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ADVANCE Perspective: Nurses

Nursing Shortage Is Over? Really?

Published December 5, 2011 6:11 PM by Rich Krisher

To those affected by the most recent RN shortage that began in the late 1990s, research by workforce expert Peter I. Buerhaus, PhD, RN, FAAN, and colleagues published in the December issue of Health Affairs is earth-shattering. Thanks to younger nurses entering the profession at a rate not seen since the 1970s, they say rather than declining as has long been predicted, the RN workforce is expected to maintain pace with population growth through 2030. See the full story here.

It had been widely accepted a nursing shortage with vacancies in the hundreds of thousands nationwide was only a decade or two away. Now Vanderbilt University's Buerhaus, lead author David Auerbach of RAND Health and co-author Douglas Staiger of Dartmouth College have upended that assumption.

"Using estimates that were available [10 years ago] of the future need for registered nurses, shortfalls of 20 percent, or approximately 400,000 RNs, were expected by 2020. These shortfalls grew even larger when those requirements were subsequently updated," they write.

The new projection sees a dramatic change: "...The baseline projection suggests that supply per capita will remain fairly stable through 2030, at just more than 800 full-time-equivalent registered nurses per 100,000 residents. The absolute size of the RN workforce (not per capita) is projected to grow by approximately 24 percent between 2009 and 2030, which is roughly the rate of projected population growth over this period. In this projection, the large retiring cohorts of baby-boomer registered nurses are being replaced by entering cohorts that will eventually be even larger, leading to a steady increase in the size of the workforce."

Projections of the coming mega-shortage always seemed overblown. Although the free market has recently taken a beating in public perception, here's evidence it still has a way of effectively allocating labor. Efforts in the public and private sectors to promote the image of nursing - led in many communities by nurses themselves - have been remarkably successful, and all involved should be congratulated.

However, we're still waiting for research examining the circumstances of those who have earned nursing degrees in the past few years. The data period in the Health Affairs report ends in 2009, which is about when overwhelming anecdotal evidence suggests new grads started experiencing difficulty landing jobs. We typically receive a number online and offline comments reaffirming when we cover the subject. Here's a recent example.

Graduates of elite schools may still find doors open to them, but too many others are frustrated in their efforts. A colleague who attended a meeting of healthcare recruiters in New York last month reported one of the major topics discussed was what to do with all the new nursing grads. Recent graduates in California having trouble getting hired were the subject of a newspaper story this week.

The nursing workforce is still in crisis. Only the focus has shifted, from employers seeking nurses to new nurses who need opportunities. If their needs remain unaddressed, these rosy projections will not be realized.

Is the nursing shortage a thing of the past in your world?


Does your brother have power of aotnrtey to make decisions for your mom? If not, it's not up to him to decide where she lives. They won't admit anyone against their will unless the person isn't able to make sound decisions due to illness, Alzheimer's etc. then they need a copy of the legal POA paperwork. The doctor can give his opinion, but legally has no say as to where she should live. A community worker usually comes   interviews the person   the family members to determine what level of care is needed. Visiting nurses, retirement home, nursing home etc. In my area it's called community care access center (CCAC) but may be different depending where you live. Call them   tell them what you told us here.

Roberto Roberto, hlOHhkuceLjf - Roberto, KLwWxtAhwYAyyFLtU March 22, 2012 3:08 AM

I'm going to agree with everyone above. Is irnsung still in demand? Not the same way it was in demand 7-8 years ago. When I first started irnsung, you could pretty much walk into any place and expect to get some kind of job.Now it is a lot more competitive. Older nurses had their 401Ks drained when the stock market crashed and can't afford to retire. Younger nurses are flooding into the field because they hear it is a good career choice. Laid-off workers are also looking to irnsung after being laid off.  Hospitals are having to make cut-backs right and left and they can't afford to lay off physicians, but the irnsung staff is expendable.So you kind-of have a perfect storm.But here is what I think  The economy is going to pick up again in a few years or so. Then stocks will go up again, the older nurses will be able to retire and some of the nurses supporting their families for their laid-off spouse will be able to go back home again   this will create some movement in the field.So while I can't say that I know of any particular state that has massive openings for RNs, I can say that if your heart is into it, there is a way to make a career out of irnsung. You just will have to really work hard at it the first few years.

Ronald Ronald, KwWYqIxFdYJFYJ - PnGnjuVphtSbi, pSnzPlAnPYHni March 20, 2012 1:24 AM
OGjqnpjrkFSMLlTuF DC

Statements of a nursing shortage is overblown.  This is reflected by the inability of new as well as experienced nurses to find work.  The economy is lousy for any type of employment, but nursing is still considered to be a lucrative opportunity where there will always be jobs.  I am afraid many individuals go into nursing for just this reason, and this is certainly a disservice to any patient especially the way healthcare is changing.

Carla , RN December 14, 2011 1:27 PM
Monson MA

Shortage Over? Really?

In response to Richard Krisher’s  editorial in the December 5, 2011 issue of Advance: we may not be in crisis at the moment but as we have seen from past experiences a new one looms  and it will be as large as the one of the late 1990s. I, too, have read Dr. Buerhaus’s articles on the nursing shortage with great interest. While I do not hold myself out to be a statistical expert as a practitioner of over thirty years the pattern we are experiencing today is really no different from the past. We are good at identifying problems and situations that need adjustment. Where we are weak is in the implementation of effective and sustainable solutions. We discuss the nursing shortage as if there were easy remedies. Were that true we would not be in the situation we face today. As someone once said; if we do not learn from the past then we are destined to repeat it. In the late 1970s we faced this shortage crisis. There were new graduate nurses who had difficulty finding employment. I was one of them; a new baccalaureate graduate. I was fortunate. I did receive several offers, finally.

We must not look only for solutions but the root cause of these epic shortages. The economy is at an all-time low for generation baby-boomers. Traditionally this segment of the population would be considering retirement at this time in their lives. Not the case today. Spouses have been laid off and offspring are graduating from colleges and universities without the prospect of employment. This has put a financial burden on families and keeps those employed in the workplace. Therein lays one problem.

We are not well advised in succession planning. Historically nurses moved up the career ladder by being a respected practitioner.  While these skills are necessary clinically other skills are required for administrative and management positions. Again, nurses do not recognize that additional education is necessary to be an effective leader. Even if we are endowed to be “good with people” this is no guarantee that it will translate into effective leadership.

This takes us to another divisive situation: the adversarial dilemma of diploma vs. baccalaureate for entry into practice. To put it bluntly if we desire recognition as a profession, if we want to be taken seriously by our colleagues in healthcare, and if we want a “seat at the table” then the baccalaureate is required. Other professions do not put a dollar sign or a time limit in front of achievement, education, value, or standards. Countless organizations including the Robert Wood Johnson Foundation, the Institute of Medicine, the American Nursing Association, Joint Commission, and others have called for higher standards in patient care and outcomes. Nurses have to be well prepared for the future. Acuity will be greater, care will be provided in other locations other than hospitals, and the population will evidence a more matured persona. Nursing will need critical thinkers to address health care in the future. Status quo will not take us forward.

I have presented only a few concerns underlying the perpetual shortage of nurses. The apparent “abundance” of nurses today is due in part to the general population unemployment catastrophe (leading to an increased enrollment in schools of nursing for a “job”). Let’s not forget the nursing faculty shortage, or  the need for a hostility free healthy work environment, or the political and economic considerations affecting healthcare delivery. Sooner than later those unemployed nurses will be in the workforce. How many of them will become the disenfranchised and leave nursing in the future? What about attrition as a result of the aging population in nursing?

Is this not the cycle of nursing shortages?

Sharon , Organization & Leadership - Student, TC Columbia University December 12, 2011 4:12 PM

Same as before, nursing shortage over?? My neighbor who is a per diem nurse has to work overtime very often, yet, as I re-entered the profession and have some skills cannot get hired and TRAINED in any basic department...The shortage seems to flows from the top administrators who cut budget in hiring nurses and work those they have to the ground. We are disposables, and there a ton of new grads being fooled by promises of shortages. It makes the nursing schools run well, but somebody need to be truthful here...I do not know where to turn anymore, and I'm very wary about going for further education without the HOSPITAL EXPERIENCE needed to be hired anyway.And again, I do have a BSN and some experience...

Guylaine December 9, 2011 10:59 AM

I am a new grad and I have to say, it has been so depressing trying to find a job.  Nursing school was incredibly stressful, but we all worked hard because we knew there was a light at the end of the tunnel.  But that was not the wasn't even a tiny beam of light at the end of the tunnel.  If an experienced nurse of 10 years is having a hard time finding a job, then we haven't a chance!  The article is right...recruiters and picking only the best of the best...and graduates from elite schools do have the advantage.

Colleen, New Nurse Grad December 9, 2011 9:47 AM
Rockville MD

The truth is, the hospitals have eliminated the unfilled positions and have been operating short staffed.   The new staffing grids show all positions filled, but the reality is far from adequate. And so we have the agency and per diem slots for new grads. So new grads will be waiting until the boomers can afford to retire.  At the same time executives are being compensated with large bonuses as layoffs and elimination of services to patients have saved the institutions money.  %0d%0a

Patricia , , RN CCRN Hospital December 8, 2011 6:59 AM

I read an article a couple of decades ago that suggested there was no Nursing shortage, only a shortage of positions that compensated nurses proportionately for the physical, mental, and emotional demands of the job, not to mention the constant threat of lawsuits.  And personally, I've always said I'd rather be one of six nurses making $40K than one of four nurses making $60K.

Margaret Shieber, Independent Contractor - RN, BSN December 7, 2011 8:10 PM
Storrs CT

Here in central New England, nursing jobs, esp. those in acute care or similar, are quite few and far between. The ripple effect of the economic meltdown is indeed affecting our profession and not in any positive manner. Recruiters and HR personnel are saying that for the foreseeable future, the present situation shows little, or no signs of improving. The only "nursing shortage" that exists, at least in this region, is for nursing jobs.

Mark, RN December 7, 2011 10:49 AM

Well, it's about time someone recognized what we've known for years:  The nursing shortage is a MYTH!  And not just for new grads.  I'm a nurse with over 10 years of experience and I've been looking for over a year.  I'm the meantime I've been getting by with per diem assignments and volunteer work.  Anyone who still believes in the "nursing shortage" also believes in the existence of unicorns.

Diana December 7, 2011 8:54 AM

currently, the problem seems to be that nursing professors are paid poorly, so not enough good people are getting the advanced degrees necessary to teach.  Personally I never felt the compensation was worth going back to school.  My BS in Biology Education has served me well in my job over my nearly 30 years as a Charge nurse & mentor in hospital nursing & I fleshed out my tool belt doing Hospice work, got a massage license & got certified in med surg, + did lots of training in Holistic therapies & energy work.  Here where I live we have Boomers getting ready to retire & no plan.

Barbara Cooper, Med Surg - RN, C, hospital December 5, 2011 7:38 PM
Tallahassee FL

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