"That's a myth about nursing"

[Emergent]

I just got off the phone with a young applicant to rent from me. I mentioned that I worked yesterday, so she asked me what I did. She's a college student herself.

She said, "Oh, wow, that's a busy job! There's always a need for nurses!" I replied that that's a myth about nursing. There's not always a nursing shortage, sometimes it's difficult to get a job. I said that I'm not sure who's responsible for the myth, but that there are a lot of for profit nursing schools that have popped up, and I'm sure they are partially responsible. Unfortunately, the quality of nursing education has gone down with that trend.

I told her, the need for nurses comes in cycles, just like other sectors of the economy.

[applewhitern, BSN, RN]

From what we've seen here, many new grads want Monday thru Friday, days only, no weekends, no holidays, like they think its an office job. We have a lot of applicants who won't even consider evenings or nights. The so-called shortage of nurses is dependent on the area. From what I understand, there are border jobs to be had, or as others have stated, jobs nobody wants. The benefits in my area are not good at all, nor the pay.

[applewhitern, BSN, RN]

Back when I was in nursing school (late 80's) we had an entire semester of OR clinicals. I have heard new nurses say they didn't have any surgical clinicals at all!

[klone, MSN, RN]

There is in fact, a shortage currently in the OR. It will only get worse as more of our workforce nears retirement. The cost to train a nurse to be competent in the OR is astronomical, even compared to other specialties. .

Ditto OB. It takes approximately 2 years to train a nurse to be safe and competent in L&D.

[FurBabyMom, MSN, RN]

Back when I was in nursing school (late 80's) we had an entire semester of OR clinicals. I have heard new nurses say they didn't have any surgical clinicals at all!

Correct. Exposure to the OR is typically, at best, in pre-licensure programs a day or maybe two observing in the OR. It's much more cool to watch the procedure than absorb any of what the circulator and scrub are doing (in our facility we have surg techs and nurses who scrub). I was lucky, I had a non-traditional practicum my senior year - pre op and PACU. When my preceptors on either side weren't busy I was allowed to watch in the OR.

Many changes in required education and pre licensure competencies have driven this to be so. Also, there are increasing issues with getting students access to quality clinical experiences as hospitals are less and less likely to be willing to allow students the access previously allowed. Also, academia does not value OR nursing in the same way the ICUs, EDs and floors are valued. More than one of my graduate instructors have written off my experience as an OR nurse as being irrelevant and I'm not even in NP or CRNA school.

I can understand some competencies (we do not generally individually titrate medications, etc), but in some ways OR nurses are far more suited to critical thinking under immense pressure, and far better at anatomy and patho than some floor/ICU nurses. I hate to be like that, but it is true. I have to understand why the patient is having surgery, their allergies, what might go wrong surgically, what might go wrong with respect to anesthesia or other medications. I have to know what needs done if a specific issue happens. I have to know medications, clinical indications, far more detailed positioning concerns, instruments, equipment, troubleshooting a great deal of technology, etc. I have to understand sterilization and high level disinfection, care and handling of many more devices than floor or ICU nurses will ever see. I have to understand the rationale and protocol for how we resuscitate some situations floor nurses or ICU nurses will ever see.

I'll be honest - I have to know the plan, the back up plan, and the back up to the back up. I also have to know the "Hail Mary" plan. I have to keep myself together in situations I've literally never seen (may be unique to a trauma center). We never really know what we're getting when a patient comes up from the trauma bay, especially true if they come from the helipad. Anyhow I'll get off my soap box now...

We're seeing some changes - some really cool and innovative changes are occurring in periop to help combat this phenomena. Even if we don't hire the students we allow to be in clinicals or rotate with us, them having the knowledge of what the OR is or isn't is helpful. One of the problems is we sometimes hire people interested in the OR, but they don't fully understand until part way through orientation. They decide it's not for them and we've wasted time and money as well as annoyed our preceptors because people aren't staying.

[FurBabyMom, MSN, RN]

Ditto OB. It takes approximately 2 years to train a nurse to be safe and competent in L&D.

Yep! It's at least a year, but honestly closer to two for us too. Luckily every day is a team sport day for us, so even unexperienced or unfamiliar staff are often paired with an experienced other staff member and/or surgeons, anesthesia, etc.

I can't really imagine what L&D is really like. We sometimes get asked to help cover sections. We also sometimes have to do sections in the Main. If Mom was a trauma patient and critically unstable they will do an emergent section and we may/may not have the NICU team (thankfully we have peds anesthesia in house almost always now). Sometimes Mom needs a scheduled procedure where we are set up to do a section if we have to code Mom. And then sometimes, Mom and/or Baby might need to be put on ECMO and/or emergent heart/vascular/airway procedure(s) which is not something our L&D ORs can do.

[DaveICURN]

Yes there has been a myriad of "The sky is falling!" mentality about nursing shortage. However I think this has been a preemptive warning. According to the current data, over 50% of our current nursing population are set to come into retirement in the next 10-15 years. This means half, HALF, of nurses at maximum will leave the field. This is an emergent problem. Couple that with the fact that there are surging number of enrollments into the nurse practitioner program, and you have a recipe that leaves 50% of the workforce understaffed and under trained.

I also agree with the sentiment that there are not enough floor nurses. Everyone is looking to specialize to make that bigger dollar. The old adage of needed floor experience is now fading, as the specialty units are hiring new grads straight from school.

[Buckeye.nurse]

There is a pretty severe shortage of *experienced* nurses in Ohio. Many hospitals now offer sign on bonuses to experienced nurses, and one hospital in southern Ohio just recently advertised a $5000 sign on bonus for new hire RNs with > 1 year inpatient hospital experience on the local news. My employer has also stepped up the number of positions our new grad residency offers, and they have added additional start dates to the program.

So while I'll agree with you that at times the nursing shortage is a myth, right now, in Ohio, it certainly is not.

[osceteacher]

There is always a need for nurses in England, send her over here please!

[kbrn2002, ADN, RN]

The "nursing shortage" is such a regional thing it's really hard to determine what's true about it and what isn't. Even in my relatively small market there is absolutely no shortage in acute care. But...nursing homes, home health and assisted livings are chronically short staffed despite having pretty competitive pay for the market.

[holisticallyminded]

Oh there's a shortage all right but it's a planned shortage! With plenty of nurses, facilities understaff on purpose based on a cost/risk analysis. This leads to higher turnover, higher recruitment and training costs which sends the cost/risk analysis further screwed toward insurance pay outs (settlements) vs recruitment and retention of new nursing staff (expensive for the reasons stated above in a never ending feedback loop). And nurses say they want more money!! (Technically it's up to YOU to negotiate for yourself but don't expect a business you don't own yourself to give it up easily.) if you want more money, I wouldn't pick a nursing career. In my home, it's just supplemental.

[klone, MSN, RN]

Oh there's a shortage all right but it's a planned shortage! With plenty of nurses, facilities understaff on purpose based on a cost/risk analysis. This leads to higher turnover, higher recruitment and training costs which sends the cost/risk analysis further screwed toward insurance pay outs (settlements) vs recruitment and retention of new nursing staff (expensive for the reasons stated above in a never ending feedback loop).

Do you have any actual evidence of this (perhaps a journal article), or is this simply your opinion?

[brownbook]

The whole is there a shortage question...depends on what experience you have.....OB...OR, etc. reminds me of something I heard in the 70's during a recession and everyone searching for any type of job was worried.

The job market is always crowded at the bottom; there is always room at the top for someone with good skills, training, and attitude.