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Staffing Shortages in HealthCare

Nurses Article   (12,953 Views | 25 Replies | 1,408 Words)

madwife2002 has 26 years experience as a BSN, RN and specializes in RN, BSN, CHDN.

1 Follower; 74 Articles; 121,530 Profile Views; 4,777 Posts

I'm overwhelmed. Can you imagine how new grads and inexperienced nurses feel like? Sometimes I feel like I am swimming for my life and the sharks are biting at my ankles and if I stop or slow down ... I will be pulled down into the depths of the ocean - where it will be impossible to come to the surface. You are reading page 2 of Staffing Shortages in HealthCare. If you want to start from the beginning Go to First Page.

4 Posts; 659 Profile Views

I'm a graduate of a ABSN program.

I graduated with honors.

I've been inducted into STTI.

I was a paramedic.

I can't get a GN job after two years.

I have invested three years of my life working on this new profession, and all you have to offer me is shrugging shoulders and finger-pointing. You tell me about how this is a cyclic thing and it will resolve itself after after a few years. Then you say that you've never seen anything like this.

You high-and-mighty experienced nurses have done nothing to change the system so to prevent this feast-and-famine new grad hiring phenomenon. What is the ANA doing? What is the AACN doing? Writing articles? Doing research that shows (over and over) that the profession of nursing will require 500,000 or more nurses by 2015? That 30% RNs and GNs in bedside care roles leave for other roles or leave the profession althogether?

What you have done is begun to lean toward "Versant" type GN programs. Thanks for that, by the way. Now GNs have an expiration date (GNs become rancid between 6 and 12 months from graduation). No RN recruiter will talk to me. I've been escorted out of an HR department after I decided to use the "walk-in" method. There are literally tens of thousands of us in Socal and only a few GN jobs.

Nursing is a worthy profession to join, but now -- for me -- the decision was a horrible, horrible mistake. And, I blame you the nurse leaders, APNs, nurse managers, RN professional organization leaders, and RN instructors. This is your fault. I held up my end of the deal and so did the other ???? thousands of American GNs who are in soup lines, living at home, living in their cars, standing in line with high school grads hoping for a job at Dairy Queen because the hospital won't hire a GN even as a CNA because they are afraid he or she will be jumping ship to get a GN job at any moment.

I wash my hands of nursing.

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109 Posts; 4,578 Profile Views

My wife is working for a small medical center in Socal and the staff are having problems with bad management and overwork-nothing new. They will get new directors every year or so who were reaching the retirement age or retirement or rotating from other locations but really did nothing to help improving besides having big salaries. It is a waste of money paying there manager but instead should use money to hire more good staff. Many times she worked without breaks on evening shift. She had filed complaints on her manager and another nurse due to abusive actions, and resulted in somewhat positive changes but surely created sort of sored relationship.

I think it is mainly laziness, ignorant, incompetent, and poor promotion for these nurses in charge. If you don't engage management in a positive way (whether it will help or not) I believe you have to give them your feedback at least especially if you do in as a team and not individual. I work in IT and surely we have bad management with poor planning and many times it is a struggling (welcome to the real world :) - we have to cancel all of our vacations for Nov-March due to a major project and work some weekends without much comp time.

However I do believe nursing and other healthcare fields are very stable and in demand as long as people get sick and old.

We all have to engage via honest feedback and don't give up making positive changes and work as a team. Good luck - imho

Edited by dianah
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3PRN has 17 years experience.

23 Posts; 1,353 Profile Views

Have you considered that dialysis nursing may be your niche? I know plenty of nurses who have never worked in a hospital and have enjoyed satisfying careers. Just a thought.

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4 Posts; 659 Profile Views

Three problems with dialysis nursing:

1. I can make more money working at my first career

2. What Pro Publica said about the problems with the dialysis business

I didn't get into nursing to take just any RN job. I worked hard at it so I wouldn't have to.

Also -- maybe some of you smart, experienced RNs can help me with this -- I've never met a non-Asian dialysis RN in Socal. I probably wouldn't fit in...

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KenNechitilo has 15 years experience and specializes in medical oncology.

1 Post; 340 Profile Views

I am an oncology certified nurse with ten years of experience. I have been unable to find any type of position for nearly a year- since last December. I suspect that because I am older and male no one has any interest in even finding out what type of contribution I could make. I doubt that anyone expects or asks for a male nurse, so why hire any? I guess they also assume older nurses frail and expensive to provide with health insurance. I was asked in for one interview in the past six months, at Florida Hospital in Orlando. They showed no interest in my experience but did tell me they had already hired five new grads for the unit.

I guess old nurses aren't offered jobs, they are just expected to fade, fade away.

I have a masters in economics. A labor shortage occurs when there are not enough qualified applicants at the prevailing wage. There is always a shortage if you include all the prejudices of those doing the recruiting- the right sex, age group, race, not too much or too little experience, etc..

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SE_BSN_RN has 8 years experience as a BSN and specializes in LTC, Agency, HHC.

805 Posts; 13,469 Profile Views

"How many nurses actually go the distance and stand up for themselves and others?

How many are brave enough to go to your manager and tell them what is going on?

Is your manager supportive? Does she roll up her sleeves and go work with you side by side? How many nurses feel brave enough to do this?

Not many because nurses are afraid of the consequences of their actions."

Yep. I was fired for doing exactly this. Voicing patient safety concerns that were overlooked and ignored. NONE of my managers were supportive. They all turned their backs when I was fired for "doing the right thing." No one stuck up for me, the nurse that was sticking up for the patient. Yeah i have since found a new job, but that isn't the point.

And when I finish my BSn I know exactly what I want to do. They just may not hire a "new grad" like me, who plans to make my dream job my career. I have no plans of jumping ship. So, wouldn't that be a better investment? Hire new grads where they want to work and offer training and support so they want to stay?

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brandy1017 is a ASN, RN and specializes in Critical Care.

2,327 Posts; 38,321 Profile Views

I'm a graduate of a ABSN program.

I graduated with honors.

I've been inducted into STTI.

I was a paramedic.

I can't get a GN job after two years.

I have invested three years of my life working on this new profession, and all you have to offer me is shrugging shoulders and finger-pointing. You tell me about how this is a cyclic thing and it will resolve itself after after a few years. Then you say that you've never seen anything like this.

You high-and-mighty experienced nurses have done nothing to change the system so to prevent this feast-and-famine new grad hiring phenomenon. What is the ANA doing? What is the AACN doing? Writing articles? Doing research that shows (over and over) that the profession of nursing will require 500,000 or more nurses by 2015? That 30% RNs and GNs in bedside care roles leave for other roles or leave the profession althogether?

What you have done is begun to lean toward "Versant" type GN programs. Thanks for that, by the way. Now GNs have an expiration date (GNs become rancid between 6 and 12 months from graduation). No RN recruiter will talk to me. I've been escorted out of an HR department after I decided to use the "walk-in" method. There are literally tens of thousands of us in Socal and only a few GN jobs.

Nursing is a worthy profession to join, but now -- for me -- the decision was a horrible, horrible mistake. And, I blame you the nurse leaders, APNs, nurse managers, RN professional organization leaders, and RN instructors. This is your fault. I held up my end of the deal and so did the other ???? thousands of American GNs who are in soup lines, living at home, living in their cars, standing in line with high school grads hoping for a job at Dairy Queen because the hospital won't hire a GN even as a CNA because they are afraid he or she will be jumping ship to get a GN job at any moment.

I wash my hands of nursing.

Stick with paramedics you will most likely get better pay and benefits anyway! Also California is a paradise so you will have a lot more competition for jobs there! Better chance to relocate to a rural area say North Dakota that is having an employment boom!

Don't blame us for the jobs crisis! We didn't cause it, we don't have much say in working conditions and staffing. This is part of a greater problem of jobs in America. Yes many nurses do leave do to stress and poor working conditions, but as the lack of living wage jobs continues more new grads are pouring into nursing from other degrees because they couldn't get a living wage and the you can always get a job in nursing rhetoric.

I'm sorry to disappoint you but nursing has always been in flux with periods of shortages and then layoffs. What's wrong with being a paramedic anyway, you do a lot of skilled things and should be able to keep up your nursing skills as a paramedic.

I would stress your on the job paramedic experience to bridge the gap and aim for emergency or ICU RN jobs if you really want to be a nurse! You should be able to make up a functional resume and letter displaying all the practical life and death skills you do as a paramedic as well as ACLS, PALS, etc. Your "skills" are really not that rusty if you are a paramedic you are using them on a daily basis and most likely unconsciously incorporating your new nursing knowledge. Think about how you can sell yourself to the hiring manager. Try to call the hiring manager and bypass HR and send a letter and resume to the hiring manager. Think about networking with your paramedics and with the ACLS certification team do they have any inside track to a hospital job, a friend or family member that works at a hospital. Any doctors that could help you give you a good reference and say something to the hiring manager on your behalf. Most hospitals lay out the red carpet for doctors as they bring in the business!

Edited by brandy1017

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2 Posts; 602 Profile Views

Brandy, while I agree that health care is now run using a corporate model, I disagree with you about training new graduate nurses. I happen to be an Intern Development Specialist. What that means is that our corporation VALUES our new nurses enough to assign one individual at each campus whose only job is following the new nurse, her/his coach, and ensure their progress for 2 full years. We provide additional training when they are first hired (of which we are part of that process) and become involved should something be wrong for any reason. Our goal is retention, competence, and a "corporation free of nurse-to-nurse hostility.

What we look for is: the new nurse a good fit for the unit, is the coach a good fit for the new nurse, and if not we can move the new nurse, from the unit and even campus to campus if necessary. Better yet we don't need HR to become involved.

The result is decreased turnover (running between 3-8%), better run units, and more successful new nurses.

Edited by shaughsee
forgot a sentence

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2 Posts; 602 Profile Views

You need to take a good look in the mirror, and ask yourself, what your prejudices are. I am hearing a huge amount of resentfulness towards a specific group of people, and truthfully that would not get you hired into our organization. Cultural competency and open mindedness is a fantastic personal trait.

But listening to what you have just said, no I do not think dialysis nursing is for you, but I am not sure nursing is for you. BTW I live in an area where there are 123 different languages spoken, so no rose coloured glasses are being worn, and I do understand cultural difficulties. I just choose to learn about the differences increasing my understanding, while improving my working conditions.

Good Luck

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mmc51264 has 8 years experience as a ADN, BSN, MSN, RN and specializes in orthopedic; Informatics, diabetes.

2,854 Posts; 39,693 Profile Views

I am in an ADN program and we do 12 hour clinicals. I am fortunate to be in a program that requires many more clinical hours than the min. mandated by the state (NC). I have counted it up and in the 4 semesters of the program, we will have a minimum of 600+ clinical hours. The state says 120 hours. we do 240 our last semester alone. We also have RN residency/fellowship programs here and I am hopeful that I will get into one.

I understand that as an ADN nurse, we are looked down as less prepared. I have a BS in Biology and a Masters in teaching. The ADN program is by far the most difficult thing I have done.

I work hard and think of my fellow students. I feel that I wold be a valuable employee. If I can get that far :)

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twinkletoes53 specializes in NICU.

202 Posts; 11,931 Profile Views

"Second, Your staffing shortages are a symptom of our health care system, it's all about the money and bottom line, health care is run as a business now and it shows and until that changes staffing shortages will remain a problem"

I agree. Hospital cutbacks started in January 2010 where I used to work. The hospital is anticipating a loss in income with Medicaid cut-backs. We had been through a phase of close to a year, where our census was low; 50-60 children less than what we usually staffed for.

Many positions were changed from a 0.6, which came with benefits, to a 0.5, which was considered part-time and NO benefits. The hospital made changes in who could be covered in their health insurance plan, and who would no longer be eligible. At a time when the hospital census was high, they were practically begging nurses to work on their days off, or if they worked 12 hour shifts, they would be asked if they could stay on and work 16 hours.

Last January, all overtime shifts were stopped. Nurses could no longer pick up extra shifts on their days off to supplement their income. Even if you worked

The results have been disastrous. The cuts were announced in a series of forums, in a very matter-of-fact attitude: "That's how it's going to be, and if you don't like it, you can find a job elsewhere." My NICU friends sent me a copy of one of one of the hour long videotaped meetings. I could not believe my ears. Nurses were crying in the audience, and the hospital CEO just stood there, expressionless.

Over 200 nurses quit within a few months span. The hospital had been attempting to apply for Magnet status. The application was put on hold immediately. A Magnet hospital cannot have a turnover rate of >8%. I had worked at that hospital for 34½ years. Just the month before all the drastic changes were announced, I went on permanent SS Disability, due to worsening chronic health problems. One of the Administrators, whom I had worked with for over 30 years, apparently stated that if nurses wanted to leave, they would just be replaced with new graduates. The hospital wants all RNs to have their BSN degrees by 2015. This nurse considers staff to be expendable. Experience and loyalty to the hospital be damned. In our unit, We had 2 LPNs who had worked for >20 years each. They were both terminated the first of this year. These nurses had worked literally thousands of overtime hours over the years; working double shifts when asked to, covering for RNs who wanted the day off, etc. I would have trusted my child to be cared for by one of these LPNs, rather than a new RN. In our 85 bed NICU, with the most critical of infants, we now have close to 50% staff who have been RNs for less than 1 year. We have an intensive 10 week orientation/preceptor-ship program. But nothing can replace experience.

Cutting back on practical experience is dreadful. Book knowledge does no good when you have an infant who is critical, and you have never seen or cared for one before. (True story: right before I left, I was in a room with an RN who's intubated baby was desaturating. The unit secretary was coming into the room. I was in the opposite end of the pod. I heard her tell him to increase the baby's Fi02, which of course he was clueless about, and was not authorized to do. She was pointing to the knob on the baby's Servo vent, to show him where to increase it. I went tearing across the room to help her, and told her--and later on, the Shift Coordinator--that you cannot ever have a secretary with no medical training do something like that! OMG.

When I was in college (yes,it was 36 years ago), from our third semester on, we worked in the hospital from 0630-1200 four days a week. We also had a night shift rotation closer to graduation. Then we had a 2 hour break, followed by classes from 1400-1600, or some days 1400-1800. We also had classes on Saturday from 0800-1200. I graduated and transitioned to staff nursing with no difficulty. I used to love precepting, and teaching. I'm no longer surprised when a new RN came to me for help, saying that she has never inserted a feeding tube, started an IV, catheterized a patient, or even seen a delivery, or assisted in Surgery. Book knowledge may teach you the pathophysiology of illnesses, and how to write a care plan, but unless you have hands-on exposure to bedside nursing before graduation, I don't know if I would be comfortable working side-by-side with you.

And re: the need for hospital cutbacks due to the economy. Sometimes, it's not all about the money. Sometimes it's about letting the hospital staff know that that they are respected, and that their hard work and efforts are greatly appreciated. A validation of all the hours and days when they have worked so hard needs to be given. Sometimes a "thank you", and an acknowledgment of their hardships, and empathy with the staff, make facing deep cuts a tiny bit easier.

The hospital census is now back to normal. The staffing numbers are not. patient:staff ratio is scary. I loved my job; it was my calling for 35 years. I will ALWAYS be a nurse. But I am thankful that I am not there today.

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5 Posts; 995 Profile Views

I am in an ADN program and we do 12 hour clinicals. I am fortunate to be in a program that requires many more clinical hours than the min. mandated by the state (NC). I have counted it up and in the 4 semesters of the program, we will have a minimum of 600+ clinical hours. The state says 120 hours. we do 240 our last semester alone. We also have RN residency/fellowship programs here and I am hopeful that I will get into one.

I understand that as an ADN nurse, we are looked down as less prepared. I have a BS in Biology and a Masters in teaching. The ADN program is by far the most difficult thing I have done.

I work hard and think of my fellow students. I feel that I wold be a valuable employee. If I can get that far :)

mmc51264

I am in your same situation. My ADN program ran their nursing program much like yours. We had clinical 3 days a week or more, as well, as went to lectures and labs. I was basically in school/Clinicals Monday-Friday all day long and also had 12 hour clinical days. I have be fortunate to do all the skills taught in lab out in clinicals, at least more than once each, and some I've lost count. I'm very comfortable in a hospital setting with patients and confident skill wise. I finished school in September and took boards in October and still currently pursuing work. 140 applications later, my app status' to every position at every hospital I applied to has put that i have 'insufficient' experience. I have had 2 phone calls from two agencies saying I needed experience and then went to an interview at a hospital, just to be told I'm inexperienced. I actually have an interview for a doc office today and tomorrow one at a nursing home. It is frustrating to spend so much time putting in applications after applications with no success. I'm going to have to keep my fingers crossed.

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