So, what gives? I thought nursing was a growth field
February 21, 2012 6:44 PM   Subscribe

I'd always thought I'd be a nurse, and I finished all but the final pre-req before I veered off to work in insurance for a while. My question is, is there really a nursing bubble going on right now, and how is it affecting new grads and more experienced nurses? If there's no bubble, what are some of the reasons my more experienced RN friends are having problems finding work? Thank you
posted by Issithe to Work & Money (13 answers total) 2 users marked this as a favorite
Anecdatum: What I've heard from a couple of folks in the field is that some areas of nursing (I'm looking at you, obstetrics) are really massively oversubscribed, whereas there's more likely to be work in end of life care and geriatrics or something else far less fun.
posted by rmd1023 at 6:52 PM on February 21, 2012 [1 favorite]

I'm a nurse (graduated a year ago, gainfully employed) and I don't see any bubble. Certainly some areas are much more difficult to get a job in, like labor and delivery, but in general there seem to be jobs available.

I will say that it is very difficult to get into nursing schools right now, because the schools can't match the salary of a clinical position when trying to hire RNs to be teachers. Not enough teachers means they can't expand their roster of students, so many schools are turning away highly qualified applicants.
posted by vytae at 7:08 PM on February 21, 2012

The economy is down just about everywhere and most people are looking for stable, middle-class jobs. Since the U.S. doesn't really manufacture anything anymore, that means service industry and/or healthcare. Service industry jobs usually don't pay anything approaching normal middle-class existence until you've gotten a decade under your belt so that leaves healthcare.

Nursing used to be something that people did out of compassion or a desire to help humanity, for many it's now The Last Chance For Upper Middle-Class Life. There are also many hundreds of thousands of vets returning from Iraq with GI Bill money, and many of them will be channeled into nursing or healthcare (is any other sector of the economy even hiring?)

Anecdata: I became an EMT (which is much, much lower pay and status than an RN) at the end of 2009. My class had about 20 students. A year ago I went back to the college to speak with the professor about an administrative issue. The new EMT class he was teaching had 70+ students -- some of them literally sitting on the floor. Many more were turned away.

People are just scrambling to find some healthcare certification/license that can pay the bills. YMMV.
posted by Avenger at 7:12 PM on February 21, 2012 [2 favorites]

My Mother is an RN and has been in the field about 35 years. I find that my Mother could leave her job whenever, whenever and pick up another job somewhere else, but then again she is in home healthcare which is catering towards the aging and injured population. A few years ago she tried to get back in the hospital, but it seemed that it was too difficult and a lot of tests were required. So it might be a mix of them not have certifications that are up-to-date or just severe competition, if in fact they are looking to get into hospitals.

From my understanding there's also a learning bubble going on. Some Nurses are being thrown into programs-- LPN going into RN and I often hear complaints on how these Nurses just don't have the same understanding and learning that they used to receive from school. I think that's primarily for some of the lower level fast-track programs.

Other than those two points mentioned, I think Nursing is a great recession proof job, so maybe it's just where your peers are job searching, what experiences they have, etc.
posted by melizabeth at 8:53 PM on February 21, 2012

Where are you? California has legally-mandated RN-to-patient ratios, meaning that, for patient safety reasons, a hospital cannot assign an RN to more than a certain number of patients at a time. So there may be more RN positions per capita here than in other locales. Still, some of the RNs I know are having their hours cut drastically. I attribute this in part to the recession; fewer people with jobs = fewer people with employer-provided health insurance = fewer patients in hospitals. Some people may be delaying treatment as long as possible.
posted by univac at 10:46 PM on February 21, 2012

Best answer: My suggestion:

*Look at a nursing school that has clinicals at hospitals you want to work at. Our hospital hires many grads that worked on our floor as students.
*Stay away from for-profit universities. The clinical portion of the training can be very questionable (see Frontline episode on for-profit universities) and clinicals are a very relevant part of nursing education and ability to actually get licensed.
*If you don't get into nursing school the first time just keep trying. It's hard to get in. Many great candidates are turned away (as mentioned above). Many people keep applying and applying until they get in.
*Try to work as a student as a phlebotomist, unit secretary, nursing assistant or student nurse while in school. Great way to network for a position later.
*Get a BSN instead of an Associates. It's almost identical schooling and testing, but many hospitals are trying to hire only bachelor degree RNs instead of Associates (even though many Associate nurses are excellent).

Know that there will still be a nursing shortage for years to come. Not only are schools not able to produce enough grads, turn over is frequent because it is a hard job to do, people leave for grad degrees, or to work in something else completely. Many RNs do find the right spot however so don't let that be a deterrent. Plus a huge baby boomer population is about to start needed healthcare more as they age so the shortage will continue.

Yes it was easier for me to get a job 6 years ago as a new grad then it is now for my new grad peers today. But that may be cyclical and by the time you get out it will be reversed. That changes quickly and often.

Good luck! The field will always need new folks.
posted by dog food sugar at 2:36 AM on February 22, 2012 [2 favorites]

I have a few family members who are long-time nurses and they are verrrry well-compensated. With good reason! Both work in larger fancier hospitals and have all sorts of certifications. But one person at least said they couldn't really find a new job because most places would consider them too expensive to hire. Just something to think about when you hear that experienced RNs are having trouble.
posted by lillygog at 5:36 AM on February 22, 2012

Response by poster: Excellent answers, everyone! Thank you so much. It does make sense why an experienced Peds home health vent nurse might be having a hard time finding a job---she's probably too expensive to hire.
posted by Issithe at 5:56 AM on February 22, 2012

I work occasional status as a home health care nurse and there is a demand, however, the benefits are next to nothing because you aren't guaranteed hours. You could be working full time for two months and then be cut down to two days a week depending on the number of clientele.
posted by sybarite09 at 6:11 AM on February 22, 2012

So, here is my take on what is happening. In the early 2000s all those fine articles came about the elderly living longer, and all patients focused on care, not cure focused health (how to live with diabetes, etc.). so health care was a booming industry. Nurses, all health practitioners, in fact, were needed, and were going to be needed. It was a good time to be a nurse, or consider the nursing field. There was lots of chatter about the dearth of nurses. Health organizations were looking to interntional nurses to full the gaps (and getting a work sponsored visa was easier).

One thing that did not seem to get noted enough, was that the reason for this was that there weren't enough nursing schools, so only so many nurses could be trained. One reason for that was that the difference in salary for a floor nurse, with overtime, could be anything from $70,000-$100,000. Nursing faculty start in the $50,000s. There is still a shortage of nursing faculty today.

But then there seemed to be a bottleneck at the school level- lots of people wanted to be nurses, and lots of people wanted to train nurses, but it was harder to get into school. Over time however, more nurses did enter the hiring pool. Several reasons for this. First, more places started nursing programs. Also, schools started coming out with accelerated programs, so it only took 1-2 years, rather than four. The idea being that a new grad training program in a hospital would finish your training. So, between 2002 til today, more nurses were trained, and entered the field. The assumption was that they would take over the nursing jobs that senior nurses were retiring from.

But then the economy tanked. And several things happened. Nurses who were going to retire decided not to. Other nurses who were retired came back to work- sometimes because their financial portfolio tanked and they had to come back. In some cases, a nurse's partner lost brier job, so the nurses had to return as the breadwinner. Part time nurses went full time. Also, a whole lot of international nurses with experience had made their way into the market as well. In short, by 2008 there were awhile bunch of experienced nurses, at the same time there was a wave of newly graduated ones, in the market. There still are.

So when people talk about a nursing shortage, it helps to think about who is having problems getting jobs and where you are. Many hospitals canceled new grad training programs , because they had experienced nurses looking for jobs. This was particularly hard on graduates from accelerated programs, because they needed the training. So these days, you'll see nursing jobs, but they will specifically require a year or two of experience, sometimes preferrably med-surg/something hospital based.

So it's a hard market for new nurses, particularly those seeking hospital experience. But not everywhere- depends on what state you are in. For popular destinations- NYC, sf, Boston, the market is tight. In less popular or populous areas, hospitals are still seeking nurses, new and experienced- but you have to be willing to move. And often the people who went into nursing as a second career can't just up and move as easily. There are private practice, clinic and home care opportunities, but they don't necesarily pay as well, which is an issue because almost every nurse took on debt to get trained, figuring they would pay if off when they got a job. Aldo those experienced still favor experienced nurses, because they feel more confident about their nursing skills.

So what does this mean for someone looking to enter the nursing field? It means everything people said above, and that there are some things to consider, like are you willing to move, to be flexible both about where you work and what type of setting you work in, and what support your institution gives you in finding a job. Does their hospital have a track record of hiring their grads, because not all do. Are there career services? Do they keep stats on whe their grads end up, and are those places that you want to go? How Long does it take their nurses to find positions, and do they have specific advice about how to find employment, and what to do if you can't find employment immediately? One should get really compelling answers before selecting a school, because some schools really aren't as clear as they could be about the challenges in the market, and the factors that make it easier or harder to get a job.

People are regional, which is why when a question like this comes up, some people will insist that there is no shortage, and other nurse will lament that they graduated six months ago, and still can't find a job in their town. And they are both right.
posted by anitanita at 8:19 AM on February 22, 2012 [1 favorite]

Arrrgh, sorry about all the typos and choppy prose, tried to type this on my phone on public transportation. :)
posted by anitanita at 8:22 AM on February 22, 2012

There is definitely a bubble but it all depends where you live. Where I am, in the northeast US, we have lots of big name nursing schools and big name hospitals, which makes it difficult for new nurses (and there are LOTS of them) to find gigs in places other than nursing homes and visiting nurse companies. There is just a lot of competition, and it costs A LOT to train a brand new grad nurse. A new RN needs hours of orientation to the hospital, a preceptor to train them to their job on the unit which essentially means they're paying some more experienced nurse and you at the same time, for the same patients, and many places need to help pay for certifications you'll need in whatever extra training that is specific to your specialty. I have seen many talented new grads that are trying to get a job in my hospitals and they are struggling even though they have worked for years at the hospital as aides or unit secretaries and have an excellent rapport with the other staff and manager. On the other hand, many of those nurses got offers from places like Texas, Florida, and AZ where agencies paid their moving costs, first and last months' rent, and licensing fees to get them to move to those places to fill positions because the hospitals are hurting so badly for newbie staff that are willing to put up with bad staffing ratios and poorly managed units. Sometimes if you need a job, you do what you've gotta do. Not to say that all places that are hiring are like that, but it happens.

I think with experienced nurses looking for work, they may be able to find a place that will hire them, but they have to have a low expectation for a salary like they had wherever they were leaving from, especially in a saturated market like it is here. I have worked in New Hampshire in the past and the pay difference for the same level of experience, within the same driving distance from my current job in MA, is a good 10$ an hour, with the hourly shift and weekend differentials being double as well. So while there are job openings the same distance away from home in NH, I simply can't afford to take a job there any longer because while my years of experience have been very lucrative to me in MA, if I went back to my old hospital I'd only be earning 1$ more an hour than I am now. So in my case, around here, I find much less of a shortage - sure, we can very often be short-staffed but it's only because the hospital can't afford to hire more full time staff right now because when the hospital census drops (as it does cyclically), they can't afford to always be paying low census leave pay to all the full timers that they don't need to have working those days.

I'm thinking within the next few years.. maybe not five but probably by ten, there will be more of a true "shortage" as the ready-to-retire types actually are able to retire like they had planned to the last five years, and then all these extra nurses who went to school looking to get an automatic job will have the ability to move into those slots.
posted by takoukla at 10:30 AM on February 22, 2012 [1 favorite]

I've been an RN for about 2 years. Got a job right out of school. These things are cyclical. A number of my co-workers had to move to find jobs, but once you have some experience it's much easier. I have two coworkers who've been RN's for less than 2 years who are moving to jobs at good hospitals in big cities. If you get your RN, you will find a job. It may take longer than you hope and you may need to relocate for a little while just to get some experience, but you will get a job. The real question you need to ask are do you really want to be a nurse. It's a tough, but extremely rewarding vocation. I highly recommend working as an aid (PCA, tech, there are a lot of names for it) for a while to see if you like it.
posted by brevator at 3:04 PM on February 22, 2012

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