The New Nurses Hiring Dilemma

Despite talk about a nurse shortage, job forums are now saturated with posts from frustrated nurses looking for employment. While in school, they thought jobs would be almost guaranteed upon graduation. “Ha, ‘Nursing Shortage’ nothing makes me laugh more than this ridiculous statement!” reads one post on a forum titled No Nursing Shortage on indeed.com, a search engine for jobs. “I graduated with BSN several months ago, passed the boards, and received my license and still no job. I think we need to get the word out that there is no longer a nursing shortage,” reads another post. Leading academics and nursing professionals agree that the economy has created a complicated nurse hiring dilemma. The economy’s impact on healthcare professionals and their employers – even in an industry sector largely considered immune to downturns – is making it very difficult for new nurses to find jobs despite a looming nurse shortage. “Finding a job in the current market is the major challenge to recent graduates,” said Marianne Hattar-Pollara, professor and director of nursing programs at California State University Northridge. The economy, she explained, has caused experienced nurses to postpone retirement, come out of retirement, or increase their workload often by going from part time work to full-time employment, quickly filling nursing positions that would have been available to recent grads. “This trend, along with the downsizing of health services to cut down on costs, has led to a saturation of the health care market and a pseudo surplus of the nursing workforce,” she said. This “pseudo surplus” of nurses, and the employment lull facing recent grads, is very problematic, according to Deloras Jones, executive director of the California Institute for Nursing and Healthcare, a non-profit organization that works to find solutions to the state’s nurse shortage. “This really is very worrisome to us because the nurse shortage is not over with.” The problem, according to Jones, is that when the economy turns there will likely be an exodus of experienced nurses and no one will be ready to jump in their shoes at a time when demand for healthcare services is expected to spike largely due to an aging population. “What is looming in front of us is pretty significant,” she said. Shortage will come When nearly 45 percent of registered nurses were 50 years of age or older in 2008, high retirement rates for nurses are also in the horizon, which will heighten the demand for nurses in the near future. “We have done a really good job in preparing for the nursing shortage and building educational capacity – we’ve increased educational capacity by 66 percent since 2004. What worries us now is that we will lose the gains that we have made.” The new graduate dilemma threatens to undermine the progress that has been made as recent grads, unable to get jobs in nursing, look elsewhere for employment. According to a recent study by CINH, 43 percent of surveyed registered nurses licensed in California from Jan. 1, 2009 through March 31, 2010 are not working as registered nurses. Ninety three percent of respondents cited no experience as the main reason for not finding a job in the field. Transitioning from the school environment into the workplace often requires extensive training, which can be expensive for employers. “It’s really very costly to train a new RN graduate and particularly to train them in their area of preferred specialty,” said Jennifer Castaldo, assistant chief nursing officer at Valley Presbyterian Hospital, who explained why most healthcare organizations are inclined to hire experienced nurses instead of recent grads. “For example it takes approximately five months of training for a medical surgical nurse and between nine and 10 months for a labor and delivery nurse – that’s nine or ten months of paying two nurses to do the job of one. In today’s economy, most facilities have done away with those clinical training programs.” Valley Presbyterian Hospital, however, is not one of them. Despite the costs, the hospital is committed to educating and training new nurses, Castaldo said, as part of its social responsibility to the local community. Through its Nurse Scholar Program, Valley Presbyterian Hospital supports nursing students from local schools with full scholarships and allows them to complete their Nurse Residency and Fellowship programs at VPH, with the ultimate goal of helping them secure permanent employment at the hospital. Last year the program helped 16 students from Los Angeles Valley College secure full-time staff positions upon graduation. This year however, the number of student nurses going through the program has been reduced to nine. Limited resources Outside the acute care hospital setting, such as in community clinics, long term care, behavioral care and ambulatory services, resources needed to put new grads into the work environment are even more limited. “These out-of-hospital settings don’t have the resources needed to offer training programs that allow grads to make that transition from school into practice – it takes resources to be able to do that,” said Jones. Registered Nurse Juana Davila is one of five nurses at Valley Community Clinic, a private non-profit agency in North Hollywood specializing in serving the uninsured population. “We have hiring limitations due to the economy,” said Davila, who’s been a nurse for 16 years. When a spot does open, she said the Clinic is looking for the best quality, experienced nurses. The hiring lull for new grads is snowballing down the nurse pipeline. Registered nurses that complete the four year bachelor program are more likely to find a job in the current economy over those that don’t and vocational nurses are feeling the brunt of the jobless market, as RN’s unable to find placement are taking jobs as LVNS often as a way to get their foot in the door. Vocational nursing schools are already feeling the impact. Rafael Tolentino, chief academic officer at Preferred College of Nursing Inc. in Van Nuys, said enrollment there has decreased by more than 50 percent over the last two years. “More students are unable to pay the tuition and at the same time the fact that graduates are not finding jobs is keeping many from enrolling in the programs”, he said. Nonetheless, enrollment at higher education institutions such as CSUN is still high, said Hattar-Pollara. The school received 270 applications this year to fill the 70 open slots in its Accelerated Bachelor of Science in Nursing Program. That number, however, has come down from 400 applicants in years past.