Assuming this is a supply and demand economy why is there a chronic nursing shortage?

Factual Questions
21

If my response is redundant, I apologize. I’m too sleepy to read the entire thread, I will tomorrow.
The nursing industry runs in about 15-20 year cycles, going from shortage, to glut.
When there is a glut, hospitals tend to take advantage. Working conditions suffer, pay for special training drys up.
People can only take abuse so long. So, they leave the industry.
There is also a steady attrition because it is a strongly female profession. They get married, have babies, leave nursing.
Then there’s the cycle of hospital administrators deciding that nurses are expensive, and that “techs” of some sort can do the job cheaper.
So, nurses get laid off. They have to feed their families, so the find work in other fields. Then people get upset about the poor quality of hospital care, so administrators start screaming for nurses.
Remember that glut I mentioned? Well, who would go to school for a saturated field? Right, fewer nurses graduating. Smaller pool to pick from.
Also, new grads are, by definition, inexperienced. Since the experienced nurses are now auto mechanics, who is going to guide the newbies?

The last glut ended in 1997 or there abouts. So, in seven years or so there should be another.
I won’t address the fact that nursing is the only profession that eats its young.

22

The employment pages of newspapers here routinely carry ads for qualified and experienced nursing staff, for recruitment in the US, Canada and the UK. I figured it was because there weren’t enough people wanting to be nurses in these countries.

23

I’ll bet you see lots of ads for programmers, as well. I can guarantee that there is no lack of people trying to find jobs as programmers in the U.S. There are other factors at work in these industries than a lack of willing applicants.

24

I’m going to post without reading on purpose to just give you my raw views.
Both my sisters are nurses. My Niece just graduated this year and is starting her nursing career.

Why demand doesn’t produce more nurses:
Well for years nurses were underpaid (grossly underpaid), overworked and often unappreciated by many of the doctors and most hospital administrators.
In the last few years, nurses are now being compensated very well. My niece will probably pull around $52,000 in her first year and that’s without overtime.
Very nice 1st year pay, even in NJ.
Guidance counselors don’t seem to yet know that nursing now pays well and has a career/schooling path to Nurse Practitioners.
I spoke to a few councilors about 4 years ago and they were all ignorant of these facts and had the epiphany that with most fields now tights maybe they should recommend nursing and Bio for their students. They were still pushing Computer Programming and Web design, not realizing that bubble had burst.

The schooling is very tough. It is more demanding than most. (Way harder than computer science or teaching, I can’t speak to most degrees)
The job is physical and somewhat dangerous and to be a good nurse you need a lot of compassion and caring.

When you enter the nursing field, you usually end up with swing shifts or night shifts. You get cranky patients that think they are in a hotel and you should treat them as a private nurse.
I have seen patients in a room were the nurse is trying to get an IV started in someone with apparently minimal veins left and the other patient is bugging the nurse for a water refill.
Did I mention that most people still think it’s a low paying job?

Nursing can now be a very rewarding and well paying job.

25

I have been an LPN for eight years. In long term care facilities, LPN’s do a large majority of the hand’s-on work, with RN’s only being used for supervisory positions. They can pay us peanuts and get a hack of a lot of work for the money. In general, I think the nursing shortage is due in large part to the demanding work and low pay, as well as the increasing levels of paperwork taking up time that used to be used to actually care for patients. Alot of facilities are so drowned in legalities that a good deal of the shift is spent charting. Most of that stems from decreased reimbursement from insurance companies and CMS, as well as increased pressure from HIPPA regulations.

26

I’m a nurse in ICU in a teaching hospital, 21 years experience. We’ve been seeing this shortage coming for several years, and this one is different for several reasons.

The mean age of nurses in Ohio was 47 years the last time I heard, and getting older. As we get older, more and more nurses are either retiring or going to positions that are less physically and emotionally demanding, so there are fewer available bedside nurses.

When we had cyclical shortages in the past, some of the slack was taken up by nurses who had opted to stay home and raise kids, or work part time. But today there are far fewer stay-at-home moms. We’re already working, so that pool is gone.

Schools of Nursing are only partially responsible. They too have a shortage of qualified instructors. I know that locally the colleges could accept more nursing students if they could fill their vacancies. Believe me, the hospitals would bend over backwards to accomodate the need for additional clinical hours. A nursing student today may be an employee tomorrow!

But shortage of instructors is not the only cause. Today most nurses are university-educated. The 3-year hospital schools are almost gone. So if you are considering becoming a nurse, you have to think about these factors:

4 1/2 to 5 years to get your BSN. How expensive is that! (And the hospitals do use tuition reimbursement as a hiring bonus, but usually reimburse only 1 or 2 semesters.) After all that time and money:

Entry level for hospital nurses is night shift. Some hospitals require swing shifts. All require weekend and holiday scheduling. All bedside nurses are exposed to infectious disease, stress, physical demands, stress, short staffing, increased patient acuity, stress, and oh, did I mention stress?

***I ** * know that there are many upsides, but how desirable does that sound to an average 18-year old? What about an older person who would consider re-training to become a nurse? That was me, going back to school at age 35. Fortunately there was a 3-yr program available, because no way was I able to consider full-time school for more that that. I needed to get to work! I wouldn’t have that option today.

And where are the guys?!! We need someone to convince guys that we do make a good wage, and they get to work with lots of women. I work with lots of men, I think they gravitate to critical care because it has more “prestige” in nursing. I wish we could attract more men to nursing.

How are we going to attract new nurses? I think we need to make it easier to become a nurse. I think we need to educate the public. We need to show the job realistically, including both the bad and the good.

27

Not all states require RNs to have a bachelor’s degree. In fact, there was a push a while ago for our local community college to more aggressivley market its nursing program because of the bottleneck in the four-year colleges.

I don’t know if it’s till possible to become licensed and registered after completing a two-year program…this was probably some 10 years ago.

Being in the medical support field, I can affirm that not all nurses work arduous hours and perform back-breaking tasks, and I have never heard of a poorly-paid RN.

28

One of the largest reasons there aren’t more nurses - and why nursing considered to be an unattractive profession - is a well documented problem called ‘eating our own’. Other nurses can be the worst part of the job. Instead of being mentored in and supported, new RNs are pretty much harassed and hazed in many places.

I’ve been an RN for twenty years - when I was still working in the hospitals, I was making about the most someone with my med-surg background and training could make, but only because I was willing to work nights, weekends, agency, and float. The work is back-breaking, legally risky, stressful, and many times unsafe. (I’ve seen figures that indicate RNs are more likely to be physically attacked on the job than police officers. From what I’ve experienced and seen, I believe it.) Given the tremendous work load and the responsibility involved, heck no the pay isn’t high enough! Two years ago, Consumer Reports published an article that indicated that the highest patient load a nurse should have to maintain patient safety was 4. I laughed when I read it, because I’ve never had less than 8 very sick people I was responsible for…and sometimes as many as 10 or 12.

Is it like this everywhere? No. There are good places to work…but not many, and the hospital industry is very very slow to implement any kind of change. Many hospitals are still being run (in an administrative sense) exactly the way they were in the 1950s.

A lot of older nurses are moving into desk jobs - disease-management and case-management companies are tapping the market in many cities, more attractive options to many nurses than even home care is. It’s hard to remember that traditional hospital nursing is only a very small part of the nursing job market.

29

Why aren’t older nurses considering teaching?

30

I think that is a little like asking why a 20 year teaching veteran doesn’t become an education professor. I can be done (my mother did it) but it requires going back to school and getting a doctorate. I am sure that not all nursing teachers have a doctorate but almost all of them need to have some kind of advanced degree. Like most doctorates, there is little or any financial payout to do that and the degree takes years to complete.

31

I agree. Most nursing instructors in our area are Masters prepared, and they make less than bedside nurses.

Teaching is certainly an option for those who find bedside nursing too strenuous, but most RN’s would have to go back to school. Other areas that tend to be less physically demanding, like infection control, quality assurance, care management, endoscopy, dialysis and home care, are viable options for some of us.

But you see, that is the problem – nurses of my age group (baby boomers) are leaving the bedside. And there aren’t enough of the next generation to replace us.

32

Nursing schools. I’m in a hurry so I didn’t read all the posts but as an ex nursing student this is the reason. When I went there were about 200 applicants, but only 30 were accepted and the other 170 turned away. On average of those 30 only about 18 would graduate. So it is the fault of the schools with their quotas and low graduation rates that there is a nursing shortage.

33

The two RNs that I know well both got their degrees and training in the starting in the late 60s and early 70s. I believe they both also got Uncle Sam to pay for everything (paid back, of course, with time serving.) At least one of them wound up at Walter Reed for a while.

Thirty years later, one does some teaching, but I don’t know if she does any actual nursing. The other quit nursing for about a decade, eventually went back to work doing 12-hour hospice shifts, and eventually switched to a much easier outpatient ortho clinic.

I’ve often heard it complained that RNs have more general responsibilities than the doctors and practically no power.

34

Nursing schools can only accept the number of students they can teach. Nursing school is not easy, and many students discover they don’t have the drive to continue, or that they just can’t make the grade. Nursing schools can’t just churn out graduates - the graduates have to pass state boards before they can practice. It does a school no good to have a reputation for a low board passage rate. The nursing school at LaGrange College had a 100% board passage rate while I was there, but at least 30% of the freshman nursing class did not return for the sophmore year, or switched majors. (I was not a nursing student)

Nursing is a difficult, emotionally exhausting, often thankless job. My mother in law was an OB/GYN nurse, and boy could she tell some horror stories! My husband did his LPN studies at a school which did its clinicals at a Catholic hospital - so he was not permitted to do OB/GYN rounds because he was male. Never mind that the doctors were male. Never mind that OB/GYN was covered on the board exams. He got his RN from a different school.

I have nothing but respect and admiration for the majority of nurses - it takes a special person to be able to do that job.

35

It is a catch 22 though. Nursing is a thankless, overstressed job so nurses leave the field. As a result the field is even more thankless & overstressed. Tons of people want to become nurses but they are not allowed to study.

After I flunked out of nursing school I switched my major to chemistry. Anyone who wants to study chemistry can, all you have to do is apply. The same standard should apply to nursing school, just take in whomever wants to be in the class. However with things like clinicals you are going to need alot more teachers but from what I saw the teachers didn’t do much in the clinicals except review what you’d done that day.

36

Why should they “take in whoever wants to apply?” Why waste a student slot whose transcripts don’t show they have the ability to make it? I never applied to vet school, which I have always wanted to do, because I knew I wouldn’t be accepted with my high school math and chemistry grades. I would do fine now, because I have learned how to study and budget my time, but straight out of high school I would not have been accepted and rightly so.

As I said previously, nursing is not easy. I know this through watching the nurses who care for my mother during her illnesses and her death, and from watching what my husband went through on a daily basis as a psych. nurse. If you flunked out, you should have some admiration for those that made it, instead of asking that it be made easier. Who knows, the life a nurse saves might be yours.

37

Many of the nurses (I am not sure which level or type) in my hometown in deep south Texas are recruited from the Phillipines, rather than depending on the local employee pool (or perhaps they are ignoring the local employee pool).

38

You made exactly my point when I posted last night about being the only industry that eats our young.
I was an ICU nurse for 30 years, and kicked around a few other specialties as well. I’m smart, well educated with loads of valuble experience, but when I decided to be a travel nurse for a while, I was required to reinvent the wheel at every assignment. I also worked for an agency for some extra money. There were times I was asigned at the place I had worked less than a year before. A place where I had been honored as a leader and mentor. When I went in through the agency, I was treated with disrespect and mistrust, by the people I had so recently mentored.

I’ve made it a point throughout my career, to avoid treating new staff with such mistrust. I was told by many experienced nurses that I was showing them disrespect by trusting the less experienced people. :confused:
Enough. I retired because once I saw the pain I had to inflict each day, on my patients and, ironicly, on my coworkers I couldn’t unsee it. So, I retired. I need to go now.

39

And ironically, as much as many female nurses complain about their not being enough male nurses, some female nurses go out of their way to make Mr. SCL feel like a second-class citizen. “Oh you couldn’t get into med school” is one of the kinder comments he has been gifted with by his female coleagues. Then these bitches wonder why he doesn’t just jump when they ask his help in rotating a 300lb comatose patient.

40
      • Yea, in the programming field it’s that companies advertise a “entry level position” as needing a masters’ degree and five years experience in all the entrprise-level software they already use. :rolleyes:

  • I haven’t been employed in the field, but I read once (some years back) that the main reason that medical staff were in short supply was because the AMA kept it that way, to keep wages high. The AMA will only certify so-many-people per year (of any employment type), from any particular school, and they control what schools can have medical programs at all, because without AMA accreditization, graduates of the schools programs aren’t really employable. …I would think that the best solution here would be for the federal gov’t to take over certification of medical professionals and certify as many people every year who could pass the tests, although (for internal political reasons) it would take some time before hospitals began hiring these “non-union” workers…
    ~