Jobs in short supply for nurses across the U.S.
Some specialized positions available
By Joyce Routson
A lot has been written about the nurse shortage. But right now it's more of a nurse job shortage in many places across the United States.
Once thought to be recession-proof, nursing has become the latest victim of the economic downturn. Many hospitals are reporting RN vacancy and turnover rates of less than 2%.
Although the economy is improving, nursing is a lagging indicator and the tight job market is not getting better. Most recruiters are not venturing a guess as to when it might loosen up.
"Vacancies are very low right now in most of the country," said Terry Bennett, RN, BSN, CHCR, director of nurse recruitment at Johns Hopkins Bayview Medical Center in Baltimore.
"In the past, folks just picked up the phone and they would get hired," said Susan Erickson, RN, MNSc, BC, CHCR, southern regional chairperson of the National Association for Health Care Recruitment (NAHCR). "This is the first time the economy has played such a big factor in nursing hiring."
Erickson is a recruiter at the University of Arkansas Medical Center in Little Rock, where the only hires have been experienced RNs.
Because of the recession, people have put off elective surgeries, affecting patient censuses at hospitals. In addition, nurses who might have considered retirement are delaying it, and those now working are taking additional shifts.
"There are people looking for work, but if they don't see a better option, they are going to stay put," said Rebecca Lobaugh, recruiting director for Sutter Health East Bay in the San Francisco area. She cites data from the California Hospital Association showing a 2.1% turnover rate in the third quarter of 2009, the most recent period for which statistics were available. At the end of 2008, the average turnover rate for RNs was 10.8%.
At Sutter Health, the vacancy rate was better, above 5% at the end of the fourth quarter of 2009. But hospitals in the system are mostly hiring for specialized, experienced RNs, Lobaugh said.
New grads
Compounding the situation is a glut of new grads. Units that might have hired dozens in the past are only hiring a few.
For instance, in the latest edition of the NAHCR magazine, recruiters are quoted as saying the job outlook is difficult. The numbers of those being placed is much lower than in past years in places such as New Jersey and Michigan, the article says. It quotes Laura Shakarjian of the University of Michigan Health System, as saying, "We are working with a number of candidates who graduated in May and August 2009 and have not secured positions as RNs yet." In Arkansas, a recruiter says that she hasn't hired any December new grads and is just starting to post a few positions for experienced RNs only.
Erickson, southern regional chairperson of NAHCR, said in an informal survey of recruiters in the South, only those in Oklahoma, Florida and Kansas said hiring was similar to last year. The majority said they were hiring fewer new grads. Recruiters in Texas and South Carolina said they were hiring only 10-20 this year. In North Carolina, one hospital planned to hire a number of new grads, while another two others were hiring fewer this year.
Erickson said her association was working with other nurse groups to establish some sort of central repository of openings for new grads.
Advice
So what does the nurse just entering the workforce or an RN relocating or returning do? Recruiters offered this advice:
• Be flexible. "It's all about what people are willing to consider and how creative and flexible they can be," says Bennett. For instance, don't limit your options to a Monday-Friday day shift. "It won't be devastating to your career to work on a general med-surg floor for a year to gain some experience," says Erickson.
• Consider relocating if possible. There are underserved areas.
• Look at alternatives to hospitals. Long-term care and assisted living facilities use RNs. Deborah Rowe, MS, RN, PHR, CHCR, a member of the NAHCR board and a regional director at Genesis HealthCare, says her facilities have openings. The work is just as challenging as in a hospital, she says: "They work with wound care, rehab, acute care patients. It is parallel."
• For new grads: Get some work experience. "Get your foot in the door even if you can't find an RN opportunity," says Lobaugh. ""Take a lower-level position, even nonclinical. You'll be in the environment and get to know the nurse manager." Adds Erickson: "Don't limit your choice. If you have to go to plan B, your life is not over."
• Leverage your preceptorship. "Establish a relationship. Those are your mentors and people will remember you if you do a good job," Lobaugh says.
• Write a cover letter. Erickson said out of 350 new grads who applied to her medical system, only two submitted cover letters. Writing one will help you stand out. "If you had a clinical rotation, put it in your cover letter and personalize it," she says.
• Be persistent. Openings may change from week-to-week so keep on top of job listings. Check on job fairs and training programs.
• Network. Find out about who's hiring by joining a chapter of your local American Nurse Association chapter. Get to know the nurse managers at the hospitals you target.
• Don't give up. Bennett said recruiters know nurses are frustrated. "We feel worse about this. We hate this type of job situation."