Much is being made of the nursing shortage, but the sad fact of the matter is that much of this shortage is a self-inflicted wound. "30%-50% of all new RN's elect either to change positions or leave nursing completely within the first three years of clinical practice"
Much is being made of the nursing shortage, but the sad fact of the matter is that much of this shortage is a self-inflicted wound. "30%-50% of all new RN's elect either to change positions or leave nursing completely within the first three years of clinical practice" (MacKusik & Minick, 2010, p. 335). The reasons are many and varied, but a 2010 qualitative study by Carol MacKusik and Ptlene Minick examine these issues and find three major themes, an unfriendly workplace, emotional distress related topatient care and, fatigue and exhaustion (MacKusik & Minick, 2010).
An unfriendly workplace can be one in which the new nurse is simply thrown to the wolves, expected to "toughen up" by more experienced coworkers, women experiencing sexual harassment from male coworkers and physicians, and lack of support from management and/or administration in addressing these issues.
The emotional distress we as nurses experience is, all too often, related to cases of futility of care. This is where, regardless of how many life support systems the patient has attached to them, the result will be the same...the patient will die. The only question being how much suffering they experience as they do so. This occurs at both the beginning of life in neo-natal ICU's to the end one's years in ICU. In either case, physicians may not be entirely honest with patient families, thus giving them false hope regarding the prognosis. The other side of the coin is families, for whatever reason, cling to the hope that their loved one will somehow arise from the bed and leave hale, whole and healthy. This is often due as much to family dynamics involving guilt as it to unrealistic and unreasoning religious views. The toll this takes on the nurses involved in the direct care of these patients is huge.
Fatigue and exhaustion come into play when, for whatever reasons, management and/or administration are more concerned with filling beds than whether or not the staff is available to safely care for these patients. Nurses are asked, then expected, to "flex up" and take more patients it is safe for them to care for, thus putting patient safety and nurses licenses at risk. This creates a fundamental conflict between the core values and terms of licensure for nurses and the values of the organization. Add to that overtime and calls to work on their days off, and the physical and emotional exhaustion simply becomes too much to bear.
So the projected nursing shortage...some 500,000 nurses by 2025 (MacKusik & Minick, 2010)...seems to be as much a result of nurses fleeing the acute care setting as it is with the lack of sufficient new grad nurses to take up the slack.
References
MacKusik, C. I., & Minick, P. (2010). Why Are Nurses Leaving? Findings From an Initial Qualitative Study on Nursing Attrition. MEDSURG Nursing, 19(6), 335-340.
Speaking from a union-oriented perspective, I would agree with some of the points raised above. However, in practice, unionized environments still present many challenges. While you may be perfectly within your rights to enlist the help of the union, there is a fine balance....because you still have to show up for work every day, and you still need those references. Employers still try to mess around sometimes, despite the fact that the contract says otherwise. Union or not, nurses still get shafted.
Yeh, I think they're always going to treat nurses like second class citizens. I don't know why they drill into you the whole time you're in nursing school about how you're going to be a professional because it's such a let down when you get out of school and get your first job and discover that you're treated like anything BUT a professional! That was and still is one of the biggest disappointments of my nursing career, how we are perceived and treated by everyone, not just the administration of the hospital. People treat us so lowly I'm almost embarrassed when someone asks me what I do, to tell them I'm a registered nurse and this is even though I have a BSN, I'm still embarrassed. We have been "put in our place" for so long that I just have this sense of lowliness, that I'm nothing. I can't wait to get out of this field altogether. I have aspirations to some day be an advocate for nurses (after I no longer am, so they can't try to destroy me like they do other nurses that would try to make a difference).
I have read hundreds of posts here on Allnurses that say there is no nursing shortage. To everyone who says that... lets stop and thinks about this logically!
Fact: The economy is still stumbling along
Fact: A poor economy means ALL employers from manufacturing to healthcare are struggling to make ends meet and keep their business afloat.
Fact: Patient to nurse ratio is higher than it should safely be in more than 75% of healthcare settings.
Just because employers are not hiring and the job market is not as robust as it once was, does NOT mean that there is not still a nursing shortage. You can't hire nurses if you can't pay them. You can't justify expanding your nursing staff when the entire healthcare community is skrimping and scratching just to stay afloat. When the economy recovers, the nursing shortage will be visible to everyone once again. If there was no nursing shortage then there would not be so many nursing on here complaining about having too many patients to deal with by themselves. They would not be complaining about lack of help.
Just because you can't get a job does not mean that the nursing shortage no longer exists. It means that you are one of millions of casualties of the recession. Nursing is not the only profession/job market that it is hard to find a job in.
Sooner or later, everything will start to even out and then everyone who is complaining that there is NO NURSING SHORTAGE, will then be complaining that there are not enough nurses! lol
I think that this a problem in all hospital and group managed care settings. Medscape: Medscape Access This article suggests that 40% of docs are intent on quitting active practice in 3 yrs (US)! I am not sure how valid that number is, but the article certainly suggestive that job satisfaction is not found anywhere in the hospital (outside of the executive offices). It is certainly appropriate for medicine, nursing and allieds to push back, because it is clear that the current management practices are favourable to no one who is actually providing care.
I also think that statistics like this and the one to do with the number of nurses leaving practice should be stratified or correlated with age. I think that current economic stresses means that many older nurses and physicians are working on later than they intended to. This became clear to when I worked with a 70+yr old nurse with kyphosis in an acute schizophrenic unit. It can be kind of an odd circular situation. i have a recent grad friend who has trouble finding work and being supported by a mother working in telemetry making the maximum pay rate (for experience). Her mother is at an age to consider retirement, but she is working on until her daughter is able to find her feet. At least part of the problem for new grads is that a good number of nurses that age are unable to or unwilling to retire...hence this circular situation. And this is something that affects a good number of professions.
Specializes in Peds/outpatient FP,derm,allergy/private duty.
I have read hundreds of posts here on Allnurses that say there is no nursing shortage. To everyone who says that... lets stop and thinks about this logically!
Fact: The economy is still stumbling along
Fact: A poor economy means ALL employers from manufacturing to healthcare are struggling to make ends meet and keep their business afloat.
Fact: Patient to nurse ratio is higher than it should safely be in more than 75% of healthcare settings.
Peter Buerhaus, the most-cited authority on the nursing labor market, and the one universally relied upon by the people most likely to insist there is still a shortage (ana and aacn) stated that the healthcare industry actually tends to gain jobs in a recession.
One of our members posted a thread about it, but here is the article she was referring to.
Registered Nurse Labor Supply and the Recession — Are We in a Bubble?
Another study from December 2011 by Buerhaus and David Auerbach in Health Affairs acknowledged that for the time being there is no nursing shortage nor will we be likely to see one until 2030 (although for slightly different reasons)
Though budget-related staff cuts may seem logical, there is a level which you cannot go below, especially in my state, where they've passed ratio laws.
Hospitals have been slowly eroding away traditional nursing tasks as well, making nursing jobs harder to predict than a "switch one out, switch one in" type of model. Those professionals who write on the subject do not dismiss the overwhelming anecdotal evidence as reflected on this board as a cypher. I've worked through many recessions. I've never seen anything like this.
I never tell anyone "do not become a nurse", though. There are so many individual characteristics that affect your chances it would be irresponsible to do that, my . Nobody wants to rain on another person's parade, but the stakes are high and the people who have the media's ear have proven themselves to be dishonest and self-serving. We don't want to see people hurt by that.
Speaking as someone who has NOT YET begun nursing school, I do believe there is a nursing shortage.
Some background: I live in a very large state that is very sporificely populated. The nearest "community college" (with a nursing program) is 25 miles away (about 45 minute drive one-way). The (Associates) Nursing program has a two year wait-list. The problem isn't necessarily too many applicants for A NURSING program, just too many for THAT college's program. They only allow 20 students per year. This is FAR too low for a community college system that has 5 locations statewide. Only two of the 5 locations have a nursing program. Imagine a state, lets say, the size of Texas, with only 40 positions open to nursing students! Crazy right?
Our state isn't immune to the less-than-perfect economy, and politics aside, WE are still hiring. The learning hospital in the town the comm college is located in had 15 pages of openings for RNs, LPNs, CNAs, Er techs, Unit Secs, etc. All positions (going back as far as January) are still unfilled. After speaking to a Paramedic who is a frequent customer of my present workplace, he suggested I get involved with the healthcare industry. After some research on the job market, I decided the best (and unfortunately most affordable to me) way to introduce myself to healthcare was to pursue CNA certification (Cost= $1100+, no financial aid available), and use my experience to decide if I'm capable of being successful in that environment.
I've found a position paying (CNAs) $15/hr wkdays and $17/hr wkends. This is in a city (where I live) that the average rate of pay is $7.75-$8/hour. The need is there, but I wonder if due to educational limitations, interested individuals aren't able to become nurses. Just my 2 cents.
The company that owns my place of employment and several hospitals in the area also have a bunch of jobs open online....except there was a hiring freeze because they closed 2 LTC facilities and 1 hospital. We are union so they had to find jobs for everyone. They are just beginning to hire CNAs and housekeepers, however there are no plans to hire (outside) nurses for the hospitals for 6 months because they expect people to try to shuffle around because of all the bumping that went on.
I worked for 9 years in healthcare; first as a CNA, then LPN before I graduated with RN. I could not find a job for 9 MONTHS. Now I *still* work in LTC. And I only got that job thanks to meeting the nurse recruiter years before (always be nice to people, you never know when it might come in handy!) and she gave me a chance. None of my other connections worked out. Hopefully I can bid for a hospital job soon.
I'm surprised I didn't see this point; maybe I missed it. Maybe the reason that so many people leave a job before 3 years is up is that they are doing what I plan on doing? Landing a job just to have a job and get experience and then bid another another job (what they really want or would look better on a resume?)
I beg to differ w/the article. There are numerous nurses out there, students AND experienced nurses, unable to find work due to institution policies and other red tape. There are enough of us out there that institutions can pick and choose with impunity. Better to choose a new grad than an experienced nurse whom they would have to compensate according to her merit.
Please get your facts straight. Instead of writing an article about the so-called shortage, how about an article or study dealing w/the realities of finding a job in this oversaturated nursing market and how institutions would do better to hire what is already out there than to create a bigger problem by whining about the supposed lack of "nurses in the market"?
I am blessed to have a job/career I love and cherish, but there are a lot of others out there who have never even been given a chance, some of them very well-motivated nurses :/
Seems to me employeers have gotten stingie. They are wanting experience and are unwilling to train a new grad. Maybe it is because the new nurses aren't staying with the co. long-term. If there truely were a nursing shortage why have the fellowships gone to the wayside. I graduated in Dec 2011 and only a couple of us have been able to get hired. The economy has caused a strain between employee and employeer. Lay off's and cutting benefits can really put a cut into someones company loyalty.
As a soon to be new graduate RN I would have to say that there is definitely a shortage...not necessarily in every hospital across the country but collectively there are more open positions then nurses to fill them. Again I can only speak from my experience, but when I began my job search, I resigned myself to the fact that I may have to make some big changes (move to an area in need) to find work. Luckily though, my ENTIRE nursing cohort (28 people) ALL have acquired an acute care position at our local hospital and we haven't even graduated yet. Sometimes it sounds like the problem is that coming right out of the gate people are very particular about where they want to work and specifically what they want to be doing. Fortunately for me I found a position on a Cardiac PCU which is what I wanted but I was willing to work my way up if that was required. I guess at the end of the day the experience of graduating and finding work is different for everyone. Not everyone is able to move to an area that is in need. I will say though, if you are, there is a map of Medically Underserverd Populations that may be very helpful in finding areas that are in a current shortage...If I can find a link I will post it.
This link will provide you with information about medically underserved populations. It is sometimes* easier to find jobs in these communities.
Thanks for the link. I live within distance of one area so I sent my resume that way. Just got an email about a residency coming up too. Fingers crossed. We just recently relocated because my husband landed his dream job so we will be tied here for awhile.
. Nobody wants to rain on another person's parade, but the stakes are high and the people who have the media's ear have proven themselves to be dishonest and self-serving. We don't want to see people hurt by that.
Chiggysmom
166 Posts
Yeh, I think they're always going to treat nurses like second class citizens. I don't know why they drill into you the whole time you're in nursing school about how you're going to be a professional because it's such a let down when you get out of school and get your first job and discover that you're treated like anything BUT a professional! That was and still is one of the biggest disappointments of my nursing career, how we are perceived and treated by everyone, not just the administration of the hospital. People treat us so lowly I'm almost embarrassed when someone asks me what I do, to tell them I'm a registered nurse and this is even though I have a BSN, I'm still embarrassed. We have been "put in our place" for so long that I just have this sense of lowliness, that I'm nothing. I can't wait to get out of this field altogether. I have aspirations to some day be an advocate for nurses (after I no longer am, so they can't try to destroy me like they do other nurses that would try to make a difference).