Why Is There A Shortage?

J. B. · Jan 14, 2004

I agree

mittels · Jan 14, 2004

From all the things I have heard regarding the nursing shortage, my assumption is this;

1- The baby boomers are nearing retirement and with that comes less nurses to care for the pt's which most are "the baby boomers."

2-Nurses are learving the health care to obtain other jobs because the cost of living, and not being able to earn enough money without doing massive overtime in nursing to support a family like it did in previous years.

3-Nurses do not feel respect, and many are just plain burned out.

Hellllllo Nurse, BSN, RN · Jan 15, 2004

Thanks for the link, hbscott!

This article makes the point that I have been trying to make on this board for over a year now!

And, like the article says, I do advise nursing students to run for their lives! Of course, it doesn't do any good. They tend to think that there's something wrong with me, not nursing and nurses' working conditions!

As for working for only $12. an hr- LVNs start at only $10.50 an hour where I work.

Listening to Nurses:

Dissatisfaction and Burnout on the Job

"We tell the student nurses to run for their lives."

Nurses may constitute the most dissatisfied professions in the United States today. According to the Department of Health and Human Services, slightly more than two-thirds of registered nurses (69.5 percent) reported being even "moderately satisfied" with their jobs.76 By contrast, 85 percent of workers in other industries and 90 percent of professional workers are satisfied with their jobs.77

A 1999 survey done by the Nursing Executive Center reported similarly troubling findings: 28 percent of RNs said they were either "somewhat" or "very dissatisfied" with their jobs; 51 percent were somewhat satisfied and only 21 percent were very satisfied. Reporting on recent changes in the industry, a whopping 51 percent of all RNs stated that they were less satisfied with their jobs than they had been just two years earlier.78

Staff nurses have lower satisfaction (66 percent) than any other type of nurse. When analyzed by place of work, hospital nurses have the second lowest satisfaction (67 percent), just ahead of nursing homes (65 percent). All other types of nurses have somewhat higher levels of satisfaction, with the highest being nursing education (83 percent). But even this highest category remains lower than the average for professionals in other occupations.79

Nurses' dissatisfaction with their jobs is surprisingly universal. Personal factors such as age, years of experience, or education have relatively little impact on job satisfaction.80 The problem is not in the person, it's in the job. The Nursing Executive Center reports, for instance, that high levels of dissatisfaction are consistent across all pay levels: 29.5 percent of RNs making less than $15 per hour are dissatisfied, but so are 30.1 percent of those making $21-$23 per hour and 24.6 percent of those making $23-25 per hour, the top ranking.81 Similarly, while there is some variation among age groups, nurses in every age group exhibit high levels of dissatisfaction with their jobs.

Percent of RNs Dissatisfied With Their Jobs82

Age Percent

25-34 21.3

35-44 28.4

45-54 33.6

55-64 30.5

65+ 25.0

Average 27.8

Source: Nursing Executive Center. Reversing the Flight of Talent: Nursing Retention in an

Era of Gathering Shortage. 2000.

Finally, while dissatisfaction varies among different units of a hospital, the two largest groups of RNs-in ICU and medical/surgical units-report the highest rates of dissatisfaction, at 29.2 percent and 31.9 percent respectively.83

Multiple studies have confirmed that job satisfaction is directly linked to retention and turnover rates.84 Dissatisfaction is expressed most clearly in the number of nurses who consider leaving the profession. While 19 percent of RNs have actually changed hospitals in the past two years, 64 percent report that they have "considered leaving the hospital in the last two years." Furthermore, when asked how long they expect to stay at their current job, more than 40 percent expected to remain just three years or less.85

The conditions on the job for hospital nurses have negatively affected the public's view of nursing as a profession, which, in turn, makes it more difficult for nursing schools to recruit students. In 2001, nursing fell to a position of 137th out of 250 potentially desirable occupations.86 One of the most disturbing facts regarding nurse working conditions is the number of nurses who state that they would not recommend a career in nursing to others or that they would not choose such a career if they were just starting out. In New York State, a 1999 survey found that only 28 percent of current RNs would choose a career in nursing if they were starting their work lives today. Many of those disillusioned with nursing remain interested in health care as a profession. Thirteen percent of nurses stated that they would choose another clinical health care profession rather than nursing, and 31 percent stated they would choose a career in non-clinical health care; thus, it appears that the problem is not that nurses do not care for the work of health care, but rather that the conditions on the job have become untenable.87 Similar findings emerged from a survey conducted for the American Federation of Teachers' Federation of Nurse and Health Care Professionals, which found that 49 percent of nurses report that if they were younger and just beginning their careers, they would not go into nursing again. Only 44 percent said they would become a nurse again. Across both groups, 50 percent of working nurses stated that they have considered leaving the field for reasons other than retirement.88 When the ANA conducted a nationwide on-line survey, 55 percent of respondents reported that they would not recommend a nursing career to their friend or child.89

Staff Reporting Job Satisfaction

Position/Duty

Nurse practitioner/midwife 84%

Certified nurse anesthetist 83%

Instruction 79%

Researcher 79%

Consultant 78%

Administration 76%

Nurse clinician 72%

Other 72%

Private duty nurse 72%

Head nurse 70%

Clinical nurse specialist 70%

Staff nurse 66%

Respondents reporting they are "extremely satisfied"

or "moderately satisfied" with their jobs.

Source: The Registered Nurse Population, March 2000, Table 29, p. 67.

While nurses face worsening conditions in many countries, American hospitals seem to be particularly hard-hit. In her five-country study of nursing, renowned scholar Linda Aiken reported that 41 percent of U.S. nurses were dissatisfied with their jobs, and that nearly one in four plan to leave their jobs within a year.90 The rate of dissatisfaction in the United States was the highest of all five countries studied, and American nurses were found to be three to four times more likely to be dissatisfied with their jobs than the average U.S. worker.91 This study used a standardized measure of burnout, and found that 43.2 percent of nurses scored in the "high burnout range according to norms."92

One of the most telling findings of the study is that 33 percent of nurses under the age of 30 were planning to leave their job within the year.93 The fact that even young nurses are already dissatisfied and thinking about leaving nursing points to the futility of focusing on the pipeline of nursing students as a strategy for solving the nursing shortage. The American Hospital Association similarly measured employee satisfaction according to a concept developed by Aon Consulting, which sets out a hierarchy of employee needs and then measures the extent to which employers have met each category of need.94 The American Hospital Association concluded that "hospitals fail to meet the expectations of their employees far more frequently than employers in other industries do." And indeed, the data show that health care employers are worse off than the national norm in every category.

The multiple frustrations facing nurses are reflected in survey after survey. One recent study, for example, asked nurses to describe how they felt at the end of a day's work. Nearly 50 percent reported that they typically felt "exhausted and discouraged"; 40 percent felt "powerless to affect change necessary for safe, quality patient care"; 26 percent felt "frightened for [their] patients"; and 24 percent felt frightened for themselves.95

Employees Whose Expectations Are Not

Being Met, Based on Aon Performance Pyramid

Health Care

Employees Employees

In General

Rewards 56% 28%

Affiliation 52% 30%

Growth 45% 23%

Safety/security 43% 24%

Work-life harmony 30% 21%

Source: In Our Hands, p. 28; Aon Loyalty Institute.

While nurse dissatisfaction is endemic, survey after survey reports that nurses would like to continue working as nurses if job conditions were improved. The American Organization of Nurse Executives, for instance, reported that four of 10 working RNs (43 percent) say that they plan to leave their current positions within the next three years. However, the authors go on to observe that many RNs who plan to leave their present jobs in the next few years say they would consider staying-and many others who have left nursing altogether say they would consider returning-if certain conditions were met. Among these conditions are better compensation, an improved work environment, better hours and more respect from management. Nurses with no plans to leave echo many of these same sentiments.96

Hellllllo Nurse, BSN, RN · Jan 15, 2004

Originally posted by Owney
Do you really think your own nursing education prepared for how much your job sucks?

:roll

Great post, Owney. Especially the above line!

Sheri257 · Jan 15, 2004

Originally posted by Hellllllo Nurse
Thanks for the link, hbscott!

This article makes the point that I have been trying to make on this board for over a year now!

And, like the article says, I do advise nursing students to run for their lives! Of course, it doesn't do any good. They tend to think that there's something wrong with me, not nursing and nurses' working conditions!

If you guys hate your jobs so much, why don't you get out of nursing like all of these other people supposedly have and do something else?

You keep telling us about all these stats about nurses getting out. Why don't you join them? If they can do it, why can't you?

Ah ... I bet you'll say you can't do it because of this or that. And, quite frankly, with the lousy job market, I wouldn't blame you.

But don't blame me either.

It's easy to complain and tell us to get out. But to date NOBODY has pointed out any better alternatives, and this is the third thread where I have asked this question.

A lousy job with decent pay and benefits is still better than NO job or, a job that pays virtually nothing with no benefits.

We all gotta eat, ya' know?

kellilou3 · Jan 15, 2004

I agree with Lizz. I haven't even started school yet but have already dedicated myself to this plan of becoming a nurse. I guess I'm the type that cannot take someone's word for it, especially when it concerns my future and a major life decision. Regardless of what everyone says, I am still going to give it a shot and do the best that I can, rather than backing down and slinking away from what could be a great profession for me. Not every person and every situation is alike, so what may suck in your particular area or circumstance may work out for me in mine. :)

hbscott · Jan 15, 2004

Originally posted by lizz
It's easy to complain and tell us to get out. But to date NOBODY has pointed out any better alternatives, and this is the third thread where I have asked this question.

A lousy job with decent pay and benefits is still better than NO job or, a job that pays virtually nothing with no benefits.

We all gotta eat, ya' know?

I believe that I have made it clear that I left nursing for a job that offered better pay, better working conditions, more autonomy, greater satisfaction, and personally more fulfilling.

I have also made it clear that Advance Practice Nurses enjoy greater job satisfaction, pay, benefits and autonomy as evidenced by multiple surveys as noted here and other BB's.

I am one person who successfully walked away from nursing because I had the education, experience, aptitude and opportunity to do so. However that was not easy to do as "education and experience" as a rule doesn't come cheap.

Many come to this and other BB's to "vent" and that is important. Many people on these BB's sing the praises of nursing and many people on these BB's curse what some nursing settings have become.

I left nursing but I still have a connection to nursing that brings me back from time to time to check on current events. My PhD work is about as far and away from nursing you can possibly get but at the same time my nursing education and experience has helped me (for better or worse) become the person I am today.

-HBS

Owney · Jan 15, 2004

Originally posted by lizz
If you guys hate your jobs so much, why don't you get out of nursing like all of these other people supposedly have and do something else?

I have been an RN for over 20 years. I was 34 years old when I got my license. The longer I remain in the profession, the more I believe that the best nurses are born, not made. The fact that so many of us sit at our keyboard to discuss how terribly we are treated shows me that we LOVE nursing. Why should anyone want to leave a profession that we love?

"You keep telling us about all these stats about nurses getting out. Why don't you join them? If they can do it, why can't you?"

If you read those stats you will find a large number of nurses who do leave the beside, but not health care. Castle Ken has made many postings with good suggestions of how to do this. Read his posts.

"It's easy to complain and tell us to get out. But to date NOBODY has pointed out any better alternatives, and this is the third thread where I have asked this question."

I see that you are in California. I am happy for you. Were you a part of the CNAs efforts at improving working conditions for bedside nurses? I have followed their efforts. The first thing they did was to secede from the ANA, which is in bed with health care big business (hospitals, drug companies, insurance, and government) at every level. CNA officials, unlike the ANA, are at least part-time, bedside nurses. Their first efforts were NOT directed at getting more money, but at improving working conditions for bedside nurses. Their latest effort is to enact patient-ratio legislation for ALL hospitals in California, whether or not they were contracted with CNA.

You say that you have asked in three threads and that "...NOBODY has pointed out any better alternatives..."
Have you read the thread, "Retaining Workers Key To Solving Nursing Shortage"? This thread points out that there has been no input from bedside nurses. Nursing salaries are 50% of every hospital bill. If nurses do not take the initiative to improve our profession (the key to solving the health care crisis), NO ONE ELSE WILL.

"A lousy job with decent pay and benefits is still better than NO job or, a job that pays virtually nothing with no benefits."

Why should anyone have to work at a lousy job, rather than to improve their a profession that they love?

:kiss

athomas91 · Jan 15, 2004

i don't think that complaining about pay/benefits means that "noone likes their job"

i live in an area where i have the benefit of picking the highest rate place to work for - as nurses - sometimes we need to leave what is "convenient" to make a point...ie: drive a little futher for a few more bucks....eventually all the hospitals must compete financially w/ one another to gain/retain nurses.....i have always made GREAT money - more than some doc's that i have worked with - but i was also willing to change hospitals in order to stay at the highest rates....

IF we want nursing to be a profession - which it is and should be - then we need to act like professionals anc take control of what is ours...the resources are there!

teeituptom, BSN, RN · Jan 15, 2004

Nursing is great

I love my work

AND THERE ARE PLENTY OF NURSES HERE

Gaye · Jan 15, 2004

I'm not sure that I am in th right section but please help me. Can anyone tell me how to get into 13 week travel assignments if I am a LPN-LVN with 5 years of Medicare Skill Care nursing experience.

Sheri257 · Jan 15, 2004

I really was referring to the other posters. It is true that hbscott did point out an alternative, but he was the only one. Perhaps I should have been more specific and said "Except for hbscott, no one has pointed out alternatives," that is, if we want to nit pick here.

As far as Owney's comment: Now you're saying we should improve the nursing profession?

Ok, one minute you guys are telling us the situation is completely hopeless, the job sucks, and we need to run for the hills and get out all together.

But now you're telling us we need to improve the system through organizations like CNA, which is fine, but that also means staying in the profession.

Which one is it? Stay and work to improve the system, or get out. We can't do both.

You guys want us to take you seriously, but your collective advice is inconsistant. As students, all this does is make our heads spin, and that's not helpful.