THCB

Nursing Shortage: Is it a Case of Crying Wolf?

How many times have you read about the staggering shortage of nurses? It’s routine to see numbers in the hundreds of thousands tossed around – representing the seemingly insatiable demand for nurses from an aging population. I’ve always been suspicious of these estimates. First, it’s not how the economy works. We’re not really going to have 260,000 unfilled nursing positions in 2025. Either supply will rise, demand will fall or there will be a substitution of other kinds of labor or capital. Second, these numbers often come from interested parties, usually advocates for higher nurse pay and benefit or people who are running nursing schools and would like them to expand.

So I was struck by an article today that mentioned a glut of nurses, even in places like California that mandate minimum nurse staffing ratios. The situation is blamed on the recession, which depresses demand as hospitals and other nurse employers seek to control budgets, and also increases supply as nurses delay retirement, seek more hours, or return to work when a spouse is laid off. I’m sure there’a lot of truth to this, but if there is really such a big shortage it shouldn’t turn into a glut so quickly.

I don’t think employers of nurses are quaking in their boots due to the prospect of a gaping shortage of nurses. Although they might not say so openly (since everyone loves nurses) the forward thinking hospitals are planning for the day when nurses comprise a substantially smaller portion of their costs than they do now. They’ll do it with better decision support systems, workflow tools and robots that will take over many routine and high-skill nursing functions. Hospitals may seem capital intensive now, but I really believe there will be even more substitution of capital for labor in the future.

So if you’re betting on a giant nursing shortage in the year 2025 my guess is you’re going to lose.

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.

THCB is looking for nurses to blog on this and other topics. Send your posts to john [at] thehealthcareblog.com

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Marie BerberichAbdul ShurtliffMicahAnne JudsosnEMacDonald Recent comment authors
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Abdul Shurtliff
Guest

Cuando veo su feed RSS que arroja un montón de basura, es el mal funcionamiento de mi parte?

EMacDonald
Guest
EMacDonald

We don’t need to import foreign nurses because there is no nursing shortage. US trained nurses are taking jobs in fast-food restaurants and as topless maids because they cannot find jobs as nurses. We are hearing reports of facilities laying nurses off in anticipation of ACA implementation, not the catastrophic shortage it was supposed to cause. Their selfishness disgusts me.

Micah
Guest

Countries which economies is driven by their labor force such as India and the Philippines for example will always be able to fill this shortage. And also, machines will never replace the tender care of a living person.

Anne Judsosn
Guest
Anne Judsosn

The bottleneck exists. It is the “new grads” that are not only not finding jobs, but are receiving anger, degradation, and humiliation in the community for even looking. I am genuinely qualified to become a nurse and spend my days at the coffeeshop putting in at least 8 new applications per day, each accompanied by a “no” letter.

EMacDonald
Guest
EMacDonald

“the glut of nurses exists in the bottleneck created by the renewed interest in healthcare careers by those disenchanted with status-quo business practices and desk jobs that give little satisfaction.” That’s one I haven’t heard before. Usually when the nurse lobby stirs itself for a renewed round of scare tactics the bottleneck contains all those who desperately want to get their BSNs (aka the only nurse who counts) with “too few seats” due to “too few faculty” even though they are simultaneously demanding that faculty have a minimum DNP degree by 2015. What a mess. Anyway, Dr Buerhaus recently let… Read more »

Bsn student
Guest
Bsn student

Predicting robots performing cares on patients is ridiculous. I hope nobody makes their career decisions based on idiotic predictions like the ones in this article.

Marie Berberich
Guest
Marie Berberich

Robots are already here. Go to YouTube and type in nursing robots. You will find some clunky looking ones whose main function is to lift heavy patients and others who are full scale androids who look so human it is difficult to tell them from the real thing. Japan has a problem of a large aging population which is why they are going down this road. And don’t forget, robotics are already being used to do highly complex surgeries. By the way I am one of the BS in nursing students with a high grade point average , who was… Read more »

Majicdanser
Guest
Majicdanser

While I can see your point that automation and technology will improve greatly in the future – with a genuine point of reducing human error and improving patient health outcomes – there is one critical element that they cannot provide. This is intelligent decision making, critical thinking regarding proper treatment modalities, and of course, the healing human touch. A machine administering medication may not only cause fear in the patient, but interaction precautions and post-administration reactions require the education and experience of a human being. Right now, I agree that we should NOT be focusing on the “nursing shortage.” The… Read more »

Sandra_Raup
Guest

Just to clarify – are you suggesting we need highly educated or highly experienced? Are you talking about skills in reliably and competently performing a complicated task, such as those that involve complex machinery or that require difficult manipulation (lines, airways, etc.)? Or are you talking about the need for more cognitive skills – such as observational or computational skills? I think it’s hard to determine what training, education and experience is needed without thinking about what’s really needed and how best to get there. I’m not sure more (classroom) education and residency experience are both needed; if they are,… Read more »

Irene
Guest
Irene

There may be a shortage of nurses willing to work for $15.00/hr, which I think is the health industry’s goal. Also, if we would finally solve the horizontal bullying crisis, 1 in 5 nurses wouldn’t leave the profession.

John
Guest
John

It seems there is always some sort of discussion surrounding a shortage of nurses in the healthcare industry. What perhaps is an interesting take off on this article is discussing the expanding roles nurses may occupy with the passage of the ACA and the need to keep practices running. It might just reframe the nursing shortage discussion we hear way too often.

http://bit.ly/Aypg0G

Shyrock
Guest
Shyrock

Although “glut” may be a strong term, this is happening all over the country. See this brief from Virginia here:

http://www.dhp.virginia.gov/hwdc/docs/NursePrograms/2010FactSheet.pdf

It seems a decade of shortage projections may have had the intended effect–higher production of nursing grads. New models of care and increased competition may mean BSN and masters trained nurses become more valuable, while ASNs and diploma-trained nurses find fewer and less rewarding opportunities. (As in most professions, the need for constant education is increasing.)

Irene
Guest
Irene

I find that hospitals will hire an ASN with experience before they hire a BSN with none. Also, the industry said they would do away with the LPN, and I see plenty of LPN jobs out there. The only reason I won’t go for a BSN, is because the curriculum is mostly management/social work, which doesn’t warrant all that classroom work and expense.

Jonathan H
Guest
Jonathan H

RJohn, please enlighten us, since many of us have an interest in the topic but aren’t going to read an entire book on it. On what basis is the argument for a shortage made? If the claim is that there is a shortage of jobs compared to what society should have from a public policy or historical per population levels, then I don’t see how you’ve refuted his point. If the argument for a shortage is based on data showing that many open nursing positions are going unfilled, at a rate higher than open positions generally, then I’d say your… Read more »

AM Judson
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AM Judson

I am a new RN, BSN, and I graduated without a job. 8 months later, I’m still spinning my wheels putting my CV online and begging for a chance to be part of the nursing field (I have a near-perfect GPA). The hospitals hear “new grad” and I get hang ups, rude comments, and slammed doors. If there were a nursing shortage, there would be new grad programs. As it is now, anyone in nursing school is NOT guaranteed a career or even a job.

RJohnRNfromMiami
Guest
RJohnRNfromMiami

Also, the work of Dr Linda Aiken, Christine Kovner, and countless articles published in “Health Affairs” are very informative and will be very helpful as you write your “factual” re-blog on this topic.
Thanks.

RJohnRNfromMiami
Guest
RJohnRNfromMiami

Mr Wiiliams,
Smart and educated, well-read folks happen to read this blog also. So may I suggest you read extensively on the topic, gather empirical evidence, and avoid conjectures. While I respect your right to journalistic freedom, you have the responsibility to publish facts not “guesses..” I highly recommend you purchase this text below and read it cover-to-cover and re-blog.
“The Future of the Nursing Workforce in the United States: Data, Trends, and Implications. By Peter Buerhaus, Douglas Staiger, & David Auerbach, 2009, Jones & Bartlett Publishers.
Thanks, John

RJohnRNfromMiami
Guest
RJohnRNfromMiami

Mr Wiiliams,
Smart folk and educated, well-read folks happen to read this blog also. So may I suggest you read extensively on the topic, gather empirical evidence, and avoid conjectures. While I respect your right to journalistic freedom, you have the responsibility to publish facts not “guesses..” I highly recommend you purchase this text below and read it cover-to-cover and re-blog.
“The Future of the Nursing Workforce in the United States: Data, Trends, and Implications. By Peter Buerhaus, Douglas Staiger, & David Auerbach, 2009, Jones & Bartlett Publishers.
Thanks, John