New Nursing Shortage
This is an op-ed I did for Nurses’ Week that ran in newspapers across the country. Perhaps some of you have seen it. I’d love to hear your experiences about getting jobs as new grads, or even veteran nurses.
Nursing shortages? They’re supposed to be yesterday’s news. In a bad economy, nurses whose husbands or wives have lost their jobs are hanging on to theirs’, with retirement savings wiped out, nurses are delaying their own. According to American hospitals, all this means that we have plenty of nurses at the bedside. Remember those alarms bells that rang at the turn of the new century, warning of catastrophic nursing shortages? Well, they’ve all have been turned off. Maybe we will short a couple hundred thousand RNs by 2020, but for now –not to worry.
As we celebrate this year’s Nurses’ Week, we should ignore those convenient bromides and begin to worry – big time.
First of all, the nursing shortage that has been declared a thing of the past is very much present in hospitals today. To cut their budgets, most hospitals are not hiring enough nurses to adequately care for the kind of intensely sick patients that fill hospital beds today. These are patients who are receiving invasive procedures and toxic treatment – patients who need intense monitoring by nurses. They may not be getting the attention they need because nurses are assigned so many patients — – say six or eight on day shift or nine or maybe even more at night rather than four or five. Even though hospitals may record no RN vacancies, at these kind of staffing levels, patients are still experiencing a shortage of necessary nursing care.
What’s more, hospital hiring policies are plugging the pipelines that produce new expert nurses. To put it simply, very few hospitals are hiring newly minted RNs today. New graduates from nursing schools all over the country are reporting difficulty finding jobs. Nurse managers tell me their hospitals just aren’t hiring new grads. “I’m only allowed to hire experienced nurses, which I am having a hard time finding. I can’t hire any new nurses,” a nurse manager at a teaching hospital complained.
This, of course, creates a patient care catch- 22. If hospitals won’t hire new graduates, the new grads can’t get experience. If they can’t get experience, then whom will hospitals hire when experienced nurses leave their positions? And since the average age of the RN is 47, a lot of RNs will be retiring in a few years, no matter how bad the economy is.
To make matters worse, nurse managers tell me that hospitals are not expeditiously filling positions left vacant when an RN quits or retires. As one nurse manager at a major hospital in the Northeast told me, “They won’t allow us to fill a position once we know someone is leaving. We can only fill it when they’ve left. Then it can take up to a year to go through the search and paper work to get someone in that position. So we’re working short for an entire year.”
For working nurses all this will sound terribly familiar. And just as happened during the 1990s, these practices are bound to produce another catastrophic nursing shortage in only a few years. The fundamental problem is that politicians, policy makers and health care administrators don’t seem to understand that it takes years – at least eight to ten –to produce an expert nurse. Hospitals seem to think you can turn on the spigot and get hot and cold running nurses. Then, when your budget gets tight, you can turn it off and, when its convenient, turn it on again. That’s the kind of magical thinking that got us into trouble in the 1990s. Unless hospitals are forced to change their ways, as baby boomers like myself get older and sicker, there may not be anyone there to answer the buzzer.