience, stellar critical care job reviews, recommendations from other facility managers, and say 5+ years seniority working for your hospital. Would you keep looking at the other candidates or would you focus on the 10 highly qualified internal candidates?

Specializes in FNP/FPMHNP-BC.

Why can't we all get a long. I am leaving bedside nursing within the coming year, that will free up a position.

Why can't we all get a long. I am leaving bedside nursing within the coming year that will free up a position.[/quote']

Not to pry..........but why are you leaving?? :sad: i love bedside nursing!

Specializes in FNP/FPMHNP-BC.

I am not proud to be a nurse. We as nurses get dump on for everything. We get no respect and we pretend that nursing is all well.

Specializes in FNP/FPMHNP-BC.

I have friends that are doctors and they tell me that they give the nurses lip service because they want the nurses to continue doing their work for them "like calling them and being proactive about the patient" when in reality they pity the nurse and think she is just one glorified secretary. Better yet, a monitor. When things don't go right blame the nurse. Nurses as a whole will eat each other up and back stab each other. Should I type more? SO PLEASE lets support each other and stop fighting amongst our selves.

I always love to see how 'defensive' people become on these forums.

I think the only one "defensive" in this thread is you.

You received some critique to make reading your post easier and some questions asking for clarification.

As for YOUR employment woes, one year of experience IS experience, but it doesn't make one an "experienced nurse." In this job market, employers can be choosy. You not getting call-backs doesn't mean the positions don't exist or that employers are looking for the "perfect candidate" but just that people with better resumes than you are applying.

If someone with one year experience applies and five with 10 years of experience apply, guess whose application is getting dropped to the bottom of the pile? These days, we've all got to suck it up and be glad if we're getting a paycheck.

Your best bet is going to be looking at internal transfer opportunities. But even there, you're going to have competition, and you still aren't at a point in your career where your a slam dunk for being one of the top candidates.

Specializes in FNP/FPMHNP-BC.

Zack1110 I understand exactly what you typed and very happy that u took the time to type it. Keep up the good works.

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