OP-ED

No Country For Young Nurses

 

The nursing profession takes a certain dedication to love. After all, most office jobs don’t involve standing for 12 hours at a time, scarfing a bite of lunch between “clients” or handling gallons of bodily fluids on a daily basis. But for years, nursing schools lured students with the promise that they would be snapped up by prestigious hospitals upon graduation, remunerated for their hard work with good pay and enviable job security.

And they were right – until now, that is.

It’s a paradox straight out of “Freakonomics:”  Even though California still faces a shortage of nurses, up to 40 percent of nursing school graduates will be unable to find jobs, according to the California Institute for Nursing and Health Care.

The recession set off a domino effect that has caused California hospitals to virtually stop hiring newly-minted nurses. The Institute estimates only half as many nurses will be hired this year as in 2008.

It’s all thanks to Botox, healthcare reform and other people’s husbands.

Back from retirement

Nine years ago, a severe nursing shortage was giving policy-makers night sweats. In 2001, national vacancies in nursing reached 13 percent, and over 120,000 nursing positions went unfilled, according to a report by the American Hospital Association. The numbers were especially dire in California, and in 2005 the state began funding and aggressively promoting nurse education.

“With this new initiative we are going to improve the quality of health care everywhere in our state. We are going to provide more classes, more teachers and more resources to expand the ranks of nurses in California,” Governor Schwarzenegger said in a press release at the time.

It worked. California nursing schools saw enrollment rise by 70 percent over four years as the profession became increasingly touted as “recession-proof.”

But the recession found a way.

A funny thing happened when the economy began to crumble. Peter Buerhaus, a nursing expert at Vanderbilt University, found that an astounding number of experienced nurses left their non-hospital jobs to work in hospitals.

Though only about 60 percent of nursing jobs are in hospitals, recent nursing graduates often rely on resource-rich hospitals to provide them with the extensive training they need to be considered ready to work with patients. In addition to having the best training opportunities, hospitals also happen to have the best pay, the best benefits and the best shifts.

“In two years, hospital employment grew by 243,000. That’s a world record. That’s astounding,” he said. “People were coming in from all over. I mean, we’ve got nurses coming down from Uranus, from Pluto, waiting to get clearance to come down.”

As one of the perks, many hospitals give nurses the option of changing a standard full-time schedule to three 12-hour shifts per week, which allows some nurses to pick up a second job on their free days.

It’s a life-preserving strategy for when their spouses (70 percent of nurses have one) lose their jobs, as millions of Americans have since the recession hit.

Retired and part-time nurses all over the country have been returning to work full time when their spouses’ jobs were threatened, or eliminated. Faced with the option of hiring an experienced nurse or a novice who needs training, the choice for hospitals is clear.

Or as a Marina Del Rey hospital representative said, “We are not hiring new grads at all. With the employment market the way it is right now, we don’t have to.”

And nurses who were going to retire decided to stay put.

“The turnover is almost nil,” said UCLA nursing school Dean Suzette Cardin. “They’re just not leaving. Everyone’s afraid to leave.”

These older, returning nurses have crowded out novice nurses who need training. And they’ve done so in greater numbers in California, where the economy has tanked harder and where there tends to be more workers nearing retirement age.

“There may have been a bigger reservoir of older nurses that weren’t working in California,” Buerhaus said, “and you had a very strong reaction of nurses getting back in the labor market.”

Fewer implants, greater uncertainty

One of the first casualties of the recession was disposable income and all the luxury items – watches, cars, and errr…silicone – that it buys: Allergen saw sales of Botox and breast implants plummet in 2009.

And as job loss led to health insurance loss, people were re-thinking not just nose jobs, but knee surgeries.

The decline has led to less demand for nurse assistance during some procedures. “Elective surgeries are down, so patient days are down,” said Deloras Jones of the California Institute for Nursing and Healthcare.

On top of that, hospitals are reluctant to beef up their staffs while the healthcare debate rages on. Hire too many nurses now, and in a few months they might be stuck paying more in salaries while getting reimbursed less by insurance companies.

“Hospitals are uncertain about what their near-term future is,” Buerhaus said. “It’s taxes one day, payment reductions the next. Given that uncertainty, it’s slowing their employment decisions.”

Pumping a dry well

Taken together, these factors have shattered the popular narrative of nursing jobs that are easy to come by. Cedars-Sinai hospital cut their job openings for new grads from 250 last year to 100 this year. UCLA’s hospital typically has two new graduate intake sessions – one in the spring and one in the fall. This year, the spring session has been canceled.

“A lot of nurses have applied to the UCLA new grad program in August,” said Kathy Carder of the California Nurses Association. “But in the meantime, they’re wondering how they’re going to feed their families.”

It took Cedric Lara seven months and 40 applications to find a job after he graduated with an associate’s degree in nursing from Whittier’s Rio Hondo college in May 2009.

“When I was in school, I was looking at jobs and seeing the well dry up,” Lara said. “Even hospitals where I looked during clinical rotation – Kaiser, Downey Regional, Presbyterian – by the time I graduated, they had hiring freezes.”

In Northern California, the prospects are even worse. Jessica Martin graduated with a master’s degree in nursing from the University of San Francisco in December, and she said just six of the 25 people in her cohort have gotten jobs so far. Those who have relied mainly on personal connections.

“It was pretty misleading,” she said. “The people that graduated before me were getting jobs easily, and people were recruiting them. But then I graduated, and there’s nothing.”

Martin is hoping for an operating-room job, but so far the only hospitals admitting new grads are those like Stanford, where there are 600 applicants for three to six open positions.

“I’m sending my resume out into the ether, and nothing is coming of it,” she said. “It’s fairly hopeless right now.”

For some, hope lies in less sought-after jobs outside of hospitals and doctors’ offices.

“Before, a new grad had 20 offers, but this is forcing them to seek other opportunities than what they thought,” said Kathy Lopez of the National Association of Hispanic Nurses. “Some students may have to start in a convalescent home, or maybe doing flu clinics.”

Some, like Martin, are looking out of state. Her student loans are coming due, and the alternative is moving back in with her parents.

“I’m 28 years old and I might be financially dependent again,” she said. “I’m trying not be be bitter and angry about it, it just takes time.”

Ironically, California is still projected to have a nursing shortage in 2020, especially since the older nurses are likely to swiftly re-retire after the economy rebounds.

Until that time comes, however, a pool of cash-strapped nursing school grads wait with increasing frustration. Healthcare experts hope they don’t give up before the recession does.

“We’ve been working hard to build our capacity, and we’re worried that if new grads can’t find jobs, we’ll lose the gains we’ve made,” Jones said. “Because if they leave California, they may not come back.”

Olga Khazan is a graduate student at the the University of Southern California’s Annenberg School of Communications and Journalism. She is a senior editor at Digital Tommy, the voice of Annenberg Digital News. More of her work can be found at OlgaKhazan.com.

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Guest

Naim tersenyum. Baru dia hendak menutup buku biru itu, Memandang wajah suamiku yang sudah masam. Aku jumpa di dalam beg tanganku ketika aku hendak mengeluarkan telefon bimbit.“Tapi, Nak tak? Arghh! Tapi mengapa wanita itu seolah-olah sengaja tidak mahu memahaminya dan masih ingin dirinya dilepaskan.“Awak lupa ke. emak dan nenek Baha.“Saje je.” “Er.taklah bukan Saya tak kenal awak.Terima kasihlah cili padi. Ha.Mamat: saya nak naik tangga ni.(sambil tersenyum)Aku: HuhKisha: Takpe-takpe aku ceritakan nantiKisha pun menyampuk perbualan aku dengan mamat itu Kemudian Kisha mengajak aku duduk diserambi rumahnyaAku: Yang kau dari tadi tu tersenyum je macam kerang busuk tu apasalKisha:ha. Malam lailatul… Read more »

John G
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John G

Few of my batchmates found the jobs in India. They were hunting for a job in California for the past 1 year. They took up the India offers and moved there. Others have found similar offers in South America. According to them there is indeed a true shortage of nurses in Third World countries and you have your choice of speciality too. Life Style and Pay is as one can expec in Third World countries but its better than wasting the precious years in US.

Amy
Guest
Amy

John G: How would someone go about getting one of those jobs? Did your batchmates have previous experince as an RN and did they all have Bachelors degrees?

Marie
Guest
Marie

This reminds me of 2 nursing articles published about a decade apart (late 70’s & 80’s) entitled “Why we eat our young” & Why we still are eating our young.” I do plan to retire within 5-7 years & hope to find a well prepared young nurse to replace me. Unfortunately, there are multiple sides of this dilema: First- healthcare facilities have to invest in the new nurse and also demand that schools turn them out better prepared. In most hospitals the ADN and BSN grads start at the same pay and with the same level of preceptorship. Weaker nursing… Read more »

RT
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RT

No place for older workers either, and degrees don’t count. I graduated from a diploma program, have a BS and MN. I have 10 years med/surg background, including supervisory positions and 22 years psych experience including ER assessments/triage. I took 2 years off, then went job hunting. No dice. Moved to GA because they supposedly had such a huge shortage of nurses. No dice. It was suggested that I do a ‘refresher course’, passed it, hands down, 98 out of 100 questions, predominately medical/surgical. Took me 9 months to find a job at less than 1/2 my previous job. Grady… Read more »

p
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p

No Country for Young Nurses sadly over the years nusing education has not changed the time frame while it has increased exponetially what our young nurses have to learn. . .It is not possible to learn all one one needs to and to get the practical experience in current education programs. While there are still theories about who is trained for what level the market does not reconize them. . .a license is a license and education is not considered. additionally, Nursing is hard and new grads are often astounded. In addition to the fact that they are insecure, they… Read more »

Brand
Guest
Brand

Colonel Pat Wise found a job working as a TV Consultant on “China Beach” . There is work to be had as consultants if you want to inflate your resume with experience you did not get in Vietnam. A knowledge of earrings is highly desirable. Send your resume to HIMSS.org.

Mollie
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Mollie

Don’t give up hope. Nursing has been evolving since its inception and will continue to grow and develop further. There is a place for everyone from the beginner to the experienced. Nurses are in the unique position to provide total patient care – it is more cost effective for most hospitals to use exclusively nurses without nurse’s aides. The more exposure you get in all aspects of nursing, the more invaluable you will be. Even though I have more than 20 yrs experience as an ER nurse, the recession affects me negatively as well. I broke my leg on a… Read more »

um, no.
Guest
um, no.

No. Do not come to TX.

Katelyn
Guest
Katelyn

Brianna,
I also live in Ohio and my school just recently lost it’s accreditation for the nursing program! Obviously I am very upset and trying my darndest to find another program that is highly recommended and legit! Where do you attend? Any tips? I just moved here from Texas a little over a year ago so I am a bit lost! Thanks so much!

ksRN
Guest
ksRN

It is depressing. I was naive in thinking that I would start working as soon as I passed the boards. It’s been 23 days now. I’ve applied almost everywhere, made telephone calls, and I still have not received any call backs for interviews.

Courtney
Guest
Courtney

ok. So I’m a nursing student living in Ohio. I hear it’s bad out there but I also see new grads from my school as well as others getting jobs right out of graduation. new grads are working as ICU nurses, on first shift! It just gives me hope that things will work out ok when I graduate in May of 2011 that things might be a teensy bit better

Brianna Robinson
Guest
Brianna Robinson

I graduated top of my class and have applied all over the country, getting the same response (if any one bothers to get back to me). They aren’t hiring any new grads or they aren’t hiring new grads that don’t have licenses in that state. I can’t afford to get a license in every state. So until someone wants to take a risk, I wait.

Amy
Guest
Amy

LOL I was just telling my friend that as well. What am I supposed to do, get a license in all 50 states and just apply at every single hospital in the country? Unfortunately I am not made of money and could never actually do this but I am starting to wonder if this is what it is coming down to? I just wish I wasn’t lied to about how easy it would be to get a job once I had my RN license, especially a 2 year one!

J. Carson
Guest
J. Carson

It must be so difficult for these new grads! However, there are plenty of jobs in other parts of the country. If people are able and willing to move, they might have better luck finding a position. Here in TX there are plenty of positions available.

Amy
Guest
Amy

Plese enlighten me as to where these plenty of jobs in other parts of the country are because I have had no luck and it’s been a year. I have a TX license as well and still no luck. Where in TX?

Lisa Xiong, RN
Guest
Lisa Xiong, RN

How depressing…..I hope things will turn around soon.

Aion kinah
Guest

It is time to change the curricula in the pre-licensure and graduate nursing programs to prepare students to assume a leadership role in the new preventive health care model proposed by the federal government.