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Finding a first job not easy for new nurses
A nurse draws blood from a donor at blood drive.
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Sarah Gardner: Ever found yourself stuck in a hospital bed, pushing that little "help" button and then waiting... waiting... waiting for a nurse? That's when all the headlines about a "nursing shortage" in this country hit home, right?
And if the forecasts are right, we could be short hundreds of thousands of nurses in the next decade. So you might be surprised to hear some nurses complaining about underemployment right now.
We asked reporter Annie Baxter to examine that seeming contradiction -- and here's her diagnosis.
Annie Baxter: A few years ago, Marc Anders decided to make a big career change. He was ready to don a nurse uniform, and throw in the bartending towel he'd sported for years.
Marc Anders: I was just not a very happy person when I was working with that many drunk people I guess. It takes a lot of tolerance and takes a lot out of you.
Anders thought nursing would allow him to do something better for society than serving up cocktails. But he was also motivated by dollar signs. When his sister-in-law left nursing school in the early 2000s, she was greeted with multiple job offers and signing bonuses.
That sounded pretty good to Anders. So he started a two-year nursing program in 2008. And he was surprised to hear soon thereafter that hiring was tapering off. Landing a nursing job could be harder than he thought.
Baxter: Did that give you pause at all when you were in the middle of your program?
Anders: I just knew it was going to take more time.
He just didn't anticipate how much more time. A year and a half after completing his degree in Minneapolis, he's still looking for full-time work.
He's 42 now and has a part-time gig as a nurse at a long-term care facility. He makes about $25 an hour, and supplements that income by still pulling bartending shifts on the side.
But a lot of his time is spent as a stay-at-home dad while his wife works. Their daughter Daphne's six months old and their son Quinn's four.
Anders: Where'd we go on the bike?
Quinn: To the zoo!
Anders: To the zoo? Nice.
Anders really likes being home with the kids, but he wants to be working more hours -- and at a hospital. He hopes that after a year at the long-term care facility, he'll be a better candidate for one of those hospital jobs. They typically pay a few bucks more an hour than what he's earning now.
Anders' wife, Dana DeMaster, says in the meantime they mostly get by on her salary as a research analyst with the state of Minnesota. But the family isn't saving for retirement. DeMaster is tired of explaining Marc's situation to friends who think hospital jobs are easy to come by.
Dana DeMaster: You go places out with people, and they're like, "Oh, Marc doesn't have a full time job yet? I thought there was really demand." Or, "What do you mean? Shouldn't there be tons of jobs out there?" And having to explain again and again and again that no, there's really not.
David Auerbach: So you're getting a lot of new nurses coming out of school into a market where some of them are having trouble finding jobs, which is a very unusual phenomenon historically.
David Auerbach is a health economist with the RAND Corporation. He says there are a few reasons for this weird historical moment: Over the past decade, nursing schools just about doubled the number of grads they produced. Then the recession hit. Fewer people were able to afford health care, which reduced demand for nurses. At the same time, the lousy economy prompted a lot of nurses to delay retirement.
Auerbach: That means there's about more than 100,000 nurses that are in the workforce now who otherwise probably would've retired by now.
Auerbach feels pretty confident that older nurses will step aside in the next few years, and loads of nursing jobs will open up again. And there's the prospect that federal reform could add millions more patients into the health care system. That would mean a greater need for nurses.
Marc Anders is trying to stay optimistic about those prospects.
Anders: That demand isn't going to go away. People aren't going to stop being sick.
But his wife Dana offers a sharper warning to people considering the nursing field.
DeMaster: In the long run, I think it's a good choice that we made. But in the short run, if you're unemployed and you need to pay the bills, don't think you're going to go to a two-year nursing program and come out and have the answer.
Sound of Daphne crying
DeMaster: Yeah, Dapher, you tell 'em.
For now, Anders thinks the answer might be a four-year nursing degree. He's considering going back to school this fall. He hopes the additional training will land him the nursing job he wants.
In St. Paul, Minn., I'm Annie Baxter for Marketplace.
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Wow, conmigo, you seem to have a firm grasp on reality. How dare nurses ask to be compensated fairly for the hard work they do? The notion that if nurses really cared, they would accept lower salaries is nonsense. Nurses are people too -- would you say the same thing about an office worker asking for a fair wage just because they don't work in a caring profession? I do believe it's possible to care about patients and oneself at the same time.
Also, insulting the intelligence of nurses and wondering about what they "actually do" during a 12 hour shift is just indicative of your own ignorance on the subject.
You must work in Nursing. Reality is what money people actually have to pay; not insurance and government subsidy of unsustainable and unrealistic wages. My mother works in billing for 4 hospitals here in Seattle and every single one of them charges more than they are actually able to take in. There is no ignorance; talking and managing for 9 of 12 hours is easier than actually working!!! If it were as bad as they pretend, they would not do it!!! Any 12 hour shift I have ever worked, I am exhausted when through. It's funny to me how every Nurse I have ever known seems so relaxed on their days off compared to people that bust their ass.
Chris W is right on the money!
No hospital has the staff or the time to train and transition new grads. So it is easier just to hire experienced Nurses.
No one wants to relocate to where there are opportunities for new grads in acute care.
No major wave of retirements as predicted a decade ago thanks to the economy.
Nursing is not a careerpath. It is a vocation. And there are many opportunities and a great need for talented, dedicated nurses. If Nursing is in your heart and soul, please follow your dream!
Nurses are just now coming up against what IT workers have been dealing with for a decade. In the 90s, companies like Microsoft fed the media crap about an IT worker shortage while they were importing foreign workers and building new facilities in places like India. For the past decade or so, hospitals have been importing nurses from places like the Philippines. Schools are also importing teachers from the Philippines, so don't be surprised if they find themselves out of work soon, as well.
Unrealistic pay and benefits coupled with high financial expectations have led to an oversupply that will eventually help to facilitate the relatively deserved wages versus the inflated fantasy that has permeated that profession for years. Get serious. $40 an hour because an RN "cares?" Give me a break. When the Nuns did it 50 years ago, they actually did care about the patients and not about the "bills they have to pay." They were not driving luxury automobiles; they really did care. Any system where the average RN is making more money then the patients they oversee is destined for disaster.
Why shouldn't people want financial security? Plumbers make double that, with less education. Should they really CARE about sewer backups? Why shouldn't EVERYONE get paid a living wage for honest labor? Hospital nurses work 12-hour shifts on their feet, often lifting heavy patients without mechanical or human assistance. Despite federally-mandated lunch breaks, nurses often don't even have a chance to pee, let alone to wolf down a sandwich.
I don't begrudge them their salaries (though the $40/hour number is rare, only in large cities, and usually for nurses with many years of experience.) I do begrudge the people who believe that there's a problem with people choosing careers that they can excel in, including taking the compensation into consideration.
The CEO of Kaiser Permanente made $6.7 million in 2009. Even at the $40/hour number, is his labor and knowledge worth more than 83 nurses?
The plumbers' wages are figured into the bills and as for the education part...I rarely have ever met a Nurse who is actually intelligent. If third worlders can pass the exams, what do you think? Besides, when it comes to "education": If you can pay for the classes and attend the classes enough at the right places at the right times, you will eventually graduate so that in itself is no big accomplishment; and in the big scheme of things means nothing. Like I said before, more education and more "certifications" to do less. The average LPN will do more in 3 years than a straight through BSN will do in 30. Also, people always pump up 12 hour shifts, but doing what exactly? Hell, if it were that bad they would not do it. It obviously isn't one of those occupations where, after 8 hours, the body can barely go on...so please spare me. I've done lots of work in hospitals and am always astounded at the number of women I see standing around in scrubs gossiping about absolutely nothing and look upon actually having to do any work as an inconvenience. I particularly liked it when I saw blood on the floor and an RN looked at me after it was there for a half hour and said "We have housekeeping!!!"
Also, I always get this really low feeling in my stomach when people who become Nurses seem primarily focused on what financial "compensation" they will derive from it. Regardless of if people are getting sick or "Need" healthcare, the pay and benefits for healthcare workers are unsustainable if those people don't have any money. It's sickening to watch some piece of sh-- gloat about how much money they make for being a glorified butt wiper that is authorized to give shots.
As a 30 year RN and former faculty member I'd like to mention the following to Mr. Anders and your reporter:
- new grad RNs had difficulty finding jobs everywhere starting with the graduation classes of 2009; when hospitals could choose to hire between an AA degree'd nurse vs a BSN vs a master entry they would pick the RN with the degree because in almost all instances the cost was the same
- hospitals and colleges were COMPLETELY out of synch when the hiring slowed down and then stopped; colleges acted as if they had no responsibility to assist their new grads and hospitals were "we have what we need - we'll get back in touch when we need more!"
- the first indication that something weird was happening is that hospitals stopped active recruiting, decreased their number of new grad programs and only wanted to interview nurses with experience
- baby boomers stopped retiring, stopped changing from FT to PT work; perdiem nurses moved to the FT or PT jobs; internal transfers filled the specialty slots [ER, ICU, L+D, etc] - everyone knew this was happening but there was little action taken about how to continue to bring in new grads - where was the innovative thinking ??
- new grads who stayed in their locales got pushed to LTC or lower paying community jobs; once pushed out of the entry to acute care hospitals they found it almost impossible to even get interviews; hospitals could hire "fresher" new grads because the colleges had geared up for the big shortage [which is STILL coming when the boomers finally age out or if the economy con't to lag]
- hospitals and colleges are finally starting to cooperate to create "nurse residencies" that allow the new grad 3-4 months of orientation time at a lower pay rate similar to the notion of a "medical residency" - the difference is that the gov't funds the medical residencies for the most part but hospitals pay for all nurse orientation costs - however, these programs continue to be hard to find - in almost all cases a FT nursing job awaits at the residency's conclusion
- many nurses are unwilling to relocate for their acute care jobs; every student I knew who was willing to relocate got the job they wanted - many students who stayed in the area were left behind to fill PT slots in lower paying RN jobs
Finally, the entire nursing workforce issue is getting the attention of the profession HOWEVER there is very little personal assistance for the newly graduated nurse who is seeking to begin their career. My feeling is that colleges [community and university] should step up and provide both entry into practice and career counseling for their new graduates in an organized fashion rather than the haphazard way it seems to be done now. It would not be that expensive to do this and
would provide an excellent bridge from college to career. So much money, time and effort was expended to get the new grad launched - why not take that extra step ?
Chris Wachsmuth, RN, MS
San Francisco
Also, the current Nurses could do their fair share and take pay cuts; this would mean more Nurses who can "dare to care." Every single Nurse I've ever known seems to get the certifications and degrees to get out of actually working but still pull some way out there, like Pluto, wages for what little they actually do.
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