The Nursing Shortage Myth

The Nursing Shortage Myth

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For years we’ve read that the US faces a looming shortage of nurses. Shortfalls in the hundreds of thousands of nurses are routinely predicted. These predictions have been good for nursing schools, which have used the promise of ample employment opportunities to more than double the number of nursing students over the last 10 years, according to CNN.

Yet somehow 43 percent of newly-licensed RNs can’t find jobs within 18 months. Some hospitals and other employers openly discourage new RNs from applying for jobs. That doesn’t sound like a huge shortage, then does it?

But the purveyors of the nursing shortage message have an answer for that. Actually two answers: one for the short term and another for the long term. The near term explanation is that nurses come back into the workforce when the economy is down. Nurses are female and tend to be married to blue collar men who lose their jobs or see their hours reduced when the economy sours, we’re told. Nurses bolster the family finances by going back to work –or they stay working when they were planning on quitting. There’s something to that argument even if it’s a bit simplistic.

The longer term argument is that many nurses are old and will retire soon, just when the wave of baby boomers hits retirement age themselves and needs more nursing care. Don’t worry, the story goes, there will be tons of jobs for nurses in the not-too-distant future. This logic comes through again in CNN’s story:

Demand for health care services is expected to climb as more baby boomers retire and health care reform makes medical care accessible to more people. As older nurses start retiring, economists predict a massive nursing shortage [emphasis mine] will reemerge in the United States.

“We’ve been really worried about the future workforce because we’ve got almost 900,000 nurses over the age of 50 who will probably retire this decade, and we’ll have to replace them,” [economist and nurse Peter] Buerhaus said.

I don’t buy this logic. And I stand by what I wrote almost a year ago in Nursing shortage cheerleaders: There you go again:

My issue with the workforce projections is that they don’t take into account long-term technological change, but simply assume that nurses will be used as they are today. I’ve taken  heat for writing that robots will replace a lot of nurse functions over time. People seem to be offended by that notion and have accused me of not having sufficient appreciation for the skills nurses bring.

So let me try a different tack. Think about some of the job categories where demand is being tempered by the availability of substitutes. Here are a few I have in mind that have similar levels of education to nurses:

  • Flight engineers. Remember when commercial jets, like the Boeing 727 used to fly with two pilots and a flight engineer? Those planes were replaced by 737s and 757s that use two member flight crews instead.
  • Junior lawyers and paralegals. Legal discovery used to take up many billable hours for large cases. Now much of it is being automated
  • Actuaries. Insurance companies used to hire tons of them, but their work can be done much more efficiently with computers

I don’t know exactly how the nursing profession is going to evolve but I do notice that the advocates for training more nurses are typically those who run nursing schools rather than prospective employers of nurses, such as hospitals.

If you want to be a nurse, go for it. But if you’re choosing nursing because you think it’s a path to guaranteed employment, think again.

David E. Williams is co-founder of MedPharma Partners LLC, strategy consultant in technology enabled health care services, pharma,  biotech, and medical devices. Formerly with BCG and LEK. He writes regularly at Health Business Blog, where this post first appeared.

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171 Comments on "The Nursing Shortage Myth"


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Mar 8, 2015

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Feb 11, 2015

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Pancho
Jan 29, 2015

California Board of Nursing is a mess and a front for Lord knows what….disorganized is too nice of a word for this FAIL of an agency. So many incompetent people working there. Nobody answers phones. Always on breaks. In meetings. Out to lunch (even when they’re back from lunch). Half the state agency staff is on Facebook the entire day not doing their job. Total joke. No wonder the BSN requirements keep changing, nobody is manning the ship. California nursing schools are now being told, “OOPS, we goofed, your students no longer need CHEMISTRY to be BSNs…” Oh, reallllllyyyy…well thank you very much after 5900 of us already took chem as a “requirement” and now, suddenly we don’t need it…GET YOUR ACT TOGETHER CA BOARD OF NURSING. QUIT ripping students off. Quit wasting RN’s time and money on this idiotic BSN (Bull S^%$ nurse degree)

Guest
Janet Betz
Dec 28, 2014

I feel that the problem with Nurses finding jobs has to do with several years ago when there was a shortage and they put Nurses on 12 hour shifts.There are many more men in Nursing as well as females.i do think some of that has to go with only working three days a week.I have been a Nurse for 50 years and have worked all three shifts, done total care Nursing and have done Nursing using the computer.I still like the total care Nursing were you do everything for the patient.I did work at one hospital that used little computers that one wore around their waist.The Nurse would document as she /he cared for the patient,then would down load the information every two hours in the big computer.I really think Nurses should work eight hour shifts instead of twelve, the care is better and we are dealing with human beings not cars or clothes.Mistakes are not fixed as easy once they happen.Putting Nurses back on eight hour shifts would open more jobs,cause less errors and Nurses going into Nursing because they want to care for the sick, not for the hours .

Guest
Dec 11, 2014

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Jeremy
Dec 2, 2014

Seriously?

I got an ASN in Orlando Florida. A hotbed of people wanting to work and live here. Big time health care. Big time fun and play. Not great on salaries compared to the north, but oh well….one can make $75k per year as a waiter in a decent restaurant as opposed to $50 k per year as an accountant, but oh well…

I have an ASN. only 5 years ago from a local community college. No hospital opportunities upon graduation. Found a job in 3 months for a private practice internal medicine doctor. $25 per hour. Then salary. In a year became a hospital rounding nurse. On call, etc etc. Great benefits. No relocation. Then left for greener pastures…

Went to a staffing company. They found me $60 per year in less than a month as an infusion nurse. No BSN required. Tons of benefits. Retirement, health care, free Disney passes etc etc…

Then came the pharmaceutical companies. I now work for two of them. Fancy dinners every night. Made $10k last year in nursing focus groups. tons of perks…just got a BSN…no difference in my life, except in will pay dividends down the road as a traveling speaking for said pharm companies. I just stayed in times square on their dime in manhatten for a week..paid me over $1000 plus all expenses…just went to San Fran…same deal…Now going to the Hyatt in Orlando for $79 per hour…

Point is, if you haven’t figured out how to market yourself and keep waiting for a handout, you are no different than those 400 pound patients you see on disability with high blood pressure and diabetes in poverty on a daily basis, if you are even employed….

Make your own way, don’t go into nursing for a sure thing/job…go into it because you are someone who can take an opportunity a run with it…good Lord people, quit whining and get a life…

Guest
Nov 23, 2014

All you nurses that can’t find jobs come to Houston! Wages are good, low cost of living, awesome town and plenty of jobs for you and your spouse.

Guest
Caroline
Dec 2, 2014

Thanks for the advice, I graduate in a year from an accelerated BSN and have been hoping to move to the Houston area from where I am now in PA! Glad to know that the outlook is good.

Guest
David
Nov 9, 2014

New RN then be flexible and move to get experience. Too many student nurses I work with say they will not move for a job. Well then you can be unemployed for a long time. In places that pay well like around cities like San Francisco, Boston and San Diego. Cities with a lot of nursing schools and places where people want to live are also hard to find a job. No medical student gets to stay home and learn, so lose your fear and spread your wings, and move for a job. Look online and start applying

Guest
Looking for more
Oct 25, 2014

Tired of Being a CNA? Nurse assistants are overworked, underpaid, unappreciated and expected to always do more for less. Might be time to find something else to do. Here’s a place that you can vent, hear others with the same experiences and maybe find a better job:

http://tiredofbeingacna.webstarts.com/

Hope it helps

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Sep 1, 2014

juneau2015@yahoo.com ———————Thanks I would prefer to work in corrections but I am not picky.

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Dec 20, 2014

Scott- I emailed you with some links for corrections jobs in WA state, also some hospital links. Good luck!!

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Sep 1, 2014

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Scott
Sep 1, 2014

If anyone has any advice on where is a good place to move to get a nursing job with benefits. Please let me know. I am not interested in reports or statistics about how nurses are in demand. I think that they are skewed.

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StacyRN
Sep 3, 2014

Oklahoma has tons of them.