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The Nursing Shortage: A self-inflicted wound?

Nurses Article   (25,369 Views 80 Replies 492 Words)
by dzadzey dzadzey, MSN, RN (Member) Member Nurse

dzadzey has 19 years experience as a MSN, RN and specializes in Dialysis, Hospice, Critical care.

2 Articles; 5,236 Profile Views; 75 Posts

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"

The Nursing Shortage: A self-inflicted wound?

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 to patient 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.

dzadzey has 17 years of experience and works as a CCU RN.

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Nurse SMS has 8 years experience as a MSN, RN and specializes in Critical Care; Cardiac; Professional Development.

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While I agree that for some working conditions are poor, from where I sit there is no shortage.

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caroladybelle is a BSN, RN and specializes in Oncology/Haemetology/HIV.

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There is no nursing shortage!!!!!

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BostonTerrierLover has 16 years experience as a BSN, RN and specializes in Adult/Ped Emergency and Trauma.

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With all due respect to the OP, I just get a negative feeling in my stomach when I hear about the Shortage with all the new grads that can't even find an acute care job.

I do believe there really is a shortage. It is kinda like when gas prices are up, you drive the minimum you have to.

I think they are spreading the workload over fewer nurses, not hiring for posted vacant positions, and as time goes by, I do believe the ones that returned b/c of the economy(like the wife that wouldn't be working if her husband didn't get laid off) leave the practice, and ones that were in retirement leave practice, we will see the sign-on bonuses, and recruiters more and more active again.

I know no one answer nails it, and even my answer is really simplistic, but I DO BELIEVE THE ECONOMY IS 80% OF THE NEW GRADs TROUBLEs.

As far as the work environments, I think each one has its challenges. I don't really forsee them being better even when the economy gets better. Insurances have made sure that only higher and higher acuity patients make the admission, and I JUST BELIEVE IT IS A SPECTRUM of issues that have to be addressed.

To the wonderful marketing people at Baby Powder Co. and their commercials, IT SHOULDN'T BE "BECOME A NURSE."

. . .IT SHOULD BE "MAKE SURE YOU KEEP YOUR NURSES IN NURSING"

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joanna73 is a BSN, RN and specializes in geriatrics.

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You're right. Technically, there IS a shortage, but since the economy has tanked, employers aren't filling positions. I don't see it improving anytime soon. In fact, someone recently posted in another thread that a hospital in Miami plans to lay off 400 nurses.

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Good Morning, Gil has 3 years experience and specializes in Rehab, critical care.

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Umm...I fled toward acute care. I left a position after one year and changed jobs, not b/c I hated nursing or was stressed, but because I wanted something more challenging and to learn more. I wanted more stress, I guess, in other words lol. Nursing is a stressful job, but I don't feel stressed at work or when I come home. I was the first month or two after orientation, but once you're confident in yourself and your abilities, that changes, and work becomes enjoyable.

I love the ICU, my nursing niche :), and I love my co-workers. However, I also really liked my co-workers at my other job, so the statistics might show that I am a stressed new grad (since I changed jobs after 1 year) according to that quote, but that's entirely the opposite....I wanted more of a challenge.

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classicdame is a MSN, EdD and specializes in Hospital Education Coordinator.

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I agree with the article, those things do exist but not in all depts or all facilities at the same time. I also believe the shortage exists, but only in certain parts of the country. As for self-inflicted, I am not sure it is the nurses who create the stress and fatique. If you have a plan, let's hear it. I am all for improving the profession.

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Esme12 is a ASN, BSN, RN and specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.

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There is a hospital in Taunton Ma ready to close.....approx 220 beds.

Nurses Are Talking About: Jobs for New Grads

 

The Big Lie?Without a doubt, the main source of frustration experienced by recently graduated and licensed but still unemployed nurses is what could be called "the big lie."In other words, the television commercials that encourage young people to become nurses -- and then abandon them for months (or years) without employment; and the educators who tell them that the associate's degree is perfectly adequate to guarantee employment, that they will have their pick of jobs when they graduate, and that there is plenty of time to get a BSN later on. Who knows whether it is greed, ignorance, or wishful thinking that underlies the fairy tales told to nursing students about their future job prospects? Whatever the motivation, the disillusionment of our new grads is palpable. The jobs they expected after all of their hard work just haven't materialized, and some grads are getting pretty desperate

Medscape: Medscape Access requires registration but it is free and great resource

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nurse2033 is a MSN, RN and specializes in ER, ICU.

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I'm still looking for the article, but I think the problem of new grads quitting is is largely related to lack of effective orientation programs. I've been through one crappy orientation after another. Without an organized program, many nurses fail. Perhaps not right away- but without a good foundation some new nurses do not feel capable in all areas of their job, never gain confidence, and get overwhelmed. This sets the stage for them to never feel like "part of the team" and as soon as another problem, say with personalities, shows up they move on.

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15 Posts; 1,186 Profile Views

I can't comment on the nursing shortage except thanks to these boards and other personal issues I have decided to discontinue the pre-req path and continue practicing law instead of going down a thankless path. Beating your wall against the walls hurts. So one less BSN out there. Maybe I will just try to be a better lawyer and help people that way.

However -- I will comment that the above is a very well-written article and so true as far as the family dynamics and poor physician advice that keep individuals on life support to no avail. I am sure you are aware of the studies re how much of our health care money is spent on the last few months of life.

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diva rn has 18 years experience as a BSN, RN and specializes in PICU, ICU, Hospice, Mgmt, DON.

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Two words that are like fingernails on a blackboard to me are "Nursing Shortage".....where I am in Southeast Florida there really IS no shortage and has not been for some time.

Same reasons....too many schools now, hospitals cutting staff....yada, yada, yada.....I personally know several experienced ICU nurses who have not gotten jobs in almost one year....and a new grad that is still looking for almost 2.

There are some jobs in LTC because of our abundant elderly population.....but I am really tired of hearing "that " phrase....

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I agree with a lot of the article except for the statement that there is a nursing shortage and that there is a lack of new grad nurses willing to pick up the slack of those nurses fleeing the work place. I also disagree with the idea that this is a "self-inflicted" wound.

There is no nursing shortage and it needs to be repeated and repeated until the media gets it right, otherwise we will continue to have these completely futile discussions about how to create better conditions in nursing, and we will continue to focus on nurses themselves as the guilty party in creating those poor conditions to begin with.

Nurses have no control over the way the medical industry works. There are a lot of powerful people and corporations, big Pharma, for-profit organizations, the insurance industry, the media, lobbyists, and politicians who work together to create the current system. Nurses are just cogs in the wheel.

And I hate it when I have to read yet another article about how we have done this to ourselves because....well, I'm not sure what the because is.

Because apparently it's not enough that we have gotten through one more day of 10/10 stress, taken ourselves home, cried, tried to find some quality time with our families, paid our bills with a diminishing income, struggled to hold onto our homes and our pensions, struggled to find some joy in life, to take care of our kids, to continue our education so we can be better nurses, looked for some outlet for spiritual support, tried to eat or exercise, deal with our own health issues, and slept.

And then after trying to do all of that we haven't picked ourselves up and taken to the board rooms and the streets to go head to head with the power structure to change the medical industry, because somehow, the onus for change lies squarely on our shoulders and no body else's.

I'm just tired of the structure of this dialogue. To accomplish change, we need to first address the flawed foundations of the debate. Meaning that there is NO nursing shortage and there is NO shortage of new grads and the health care industry has no real impetus to change the way they treat nurses.

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