The Dog Ate My Care Plan…

Just a mom/wife/nursing student extraordinaire trying to make it in the big bad city…

What Nursing Shortage???

Posted by isntshelovlei on July 13, 2010

I came across an article today about how even in this “nationwide shortage of nurses,” one of our local nursing schools’ grads can’t find jobs. So let’s have at this so-called nursing shortage thing.

Many people think it’s the economy. The hiring freezes. That nurses are working to later ages—even past retirement. Among other things. And all of those things probably do contribute to the problem. But this is my spin on the situation. I live in the Delaware Valley / Greater Philadelphia area. IMHO (and what do I know anyway?), I don’t believe there is a nursing shortage here. Why? Because this area is just too saturated with nursing schools. Diploma programs, and ADN programs, and BSN programs oh my! There are day programs and there are evening/weekend programs. There are even various accelerated programs (such as Villanova’s BSNExpress, Jefferson’s FACT, and Drexel’s ACE) that are pumping out new nurses as fast as every 11 months!

Now what surprises me most about not a single one of the AMH Dixon SON grads being able to secure a job yet is that the school is part of a hospital. A lot of their students do in fact think that gives them an edge as far as securing a job after graduation—which evidently is not the case. I have noticed job postings on AMH’s website for “Clinical Associates” (tech-type positions) which are only open to their own nursing students—why not initiate something similar for their graduates? One would think they’d be able to hire at least some of their own grad nurses.

Secondly, Abington is a diploma program. Though they have recently partnered with Jefferson to offer an RN-BSN or RN-BSN/MSN option after you’ve completed their program, that really doesn’t help the new grads right now, with their fresh diplomas in hand. And depending on where/what type of setting (hospital, etc.) you’d like to work at as an RN, know that many of the major players (at least in this area) are now moving from a “BSN-preferred” to a “BSN-required” model. Just food for thought.

Before anyone gets their panties in a twist, please know I am in no way bashing Abington or any of the other diploma or ADN programs—in fact, I almost went to Abington. It’s a great school, the faculty that I’d dealt with were great, and they have stellar NCLEX pass rates—though if it’s anything like my program the bad test-takers and flat-out slackers are weeded out of the program way before you get anywhere near the NCLEX (which is why I never really considered NCLEX pass rates as a determinant of how good a program was). But in the end I decided that it would be best for me to pursue the BSN. Besides the fact that I just couldn’t wrap my head around going to school for 2 years and just getting a diploma when I could go for an extra semester and get a BSN, again, where and what type of position I plan to pursue after graduation requires the latter. That’s just the way the cookie crumbles.

So is there really a nursing shortage? Maybe—in Texas, California, or the Midwest—but not so much here in the city of Brotherly Love…

27 Responses to “What Nursing Shortage???”

  1. Patricia Nelson said

    Nursing shortages are usually geographically related…I moved from NY, where I had a job right out of school at the hopital where I trained in 1989.
    I arrived in San Diego, California to find that they didn’t have a nursing shortage and they wouldn’t even allow me to interview for an ICU position because I had just moved there and didn’t own a home. They told me I could interview after I had established residency for at least a year. I took a position through an agency but found I was canceled frequently.
    I was headed back to NY when I stopped in Nevada to visit friends…checked out some hospitals (they only had one surgeon in town performing heart surgery at that time & nurses were still wearing the white caps, I only had worn mine for graduation) – they offered me a postion, paid to relocate me, gave me a sign on bonus & I went right to ICU…so, the need is different in every city/state.
    I am a re-entry nurse in AZ right now were jobs are few & far between but, most places are taking experience over new grads, except for the county hospital…they will take new grads before they take experienced re-entry nurses. I will be applying in the next few weeks …I will let you know how it goes.
    I love reading your blog!

  2. KLS said

    There isn’t one in Northern VA either, and it sucks.

    • janet said

      I’m a clinical instructor for two schools in Northern VA & am an ICU nurse at a large hospital in the area. What has helped my students is first I tell them to network while in school. Also your clinical instructor can be a good resource; I’m pretty bold about asking managers and patient care directors if they are hiring. If they are and I have an outstanding student…it is a win-win.

      Many new graduates (and this may not be you)- apply for jobs post graduation and wait for the recruiter to call them. As I tell my students…you need to WORK IT! Call the recruiter, find out who the patient care director is by calling that unit and shoot them an email with your resume. Also accept that you may not get that ICU/ER/L&D position but you may get a tele floor or postpartum unit.

      The market is easing up around here versus 2010 BUT you must network!

      • isntshelovlei said

        Thanks for your comment–great advice!

        I actually work in a NICU and so I get to network on a daily–or nightly since I work nights–basis. I’ve also reached out to the nurse manager on the floor where I’d really LOVE to work. We’ve met and talked; they took me around for a tour and to meet some people; and I was invited to come shadow a nurse (had a GREAT time!). I finish nursing school this December so I’m just trying to get my name and my face (and my interest) out there because we are a big hospital. I think it’s going well. 🙂

        I also think it’s helpful for students to work as a CNA/tech/unit clerk (on a unit they’d like to work on is even better). This is only a guestimate, but at my hospital, about 90% of the new RN hires already worked here in some type of tech/nursing student capacity.

    • Quinda said

      I am a RN with many years of expertise in PICC line insertion, IV infusion, IV teams, Pre op Post op, Ambulartory Care, and even Utilization/Quality control. I am living in Northern Virginia and have been applying for positions for 6 months with no calls backs. I found a position reviewing VA contracts with very limited hours. First time since I graduated in 1995 that I cannot find a job. And I network, network, network. Unbelievable. I feel sorry for the new graduates. I need a job …:)

  3. nurseXY said

    Shortage doesn’t equal jobs.

    If the hospital doesn’t open the positions, they can’t be filled. Meanwhile the units scramble to staff for patients on hand. They pay overtime, bonus shifts. Just seems to me another regular time person would be cheaper, but what do I know.

    • isntshelovlei said

      So true (but what do we know lol). And safe staffing ratios–is a whole other can of worms that I think I’ll save for another blog…

  4. Susan said

    I moved from Chicago to Philadelphia last year, trying to get my first nursing job. I graduated from nursing school in December 2008 and moved out this way to be closer to my boyfriend at the time. I applied to over 150 jobs (that’s after I started counting!) in Philadelphia, New Jersey, and Delaware…I even went as far as to apply in Maryland and Connecticut because I couldn’t find ANYTHING. Five months later, I finally got a job at a small community hospital (I wanted a big city hospital…), and I had to take it because I had nothing else. I knew from the start that this wasn’t the place for me, but at some point, a job is a job. Things are better now that I have a year of a experience, but it’s been a rough year. The funny part is that a lot of the city hospital are now telling me that they don’t feel I can “handle their acuity” coming from such a small hospital…yet they hire new grads. Drives me crazy!

    I know in Boston, they tell their nursing students not to even bother trying to get a job in city…how sad.

    • isntshelovlei said

      150 jobs?!? Wow, that’s crazy, but I totally believe you.

      I currently work at a big city hospital (but in a non-clinical capacity), but am already open to relocating if need be after I’m done my nursing program next December. I always dreamed of working here as a nurse and I figured it would be easier to get in beforehand and just transfer to an RN position once I graduate (and have the advantage of being an internal candidate), rather than apply with the masses. The way things are looking, I’m not so sure that will even be the case. I’ve been applying for tech-type jobs (I have a Medical Assistant background in addition to my nursing clinical experience) trying to transfer within the institution for over a year now with no success. I feel that everyone sees me as a retention risk the closer I get to the end of my program, but I think it would be great to work as a tech on a unit where I may even be able to stay as a nurse! Go figure…

  5. Wanderer said

    Our hospital system just mass interviewed 500 new grads for a pitiful number of positions. Portland, Oregon is not a place to go if you’re new grad looking for a nursing job… Totally saturated market combined with a hiring freeze pretty much everywhere = no jobs. Sucks.

  6. I think, as I said in the post I just wrote about this, that the shortage still exists, or at least is impending. I think hospitals just aren’t hiring and are making do. Also many nurses are delaying retirement, coming out of retirement, working more hours, or going back to work and forgoing being stay-at-home moms. When the boomers retire and when the economy improves, these positions are going to be vacated. If you look at the American Association of Colleges of Nursing statistics, they seem to bear this out.

    Hospitals typically represent nursing as their largest business expense (and it generally is), so that’s where they cut. They feel they need new 64-slice CT scanners, and can make do with the minimum number of nurses to be safe.

  7. Not so much a nursing shortage but a shortage of attractive nursing jobs…


    • isntshelovlei said

      True… And I know a lot of students have their hearts set on certain places/hospitals, certain departments/specialties, and even certain schedules…but we may have to “settle” for something a little different…a job is still better than no job–especially once we have to start paying back our loans!

      • joni89 said

        I can see this being true for some of my classmates who are currently on the job hunt – many of them strictly wanting specialties like ICU cause they want to goto CRNA school or peds cause that is just simply what they want to do.

        But for the couple us (myself included) that are willing to take anything we can get, we are definitely having trouble with even the less attractive ones. I myself am from the Philly region and have applied left and right. Now, my definition of less attractive would be facilities like long term care and nursing homes, not because care is below standard, but because the status quo doesn’t want to be there. But even they don’t want new grads. It seems the phrase “at least 1 year of experience required” is automatically attached to every position that is posted. I’ve looked to Jersey, Central PA, Delaware, Maryland, Virginia, and DC. I’m not even gonna start looking at NYC cause that is probably one of the most saturated cities on the east coast. On Monday, I’ll start looking more west toward Erie and Pittsburgh. Hope there is some luck out there, but I bet UPMC is churning out just as many nurses.

        At the moment, I’m clearly willing to “settle” but still no luck. I hear some cant even get CNA jobs cause they are ‘overqualified’. Talk about barriers from every direction.

      • isntshelovlei said

        Thanks for sharing!!–it’s nice to hear from a local actually in the thick of it all…

        So…this is my problem with “settling…” After I finish my BSN, I plan to go for my master’s. All of the programs I’m currently looking at require 1-2 years of work experience in the MSN program field/specialty. If I’m “forced” to work in some other field, the experience I’ll be getting there will kinda be…for nothing. And while I’ll gladly accept that job offer–because after all I DO need a job–I’ll still be job-hunting for the one I really want. I think this is a concern of some of the employers as well. Say they hire these new grads, with their student loans that they now have to pay, who are willing to take just about ANY job at this point…they train them (which costs money), get them a year of experience under their belts…now they’ve just made them a better candidate for the next job–the one they really want…and the not-a-new-grad-anymore nurse leaves that employer that was willing to take a chance on them. And so now employers hesitate to hire new grads…

        So I’ve tried to do things to make it a little “easier” for me to secure the job I want after I graduate: I’m getting my BSN…I actually work in the hospital that I’ve dreamed about working in as a nurse (in a non-clinical capacity)…AND I even volunteer on a unit where I’d love to work. I’m a shoo-in right?–so I hope. 🙂

        Good luck with your search!

        Sent from my iPhone 4

  8. jon brierton said

    So interesting to read “new grad” comments.
    After 33 years as an RN (bedside practice) it gives me pause…

    In “those days” nursing was an avocation, not a vocation.

    Now, for reasons of economics, “we” wonder about our choices.

    Would that I had chosen Diesel Mechanic, PhD. as my vocation.

    Did I mention, I’m “tired” of it all?

    Best of luck, y’all. You’ll need it !

    Old Nurse

  9. NYBlues said

    I’m a new grad in New York. I can’t find anything. Forget a shortage of just “attractive” nursing jobs. Two nursing home told me they are not hiring new grads right now. The others said they would get back with no response for weeks. I’ve wanted to do this since I was in 2nd grade! It has nothing to do with money or security for me. It’s not like I’m locked into one thing looking at only specialties and hospitals, etc… I’m still working as a nursing assistant and I love what I do! I would just love to finally work as a nurse too…

  10. hesi test said

    Thank you for the wonderful post. I like the way you have explained about importance of nursing. i agree with all you views. Keep writing such awesome post.

  11. Caitlin said

    It’s the same even in the deep south. Here in Mobile, Alabama, we’ve got NOTHING in the way of employment for new grads, and we have 4 hospitals. We are so saturated with nursing programs that 500+ applications are received for every position…

    • james said

      i can vouch for that – mobile alabama market sucks – i am so sick of nursing anyway – im going back to school to be a truck driver – paper is full of job ads – and less stress!

  12. Mike said

    In Pittsburgh, Pa I wouldn’t consider it a nursing shortage but there seems to always be plenty of vacancies. The market here is much different from my native Philadelphia because the most attractive jobs, in the city hospitals, are only run by two health systems. Like Philadelphia there is a saturation of diploma/associate’s schools with multiple community college branches in the same county having nursing programs that really churn out students. Good/bad for those looking for jobs it seems that many of the BSN grads don’t stick around long and many of the Diploma/AD grads either move out of the city into the regional hospitals or leave the profession..very high turnover rate out this way. Same goes though, heard several supervisors comment that if someone is unhappy with their job that they can have an opening posted and receive 25 applications by the end of the same day

  13. Justine said

    I am also very doubtful of the pennsylvania nursing shortage. I don’t believe it is a rumor or a myth, I believe there are places in PA that are indeed in the midst of a shortage. I called the PA association of Hospital and Healthcare Systems who are supposedly taking part in measures to recruit and retain PA nurses, and while the representative could affirm that there are shortages in areas within the state, she also stated that she didn’t believe that the Phila area was one that is experiencing a defecit at this time. Philly is an area that is filled with hospitals. There’s pretty much one on every corner, and while some people believe that this equates to a surplus of employment opportunities, for RNs, this really is not the case in 2012 because for every hospital, there’s also a surplus of schools that, over the past few years, have experienced a surge in funding in response to the shortage and have produced a large number of qualified candidates (new nurses who now have 2-3 years experience) that are now a major percentage of the currently employed. Basically, if you graduated before 2010, your choice of professions was a good one, so long as you can hold a job. I believe the “clamp down” in hiring began around 2010 after the shortage began to taper down. I suppose a lot of RN programs didn’t really discuss the “end of shortage” because a lot of the statistics that were published were based on a national reports rather than local ones. Even if any of the nursing programs were aware that the shortage in the Phila area was ending, what probably kept them filling the rosters was the idea that students could train here and relocate. What they somehow failed to realize is that a lot of Philly schools are really “commuter” institutions where a large portion of their enrollment are coming from local areas and really aren’t planning to move. But new grads aren’t the only ones looking for employment here and getting the cold shoulder. There are loads of qualified RNs with experience who are also looking for jobs. When I graduated in 2002 with my BSN, I was told that nursing was a great career because if you didn’t like your job, you could change specialties and try something new without having to go back to school and pay a lot of money to start in a new field (perhaps one you would like even less). With a lot of hospitals placing recruitment on hold in response to the current economy, this in no longer the case. Being a single parent, I left the 12 hour shifts at the hospital to try homecare because of the illusion it had more flexibility. I even did private duty for a while too. Both had their downsides. The downside of homecare is that while there is some flexibilty in your scheduling, the Bush administration had placed a magnifying glass over Medicare/Medicaid contributions to the industry. They began placing limitations on pay outs to home care companies, while increasing the need for more documentation to justify a patients’ in home care requirement. In response this fiscal loss, home care companies then began to pressure it’s practioners to increase their case load and increase admissions even if it meant kinda fudging your documentation to include patients who would were inappropriate for the service. Part of my written job description was to “assess patient’s appropriateness for home care”, but that soon gave way to the idea that if a patient could somehow produce the funds via private pay or third party, they were considered appropriate, even if you knew they could benefit more from outpatient programs or services that were offered elsewhere. Private duty is rarely a good decision for an RN because, not only is the pay painfully low, but it has limited opportunity for growth if you prefer hands on patient care. It may be different for the management side, but then you’re going to have to look at getting some kind of advanced degree in nursing management if you really want to compete in the Philly job market. When my son started school, I looked to return to the hospital setting. I have been really actively looking for two months. I’ve had one interview, one offer that was recinded, no new prospects in sight, and staffing agancies that won’t hire me because I’ve worked home care for the past two years. The idea that you can move from speciality to speciality has also been put on hold with this economy, and if you decide to change your setting, it’s probably best to have a per diem job in another sector just in case. During the shortage, you could work in another venue and then come back to facility. You could even leave the job altogether to raise children or take care of a sick family member and return to the facillity. I really don’t believe we have those choices any more in this particular urban enviorment. I hate to sound bleak. I don’t think the situation is permanent. There are a lot of changes taking place right now and the focus is going to shift away from the facility and into the community. I think more money will be reserved for preventative programs rather than point of service (i.e medical/surgical) initiatives. It’s ultimately better for our society and may produce more opportunities with higher wages for those employees in clinics, doctors offices, and home care settings. If you’re a new grad from a diploma program, seriously think about your BSN if you plan to remain in the Phila area. An RN to MSN program may even be a better bet. Just keep in mind that everyone else may have the same idea so it might be a good time explore educational options in other parts of the state or even the rest of the country. Hold steadfast to your facility position if you have one. It may be a bumpy ride for the next couple years. Just keep in mind that the jobs in the community may soon become the coveted, high paying positions.

    • isntshelovlei said

      Thanks for your comments. It’s definitely rough in the Philly area–and like you stated there’s a nursing school on every other corner. I was fortunate to land my dream job–it was not an easy task. Good luck to those still searching.

  14. Justine Carpenter said

    I completely agree with you. I also wanted to share with you what I found interesting about the so-called “nursing shortage” in the Greater Philly area. I’ve lived in this area most of my life. I graduated from Temple University in 2002 when there was a glut of programs that allowed new grads to become Critical Care Nurses. I participated in the Gateway to Critical Care Program at PENN. The presence of these programs seemed to reflect the true need for RNs (better than any media publication, or labor department report) and I noticed that within the past few years, they have all pretty much vanished from Philadelphia scene. On an anectdotal level, I realized, myself, after leaving a full time hospital job in the city to dedicate more time to my preschool age son, how difficult it was to return to full time employment in the same sector. I had trouble understanding why this was occuring, seeing as I had 10 years of experience, most of which I had acquired at a level 1 trauma center that prides itself as one of the best facilities in the nation. Many of my friends and overall aquaintances began to insinuate that this had something to do with me, personally, and frankly, I couldn’t blame them seeing as the reports of the nursing shortage continued to flood the media. But then, I realized something. When I was working in a hospital in Philadelphia, I noticed that the approximate median age of the current nursing workforce there was between the ages of 25-28, with the average amount of experience being between 2-4 years. Like many of the urban hospitals, the pay rate offered at the institution where I was employed was based on a tier system, in other words, an employee would receive a certain salary based on years of experience. Unfortunately, I had about 10 years under my belt, and this usually placed me within the upper limits of this compensatory system. This led me to believe, especially in consideration of the current economic climate, that many employers were beginning to favor hiring new employees that fell within the lower end of the pay scale. That the current thought in many hospital HR departments was why hire someone with 10 years of experience, and essentially have to pay them more, when you could hire someone else with fewer years of experience, and pay them less to do the same job? I found myself in the same jobless situation as many of the new grads, but not because I didn’t have enough experience, it was because I had too much. I also thought that having my BSN gave me an edge, but with the recent abundance of accelerated programs being offered, this turned out not to be the case. I do believe there is a nursing shortage in certain areas of the country, and in order to use this to my advantage and actually secure employment, I had to move out of the Delaware Valley. I think it’s also interesting to note that the hospital where I work now has opportunites for new grads in critical care areas and does not offer a tiered pay scale.

    • isntshelovlei said

      Hi there, thanks for your comments. I believe Penn still does the Gateway program, but you’re right you don’t hear about many other programs of the sort. Now securely in my hospital position, magnet status and all that, I’m now afraid to leave the hospital setting to explore others (home care, outpatient etc.) for fear that I will find myself jobless and unable to get back in!! What to do, what to do…

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