Why is there a Nursing shortage?

[DawnCt1]

When I was graduating from high school, I had at least 10 nursing schools, including UConn, that I could have applied to. I chose a small, hospital based 3 year diploma program. Like all diploma programs, we attended classes and had clinical 10 months out of the year, with a week off at Christmas. Since our hospital was small with limited pediatric and psychiatric experiences, we went to other hospital based nursing schools that provided that experience; The Institute of Living and Babies Hospital at Columbia Presbyterian in NYC.
Tuition was affordable, even in those days. My room, board, uniforms, books and tuition for my first year, plus a $5 a week stipend was $500. The following year it went up to $750 because we were sent to other schools/hospitals and $600 the last year. My parents could not have afforded to send me to UConn so this was a good alternative. Other programs were similarly priced or a bit more expensive. I had 14 students in my class. That was the capacity. I felt that by the time I graduated, I had an excellent nursing education and that by the time I took and passed the boards in July, and got the results in the fall, I was more than capable of taking charge of a unit. Since then, this route to a nursing education has essentially been eliminated. The BSN programs and the AD programs are overwhelmed with applications and are extremely competitive. There is also a shortage of nursing instructors; classroom and clinical. Some have suggested that we open our borders to foreign nursing graduates, however, I don't think that there is a shortage of students who would like to be nurses. Should we expand nursing education back to a hospital based classroom? What are your thoughts?

 

[Janet Hill]

I just heard on the radio yesterday that there is no nursing shortage in the DC metro area. I think the shortage is a regional thing.

I agree that a hospital based classroom is the way to go. We essentially do that to train doctors. While their is much knowledge involved in nursing care, there is no substitute for hands on experience. Let's be realistic not many patients actually fit the textbook case, so one has to learn how to think and apply their knowledge.

 

[rie'smom]

There are a couple of reasons that I can see in our area:

1. The pay for university professors is nowhere near what a nurse can earn in the private sector, so there aren't enough teachers. Our local university built a beautiful enormous building. They should have used the money to hire teachers but the way the university system is structured, the schools can't choose to spend the money the way they would like. The school has 1000 students applying for the nursing program and they only take about 100.

2. In the 70s when I was in nursing school, the classes were hard but manageable. The courses now are more like med school classes. I'm not saying they should be crip courses but there are many people who are opting to become physician's assistants because the schooling is about the same length of time and the classes are on the same difficulty level plus the pay is lots better.

 

[Dina]

There is no nursing shortage in the Philadelphia area. Right now, graduate nurses are having a very tough time getting jobs. I'm about to graduate from nursing school, in my class of 30---only 2 have secured nursing positions. It's definitely regional. Philadelphia has always had a supply of nurses because there are so many nursing schools. But, go to places that lack nursing schools--- that's where you'll find the shortages.

 

[okeydokey]

I have family members who are nurses. They do pay well now, but the patient load has increased to what my relatives consider an unsafe level. There is no way to provide the quality of care that nurses desire to provide.

 

[ChillyWilleys]

Lack of teachers. When I was in nursing school I spent 2 years sitting on a waiting list taking no classes at all because I had finshed all of the prerequisites. At the hospital I work at now a university that uses us for clinicals was asking nurses if they were interested in teaching because they lowered their teaching requirement from Masters to bachelors because the shortage of teachers is so bad. No one took them up on that offer. Lots of work and responsibilty for very little pay.

 

[laurie31]

I think the "why" is multifacated.

Women used to have only a few career choices - teaching, nursing, etc. Now women can choose anything. Many women who might have chosen nursing 30years ago are choosing medicine instead. So the "pool" of potential nurses is smaller.

Second, as you mentioned, there is a serious shortage of instructors, so there isn't enough space for all of those who do want to study nursing.

I think nursing has changed dramatically in the last 20 years and I don't think the diploma programs are appropriate for today's professionals. In fact, I'd like to see the Master's Degree as entry level for an RN, but I know that's not practical so I don't push for it. In fact, I have no problem with an Associate's Degree as long as there is a thorough orientation. It is obscene what a college education costs these days, though. I'm afraid I don't have any suggestions how to make it better, though.

 

[clgwli]

There isn't one here. In fact I know some who have recently lost their jobs due to cut backs at hospitals and clinics.

 

[mom2kazkids]

Actually there was an article in our breakroom at work about how nurses that are near retirement age are not retiring due to the recession, and the shortage is no more. Due to seeing that the shortage we have seen in the past is not there, high school students and those looking into to nursing as a career are rethinking the decision due to the numbers of new or soon to graduate nurses that are having a difficult time finding a job.

What does this mean for the future? When the recession is over and the country is more economically stable, all of the nurses that did not retire or are close to retirement will leave the profession and the shortages that we have seen in the past will be nothing like what they will be.

I know that in the hospital and unit that I work in, many of my co-workers are frustrated with the staffing cuts that are being made. I think that once other jobs start opening up, my unit could lose a lot of staff that want out from the frustration. Also due to hiring freezes back up staff is not available.

 

[DawnCt1]

I think that the American Nurses Association had everything to do with the direction of nursing education. That said, it hasn't been 'bad' for nurses. Limiting the routes of education, limits the number of graduates and drives up the pay. That said, there is a finite number of dollars, and nurses are working harder, taking on more responsibility with sicker patients than ever before. I agree with the poster who said that it stretches the 'safety' limits. When I graduated, team nursing was the method of patient care. I worked under that system for years. It took staff of varying skill levels, the head nurse, (now nurse manager), the team leader, staff nurses, LPN's and aids and delivered patient care within the scope of each member's abilities. All members of the team knew something about the patient. I think it was a big loss for patient care to go to primary nursing. It didn't serve the patients well if they had a temp nurse or a part timer when "their" nurse was off, and for the brief time that I worked under that system as a per diem, I found the lack of interest for the patients that the staff 'didn't have', very concerning. Team meetings acquainted everyone with the patient.

 

[ChillyWilleys]

I have family members who are nurses. They do pay well now, but the patient load has increased to what my relatives consider an unsafe level. There is no way to provide the quality of care that nurses desire to provide.

Completely true also. A night at work not too long ago that almost had me out the door permanently...5 pts,...2 post ops, one getting chemo, had to watch 2 pts on top of my 5 for another nurse who had a meeting to go to, one of those was having a thoracentesis that I needed to assist, and also an out patient getting 2 units each of blood and platelets (out patients don't count according to staffing) Its an oncology floor so everyone is in pain, and I got a huge attitude when in the middle of all this (and yes this is all at once right at start of shift) they tried to give me an admission and I flat out refused. We're not allowed to do that but somehow I made enough of a stink that they sent my out pt to a different floor ( of course that took about an hour to do) and gave me the admission. It was a horrible night. I prayed through it and thankfully everyone made it. Very unsafe though. I became a nurse to provide care to people and some nights I struggle to just do the bare minimum that needs to be done.

 

[Chicago526]

I know our local community college had to turn down tons of applicants because they had limited slots in their program. Our city just a few weeks ago passed a referendum to increase property taxes to help fund a major expansion of the college, including a huge increase to the nursing program. The tax increase was modest, $25 to $50 per year for the average home owner, that's a bargin if you ask me. They're also expanding the police and firefighter programs and a host of other useful things.

 

[DawnCt1]

Completely true also. A night at work not too long ago that almost had me out the door permanently...5 pts,...2 post ops, one getting chemo, had to watch 2 pts on top of my 5 for another nurse who had a meeting to go to, one of those was having a thoracentesis that I needed to assist, and also an out patient getting 2 units each of blood and platelets (out patients don't count according to staffing) Its an oncology floor so everyone is in pain, and I got a huge attitude when in the middle of all this (and yes this is all at once right at start of shift) they tried to give me an admission and I flat out refused. We're not allowed to do that but somehow I made enough of a stink that they sent my out pt to a different floor ( of course that took about an hour to do) and gave me the admission. It was a horrible night. I prayed through it and thankfully everyone made it. Very unsafe though. I became a nurse to provide care to people and some nights I struggle to just do the bare minimum that needs to be done.

Wow! That does sound like a horrible night. I have had those nights when I prayed 'everyone would live through the night'. Your description brought back that memory. 20 years ago I limited my nursing to occupational health. I started per diem when the kids were little an my mom was able to care for them, increased to part time and full time. It was ideal nursing; the kind of nursing that made you chose nursing in the first place. There was time to spend with patients, respond to emergencies, deal with work related injuries, accidents, safety, emotional issues, ergonomics and the kinds of medical issues that occur that sometimes patients don't even notice. They just get used to 'not feeling good"

 

[OceanAnnie]

I think the "why" is multifacated.

Women used to have only a few career choices - teaching, nursing, etc. Now women can choose anything. Many women who might have chosen nursing 30years ago are choosing medicine instead. So the "pool" of potential nurses is smaller.

Second, as you mentioned, there is a serious shortage of instructors, so there isn't enough space for all of those who do want to study nursing.

I think nursing has changed dramatically in the last 20 years and I don't think the diploma programs are appropriate for today's professionals. In fact, I'd like to see the Master's Degree as entry level for an RN, but I know that's not practical so I don't push for it. In fact, I have no problem with an Associate's Degree as long as there is a thorough orientation. It is obscene what a college education costs these days, though. I'm afraid I don't have any suggestions how to make it better, though.

I was going to state the same thing.

Also, IMO the patient's that can manage at home are released much sooner than years past. The patients that remain hospitalized are "sicker" for lack of a better word. Between the sicker patients and increased nursing load, I imagine burn out is another reason.

 

[barkley]

There isn't one here. In fact I know some who have recently lost their jobs due to cut backs at hospitals and clinics.

same here-we're seeing on the news about the massive layoffs some of our regional hospitals and medical groups are experiencing. we're also looking at one hospital closing so there's more experienced staff out of work.

 

[DawnCt1]

There is no nursing shortage in the Philadelphia area. Right now, graduate nurses are having a very tough time getting jobs. I'm about to graduate from nursing school, in my class of 30---only 2 have secured nursing positions. It's definitely regional. Philadelphia has always had a supply of nurses because there are so many nursing schools. But, go to places that lack nursing schools--- that's where you'll find the shortages.

Some of these graduates will be graduating with a lot of debt. I hope that they will be able to get jobs. Their loans will be coming due and with no jobs, it will be tough.

 

[NewmanFam6]

I am graduating May 13th. I am one of the lucky people in my class to have a job lined up. There is definitely not a shortage here in SW VA. We have 5 schools churning out new nurses and several hospitals with hiring freezes.

 

[Pigeon]

Maybe it's a fluke but all the nurses I know have gotten out of patient care in the last couple of years. They were just burned out from the patient load in the hospital setting. I'd also heard them describe hospital conditions as unsafe because of the number and severity of illness of the patients they were assigned.

They can make more money working for insurance companies, have a 9-5 work week and reclaim family holidays.

 

[jordansmomma]

I agree with a PP, there is not enough teaching staff. Last year when I applied for the nursing program, 100 applied, 30 got in, and the rest were on the waiting list. I was number 11 on the waiting list. I would rather not attend BBCCs nursing program, but it is in the same town I live in.

Every school year there is a teaching position open at the school.

 

[disbridemimi]

I am a nursing student right now, in a 2 year ASN program (have a BS in another field) and there was just a big article in the paper about the influx of new nursing graduates, and no jobs for them. It was a bit of doom and gloom and pretty discouraging. And a lot of the city hosptials are no longer hiring asn/2 year nurses. SO no shortage of nurses to speak of here!

It appears as though a lot of more experienced nurses who had been part time or stopped working have come back into the workforce after a spouse had been laid off etc. So jobs are hard to come by for new graduates.

In most areas there is not a nursing shortage, there is a shortage of EXPERIENCED nurses. The baby boomers are retiring etc, and you can't have a floor staffed with all new nurses, it would be like the blind leading the blind.

A lot of big hosptials in the area have been doing layoffs, the nurses are overwhelmed with patients. It just isnt what it used to be.