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.

Specializes in FNP/FPMHNP-BC.

And this is my opinion. There is no need to read every word in a passage to get the whole message.

Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.
Okay, I am glad that at least I found out some good information here. Its very rare that you can call human resources or a nurse manager where you have applied and they tell you the real reasons behind why they do what they are doing. That is all I have wanted for 3 months...just to be told that information. I know its a political game (and managers are not the top dog for those decisions...it comes from higher up) and its all about making the numbers add up and thats just business. I would just rather be honestly informed, rather than feel ignored. At least if I know a company is just posting without the intent to hire, then I don't waste my time applying. Its a lot of work to apply for stuff thinking one thing, only to find out that all of your effort was in vain. You know what I mean??
They are under no obligation to tell a person who is applying the internal workings of a facility...unfortunately this is name of the game and it isn't just nursing.

They are in control right now...HR is NEVER your freind. The manager IS apart of administration but they do as they are told...nursing is a dog eat dog world right now. Depending on where you live it can be really bad. This stinking economy has affected nursing as well.

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

I SECOND THIS!!!

So does ANYONE ever think this "nursing shortage" or "talks of nursing shortage" will ever come to a halt?

Specializes in FNP/FPMHNP-BC.

The nursing shortage was just a scheme, now they got a new one, "DNP".

Specializes in FNP/FPMHNP-BC.

Maybe we should get doctors to go back for their Ph.D's.

Specializes in mental health/psych; peds.

"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."

You're exactly right about this! But you forgot to add that these medical assistants are not only taking over the clinic/office setting market, but they are taking the title of "nurse", too! I get so angry when I hear the assistants saying, "Hey, Mr. Doe...I'm Jane, Dr. So-and-So's nurse." :madface:

But I guess this is for another forum topic, huh?

Specializes in FNP/FPMHNP-BC.

When the nurses that are in management finish with us, we are going to need double doctorates to practice nursing.

Specializes in FNP/FPMHNP-BC.

mso819. and the sad part, they don't want us to be called doctor even though we have a DNP.

Specializes in FNP/FPMHNP-BC.

I want to type freely and don't offend anyone.

Specializes in mental health/psych; peds.

I know exactly what you're talking about, Zack. I hope you get a call back soon, especially since it's Christmastime! As you can obviously see on these postings and comments, the nursing profession is a dog eat dog world. You'd think since nurses take care of people for a living and take an oath to care for human beings to the very best of their abilities, that we would treat our fellow nurses with the same amount of care and compassion! But, unfortunately that's not always the case. Sad really...

But, again, best of luck to you!

Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.
"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."

You're exactly right about this! But you forgot to add that these medical assistants are not only taking over the clinic/office setting market, but they are taking the title of "nurse", too! I get so angry when I hear the assistants saying, "Hey, Mr. Doe...I'm Jane, Dr. So-and-So's nurse." :madface:

But I guess this is for another forum topic, huh?

You indicate you are from South Carolina....when you hear this call them out. Your state has very specific laws that address this.

South Carolina

Title 40. Professions & Occupations. Chapter 33 Nurses. Article 1. Nurse Practice Act. 40-33-30 © A person may not use the word "nurse" as a title or use an abbreviation to indicate that the person is practicing in this State as a nurse, unless the person is actively licensed as a nurse provided for in this chapter. If the term "nurse" is part of a longer title, such as " nurse's aide", a person who is entitled to use that title shall use the entire title and not abbreviate the title to "nurse". This does not prohibit the use of the title "nurse" by persons who hold a temporary permit pending licensure by endorsement from another jurisdiction, and it does not prohibit the use of the title "nurse" by persons enrolled in a board¬ approved refresher course for the purpose of obtaining an active South Carolina license.

http://nursingworld.org/MainMenuCategories/Policy-Advocacy/State/Legislative-Agenda-Reports/State-TitleNurse/Title-Nurse-Summary-Language.html#southcarolina
+ Join the Discussion