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ADVANCE Perspective: Nurses

Two Views of the Nursing Shortage

Published January 28, 2013 9:02 AM by Linda Jones
David Williams writes a healthcare blog and has tackled the "nursing shortage" on more than one occasion. In a recent post he once again questioned the reality of a pending shortage. He questions the logic of the numbers being used to make predictions. Part of his argument is that those predicting a long-term shortage are not taking into account for how technology will impact the way nurses work. He predicts more tasks will become automated, using industries such as the airlines and accounting as examples.

In a recent survey by Jackson Healthcare on nursing attitudes and outlook, 72% of nurses surveyed said their "duties required" have increased, and 51% report an increased patient load. Perhaps these nurses would look forward to the automation Williams is predicting.

I'd like to bring in other numbers to challenge the predictions that can take the shortage in the other direction. The American Society of Registered Nurses found around 43% of newly licensed RNs in California can't find jobs within 18 months of graduation; and the annual study by the National Student Nurses' Association found that of those graduating from a traditional BSN program in Spring 2012, 28% were not employed as nurses 4 months later.

If you can get a recruiter to talk about it, you'll find that most say once a grad is out of school for a year, they are no longer considered a "new grad" - whether or not they have clinical experience. So if they don't have clinical experience, how will they get hired? Ask any grads who can't find work and you'll hear this: "I can't get hired because I don't have experience and I can't get experience because no one will hire me."

When the number crunchers look at the availability of licensed nurses, they count the 43% of people who are essentially unmarketable because they've been out of school for 6 months or more and  have no clinical experience. If this is the case, one could say the shortage will be even worse than predicted, even if robots are doing part of the work.

To avoid a worse shortage than is already predicted, which will result in hospitals incurring additional costs for hiring, training and employing, the industry must find a way to get current eligible nurses the experience they need so they can be hired when positions are available. It's called investing in the future.

Hospitals, communities, government, schools and industry stakeholders should come together to find ways to keep these educated and licensed nurses in the workforce, prepared to care for our aging population. Instead of recruiting more and more people to go to school to become nurses, let's make sure the ones we have are rewarded with the experience they need.

posted by Linda Jones

9 comments

What I see is a total lack of money or concern for care in todays health care.  Employers look for those who have the experience to lie about care to save money(taking care of 40 patients at a long term care facility; most being acute).  New graduate nurses are to honest to be part of this "cat-fight".  If you are a good looking nurse you will be welcomed as a target for the systems sex club.  Such a shame and a complete shame for the American people.

Rick, new grad RN February 19, 2013 8:12 PM
Hartford CT

With the advent of Magnet certification which seems to be achieved by every hospital at this point, administrators are seeking the BSN RN to meet the suggested standards.  The ASN nurses often have more practical experience than the BSN and can enter the work force in a minimum of 2 yrs of schooling.  Unfortunately with the focus on BSN, the end degree is the deciding factor, not the drive, initiative or capability of the nurse.  Mix in the continued training of LPN's in a field that is again at this time "phasing them out of acute care", the shortage may not be in numbers but in the caliber of the nurse being sought (ones that will tolerate the increased work load and stagnant pay scales).  Long term care is increasing by leaps and bounds but very few of the nursing students encountered today will even consider this environment? So are the unemployed at this stage due to preferences?

Sandy, Nursing - Faculty, Ivy Tech Community COllege February 12, 2013 1:24 PM
Columbus IN

I think I have found my sisters and brothers.   NURSES  UNITE.

Cathy Burrell February 12, 2013 7:07 AM

It is very frustrating for me that I cannot get a job in a hospital or a full time and stable job just because I don't have experience. I just achieved the BSN degree and working on my master, I am bilingual and a hard working nurse. So why is not possible find a job if is a shortgate??? At this point my future in nursing seems uncertain.

Marianela Barnett, Oncology - RN February 10, 2013 2:27 PM
Tremont MS

I started nursing school in 1997 and completed a PhD in 2004. From the very start I saw that the dominant trend was increasing patient to nurse ratios, wasteful documentation, inadequate use of technology and a primary focus on cost-cutting to manage the insurance risks assumed by health care providers including hospitals, physicians, nurses, nursing homes and home health agencies.

The "nursing shortage" has always been a fabrication. Hospital chains like to promote the idea of a nursing shortage because they can justify importing foreign trained nurses, rationalize the use of ill-prepared nurses and CNAs, and increase the number of nursing schools and throughput.

Some estimates are that more than 60% of nurse's time is spent doing documentation. I have often suggested that if accountants and bookkeepers signed their names, or initialed every column of numbers they added, they would be as inefficient as nurses. Yet nurses who do their jobs cannot simply say - I came to work and I did my job. Nurses who do not do their jobs aren't eliminated because of documentation - they do the documentation but do not provide patient care.

If we achieved 90% reductions in the time nurses spend doing wasteful and inefficient documentation,  searching for resources that are in short supply and swapping patients in and out during single shifts we could double the number of hours nurses could provide patient care.

Shortage? Not even remotely and the glut of nurses is only going to get worse for the next 1-2 decades because once they start, nursing programs tend not to shut down simply because too many nurses are flooding into the market.

Thomas Cox February 10, 2013 12:21 PM
gainesville FL

I have been a nurse since 1997 and have seen the nursing shortage come and go.  Most Hospitals today are once again doing away with LPN's in the hospital setting.  This again is sad news.  I have worked with many LPN's who have not had the opportunity to go back to school to obtain their RN degree.  I think that if the nursing profession would recognize their contributions more and allow them to sit for the NCLEX-RN after 10 years exp. and should they pass, allow them to work as RN's, then I think the nursing shortage would no longer be a problem.  We need to wake up and realize they are a valuable piece of the medical puzzle and many times have had more practical experience than those coming out of school with a RN-BSN or RN-MSN.  I am not knocking education, but many times the practical experiences outweigh book knowlege.  

David February 10, 2013 7:39 AM
FL

How can there be a nursing shortage when well educated, experienced nurses with advanced certification, such as myself, cannot even find volunteer work in nursing? If the market permits age and gender discrimination, that indicates a glut from which employers can cherry pick to reflect there own preferences and biases.

Kenneth Nechitilo January 29, 2013 12:18 PM
Woodbridge VA

Although I am currently not working, I have been employed as an RN since 1975, and keep my licensure current.  It is a shame that there are no longer Hospital schools of nursing.  That is where student nurses literally staffed the hospitals while they were receiving their educations, and upon graduation were experienced enough to  be hired right away.  It was hard work, but provided  the best clinical experience compared to todays' limited clinical hours in BSN programs.

Melody, RN, BSN January 29, 2013 11:41 AM

Thanks for referencing my post. If demand were stronger hospitals would take the trouble to train in new nurses to help them become experienced. I do think robots will be an aid to nurses and won't replace them in full.

David Williams January 28, 2013 7:24 PM
MA

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