Nursing shortage?

[kslib]

Well, I just heard a story on the radio today about the "brain drain" in the Phillipines. They are "outsourcing" nurses at an alarming rate to the U.S. and some other European coutries because of the severe shortage of nurses. They now have an even greater shortage there, and can't get enough nurses to stay and support their failing health care system. Even doctors in the Phillipines are going back to school to become nurses because they get paid so much more in the U.S. as nurses then as doctors in their home country.

It would seem that we need to churn out more nurses here to help with this crises of the severe nursing shortage.

Now, I've just been put on a two to three year waiting list to get into a nursing school. Not a "prestegious" 4-year school; a two year program. And this isn't uncommon. 125,000 QUALIFIED applicants were turned away last year because there aren't enough teachers. (this is according to the National League of Nurses, some estimates are much higher)

To be a teacher of an ADN program generally requires a Master's degree. The pay? An average of $40,000. Half (at least) of what they would earn as a Master of Nursing in the field or management. Less by about $10,000 of what a Bachelor's degree RN makes on the floor. The average age of instructors is 48 years old. Most are in their upper 50s. Which is great for me because I get the benefit of their years of experience, but bad because they are going to retire, and who will take that pay cut to teach?

Get used to it people, the nursing shortage will get much, much worse, patient ratios are going to go to hell, and the care will suffer dramatically. Aides will be relied upon to give increasing amounts of care that they may be untrained for, and things will get overlooked (like med errors, bedsores, etc.) because there will be no time to do a proper assesment.

Support your nurses, they work hard, and are a valuable commodity. Fight your congressmen and governors if they propose an increase in the patient ratio because it is a temporary fix. They can say "see there's no shortage, each nurse is SUPPOSED to have 10 critically ill patients to care for, not 3-5!" It is a quick fix to enable them to ignore the problem until it gets so bad they must fix it; until people die on someone else's watch.

[whodiedandmadeUSgod]

1. Thanks for your post.

I'm a nurse with an Associate Degree. I've been working in the field for the last 16 years. There is a shortage as when I worked on the floor we would be 4-5 nurses short at times especially Saturday mornings. It is a difficult job but also rewarding. Best wishes to you.

[kslib]

2. Thanks!

And thanks to you for all you do! What kind of nursing do you do? I'm interested in either community health (working with Indian Health Services) or ER. I've worked a lot in the nursing home industry as well, and that could also be a possibility, but they often barely make enough to live on I've heard...

[TNDemo]

3. Preach it, sister.

I have been on the waiting list for a two year program for a long time but I think I will start this fall. The media always acts like there just aren't people willing to do it but in reality they can't find enough teachers. It's a bottleneck at the school level.

[PEmboli]

4. there's been a nursing shortage for 15 years now

I'm a PICU/NICU and have been for 20 years. We've been bringing nurses here from the Phillipines, Haiti and Nevis for about 10 years now. It's nothing new. I'm not sure how it is where you all are, but we get paid very well and have excellent benefits. I do 3 7p-7a shifts a week with 4 days off. But, not a lot of young people want to go into nursing or quit soon after they start.

[TNDemo]

5. Why do you think they quit soon after starting?

What is different from what they were expecting?

[tavalon]

10. I can answer that one

About five months after you asked it. I just happened to run across this thread.

I've been a nurse for over 15 years. The only way I've been able to stay in nursing is by changing hospitals every couple of years and sometimes every few months. The patients are generally great (some exceptions but, hey, when you're sick......). The problems are threefold (at least), the administrations don't support the nurses, many of the doctors feel that they are nurse's superior (instead of colleague, as they actually are supposed to be. Nurses and Doctors are supposed to be complimentary, not hierarchical) and that abusing a nurse is, well, normal and lastly, the public sees us as virtuous angels, fully disregarding our professional abilities. A seasoned nurse has done about 100 assessments and is forming a plan to help you after five minutes in your hospital room but she (predominantly female) is remembered by you as being "so sweet".

[Warpy]

11. 15 years? Try 25

They were bringing in nurses from all over the world when I started in 1982. The nursing shortage is a longstanding problem and the factors creating it have simply never been addressed. Now there is a massive shortage of nursing instructors in the US, so the bandaid fixes of tuition breaks for student nurses and low interest loans are simply not going to do a damned thing.

If they want to end the nursing shortage, they're going to have to do something about the JOB. The acuity of patients (meaning how sick they are) has gone nowhere but up while staffing has gone down. Hours have gone up, and 12 hour shifts with mandatory extra 12 hour shifts are now standard. The job wrecks your back, wrecks your health and wrecks your family life.

Pension plans from nursing are laughably low, and hosptials that own HMO plans often give the worst plan to nurses, using them to subsidize the big breaks the HMOs give to large corporations. Nurses are the most likely to be uninsured or underinsured of any profession in this country.

Nurses in this country have been treated like SHIT for decades. They're the first place hospital bean counters cut costs and the last to be cared for by those institutions. Hospital management need do nothing but look into their mirrors to find the root cause of the nursing shortage.

[HuckleB]

6. Yeah, the teaching pay is a serious sacrifice.

I'm an NP who is consistently recruited to teach at area nursing schools, but I just can't justify the pay cut for my family. I take as many students as I can into the clinic to get necessary experience, but I still feel guilty that I'm not teaching. At the same time, there is a shortage of people in my specialty, so I'd feel guilty spending less time at the clinic, too.

[kslib]

7. So glad to hear that others know about this.

I wish more people outside of the industry knew as well. To the poster who talked about people quitting soon after they started. Do you know why? Tough shifts? Emotional drainage? Old nurses "eating their young?"

I've heard this a lot, and it does concern me a little. Hope I don't become a statistic! I think I'm in a little better position to understand the pressures I'll face since my mom is a nurse, and I went to school for/trained as a nursing home administrator for a few years. I've heard that med/surg and elder care can be really tough environments. Conversely I rarely hear peds nurses complain about their jobs (or if they do, it's often done with a little smile--as in "oh those babies!") I've always thought that perhaps this might be due to the popularity of the specialty so there are more nurses trying to get into peds, and since you have to really, really pay your dues to get into a NICU, then you must really, really want to do it.

Thoughts?

[HuckleB]

8. Interesting thoughts.

You may have a point re: peds patients and nursing "happiness." My anecdotal experiences do seem to back this theory up, though not just for NICU nurses, but for nurses on more "med/surg" type pediatric floors and in children's hospitals, even on cancer units.

[Warpy]

12. I've never seen that "old nurses eating their young"

phenomenon. What really happens is that staffing is so piss poor that the new nurse is pretty much thrown to the wolves in her first job. It's sink or swim, because we are already running as fast as we can just to make sure our patients are taken care of. A tentative, unsure of his/her skills new grad is going to feel awfully lost. THAT is what is going on, not abuse. Nobody has the time to hold their hands and do the type of teaching that every new nurse desperately needs. Some of them crack and leave.

Then there's the reality of staffing cuts by attrition, shortened hospital stays leading to only the sickest of the sick being in the hospital, and reductions in ancillary staff from phlebotomists to housekeepers and their work being dumped on already overworked nurses.

It's a tough job and it will have to change if people want nurses there to take care of them when they get sick.

[Heddi]

9. I'm a nursing student -- 1/3 of the way through for my RN degree

The school I go to has 24 open slots, and they admit 3x's a year. That's 72 students per year that are admitted to the nursing program.

Last quarter, they received over TWO HUNDRED APPLICATIONS for this fall's nursing program. TWO HUNDRED APPLICATIONS for 24 spots.

I don't know how it is in the rest of the country, but out here in Washington, all of the schools grant enrollment into the program on a "point based" system. You get so many points for your GPA, so many points for work experience, so many points for having a bachelor's degree, etc.

Luckily, the school I am in was the last school in the state to have a wait-list system. They just changed to point-based for Fall Quarter 2005. I had to move 1/2 way across the state to get into this school because it was the first one that accepted me, and I can't play odds like the ones you're rolling when you're getting into a point-based system.

At the school I took my pre-req's at in Seattle, you were pretty much SOL as far as entrance into the nursing program if you had less than a 3.9 GPA, and didn't work in health care for at least 10 years. 80% of the applicants that were accepted had been EMT's or Paramedics---that's how they got in.

I wasn't just competing (in pre-req classes) with myself, or even just with the people I was going to school with---I was competing with EVERY SINGLE PERSON IN THE STATE OF WASHINGTON to get the best grades I could.

Because of the timeline I was on, I was taking 18 credits a quarter, doubling-up on hard sciences (I took Anatomy AND Microbiology during SUMMER QUARTER---which meant 3 months of normal-quarter class time was squeezed into 8 weeks. Talk about PUSHING!!!)

It's impossible. AND now the State has just passed some thing where you can only repeat "high demand" classes like Chem, Bio, Anatomy, Phys, Microbiolgy ONE TIME. I was in biology with people who were taking the class for the 4th or 5th time JUST to get a higher grade than a 3.75 or 3.8. It was brutal. I saw people steal notes from other people, sabatoge tests, purposefully disrupt class so that OTHER PEOPLE would fail or get lower grades so that the disruptor or sabateur would have at least some advantage to the 'point based' system.

Not only that, but funding for community colleges is just depressing. THey don't have the money in the budget to expand class space, they don't have the money to hire ARNP's (nurse practitioners---the only people who can be nursing instructors) at a decent rate (My professors are all ARNP's---they make about $35k teaching. IF they worked as nurses in their field, they'd make about $75k+ per year). THey don't have the money to expand clinical areas in hospitals---right now, we are in clinicals at a local hospital and there are 12 students to 1 teacher. That's 12 students who ALL need instructor supervision to give meds, do certain procedures, etc. She's stressed, we're stressed, and everyone is getting (in a way) the short end of the stick because of funding crises.

EVERYONE who is in my class has worked their ASSES Off to get where we are right now. I"m fucking LUCKY AS HELL to be in a nursing program to begin with---firstly because the pre-req's are so demanding, and secondly because there's just not enough spots.

Thanks so much for this post. I get really infuriated sometimes when I see all the "DOWN WITH DOCTORS! NURSES ARE SATAN INCARNATE" threads that come up when someone has a bad experience in a hospital, or gets a shitty bill for a minor service. I just want to shake them and ask if they have ANY idea the time, sacrifice, money, and dedication I (and all other nurses & dr's) have put into just getting INTO a program, much less getting through school? We're doing the best we can to decrease the number of patients that a nurse has to care for---which would of course decrease hospital errors, decrease health care costs, etc.

I'm gnawing at the bits to get through this program. Four and a half more quarters and I"m a Real-Life Honest to Goodness RN. I can't wait. At least DU can rest easy in the fact that come June, 2006, there will be 24 more RN's out there to decrease current workload. In September, 24 more....If only programs could get expanded so that 24 turns into 50...then 75...then 100......

Those will be the days!

[Sgent]

13. A hospital near me

Who has had a rural family practice residency program for a few years just opened a 2 yr nursing program. They use employed nurses as instructors, and I imagine they pay them their regular salary.

They do have a requirement to work for them for 2-3 years after graduating, but that's not a huge issue (IMHO) given that the hospital is considered one of the better places to work, and most nurses want at least a year of med/surg experience anyway.

[MountainLaurel]

14. Finding instructors

Is a major problem at the community college where I work -- the nursing program would have the capacity for twice as many students (we just opened a new medical campus) but for the lack of qualified nurses willing to teach.

[Warpy]

15. They may have to abandon the paper chase

and hire instructors who have been nursing for 20 years instead of nurses who jumped through academic hoops instead, getting that advanced degree.

This isn't to say that those advanced degrees are worthless, but we're living in a world that discounts experience in the actual job in favor of advanced degree preparation. Both should be utilized in nursing education. If they aren't, the situation in nursing education with a lack of instructors is going to worsen.

[HuckleB]

16. A lot schools already use RNs without advanced degrees.

The problem is that most RNs can make far more money outside of "academia."

[MockSwede]

17. Nurses licensed versus nurses practicing

I'd suggest we search for more details about 'shortage'. What percentage of currently licensed are just not practicing? Will indicate a shortage in actual numbers available versus need as opposed to unattractive job situation. (Relative versus absolute shortage, job satisfaction versus not, etc.)

In pharmacy, you cannot find anyone under age of 60-70 with license NOT practicing, and there are chronically 10,000+ open positions (about 165,000 total RPhs in US) and number is increasing while total pharmacy school enrollment is dropping..... And workload is increasing, too. You could double the pay today and still not fill those positions in less than 7 years.

In about ten years patients will have to learn how to DIY! DO It Yourself! Good luck.