Hospitals nationwide reject new nurses despite shortage

(Jamestown Sun) Although the country is struggling with a nursing shortage, some newly licensed nurses are being turned away by potential employers who say, in effect, “new grads need not apply.”

Heather Perry, who came to Grand Forks from Denver about two months ago, was one of them. “I had a lot of trouble finding a job in Colorado,” she said. “I applied for hundreds of jobs.”

Some hospitals require a year of professional experience, a policy that frustrates new registered nurses who are looking for work.

The problem is well-documented by the nursing industry. About 43 percent of newly licensed RNs still do not have jobs within 18 months after graduation, according to a survey conducted by the American Society of Registered Nurses.

Tough market

New grads have taken to posting their frustrations on allnurses.com, a social network for nurses.

“It is a tough market for a new grad RN. A ‘year experience required’ or ‘not considering new grads at this time’ is pretty much the norm,” wrote one.

How can this be, during a time when health care jobs are booming and a supposed shortage of RNs sent many career-seekers running to nursing school?

The recession is to blame, said Peter Buerhaus, a registered nurse and economist who teaches at the Vanderbilt University School of Nursing. In a paper he co-authored in the New England Journal of Medicine last year, he notes an interesting phenomenon happens in the demographics of the nursing workforce when the economy is weak.

About 90 percent of nurses are women, 60 percent are married and about a quarter are older than 50. It’s typical for many nurses to take time off to raise children in their 30s and, given the long days spent working on their feet, many often retire in their late 50s.

Before the recession, about 73,000 nurses left the profession each year because of a focus on raising their children, retirement, burning out or death. But when the recession hit, spouses lost jobs, 401(k)s lost money and facing financial uncertainty, fewer nurses chose to leave work, Buerhaus said.

“Many of those nurses are still in the workforce, and they’re not leaving because we don’t see a convincing jobs recovery yet,” Buerhaus said. “They’re clogging the market and making it harder for these new RNs to get a job.”

Enrollment rises

At the same time, enrollment in nursing colleges has exploded in recent years. In the 2010-11 school year, 169,000 people were enrolled in entry-level baccalaureate nursing programs. That’s more than double the 78,000 students from a decade earlier, according to the American Association of Colleges of Nursing.

At the University of North Dakota, enrollment of undergraduate students majoring in nursing at the College of Nursing and Professional Disciplines, increased from 789 in fall 2005 to 822 in fall 2011, according to figures from the Office of Institutional Research.

At the graduate level, another 270 students are working toward master and doctoral degrees in nursing this year, said Ray Pospisil, manager of academic reporting at the college. That group has nearly quadrupled in 10 years, from 70 in fall 2003.

“Not all nurses want to work where there is a job,” said Laurel Shepherd, vice dean of UND’s nursing school.

Also, openings generally are in long-term care or medical-surgical areas where patient cases are more complex and it’s preferential to have nurses with at least one year of experience.

Some hospitals are moving toward hiring only nurses with bachelor’s degrees, rather than those with associate degrees or LPN training, Shepherd said.

“Studies have shown that quality of care and better outcomes are tied to the proportion of four-year (degreed) nurses. The higher number of RNs who are educated at the bachelor’s (degree) level, the better the outcomes you’re going to have.

“That’s not to say there’s not a role for other nurses. It’s getting the right mix of costs — the lower-cost provider with the higher-cost provider,” she said. The right mix of nurses is “very important” to reducing the cost of health care in the United States.

Demand for health care services is expected to climb as more baby boomers retire and health care reform makes medical care accessible to more people. As older nurses start retiring, economists predict a massive nursing shortage will reemerge in the United States.

“We’ve been really worried about the future workforce because we’ve got almost 900,000 nurses over the age of 50 who will probably retire this decade, and we’ll have to replace them,” Buerhaus said.

No barriers here

Altru and Sanford not only don’t require new RNs to have a year’s experience but offer programs that attract nursing students to gain professional experience even before they complete their education as well as mentorship programs to retain them after they’re hired.

After completing a two-year, associate degree in nursing at a community college in Denver, Perry went on to earn a four-year bachelor’s degree in nursing from a state university, also in Denver. She plans to finish the BSN degree soon, she said.

While searching for work in her field, she attended job fairs where representatives of health systems would say, “We don’t have any new-grad jobs,” she said.

“Some hospitals would say, ‘We’ll be in touch.’ But I didn’t hear back from them.”

The invitation to join Altru was “the first offer I received after searching for 1 1/2 years at least,” she said. “It was amazing. I applied on a Monday, Altru called me on Tuesday and I was interviewed on Thursday. I was hired within a week.

“I was surprised. And it was the right job I was looking for.”

An agreement between about 20 states allows licensed registered nurses to practice in the other member states in the “compact,” Perry said. North Dakota is one of them.

“I ran into North Dakota on my list,” she said. “Someone had recommended it as a nice place to live.”

She’s happy with her decision to come to Grand Forks.

“It is such a different atmosphere and different response from what I was hearing — ‘no new grads’ or ‘we don’t want you,’” she said. “Everyone is very welcoming.”

At Altru, “in the first week of orientation to Altru — which no one at home would do — speakers came in and talked about how the hospital runs. That was nice, really nice.”

As a new nurse, Perry is assigned to a mentor, Rachel Letvin, an RN who holds a bachelor’s degree in nursing from UND, for 12 weeks. Altru’s mentor program was created in 1996.

Twelve weeks with a mentor is “nice and long,” Perry said. “Rachel is amazing. And we have a lot of good nurses on this floor.

“After eight weeks, I’m starting to feel comfortable.”

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