For years, we heard that a nursing shortage was imminent, projected to reach monumental proportions by the second to third decade of the new millennium and threatening to bring the U.S. healthcare system to its knees. However, many feel that there is now, in fact, a nursing surplus. Do a quick Google search of the term “nursing shortage” and you will find articles, blogs and papers both for and defiantly against the idea of a nursing shortage.
Over the past decade, several trends have occurred which have somewhat mitigated the shortage situation. The economic recession has undoubtedly played a role. It seems likely that nursing projections of a decade ago did not take into account the recession of the past few years. As a result of the recession, many older nurses who might have retired if their economic situation were a little more stable have instead continued to work. In fact, 45% of working nurses are older than 50 years (American Nurses Association, 2011).
Graduating nurses are also younger than they were years ago, another factor that throws off the projected shortage data from the 1990s. At that time, nurses were typically older upon graduation and thus were projected to spend fewer years in the workforce.
Additionally, nursing schools are graduating nurses in higher numbers than ever before. Between 2007 and 2008, 250,000 nurses entered the workforce, one of the highest increases seen for a two-year period in 30 years.
Factors that point towards a surplus include the fact that, since the recession hit hard, hospitals are hiring fewer nurses and when they do hire they generally choose to hire nurses with experience over new grads. However, even nurses with experience and a degree are having difficulty finding a job in some areas of the country. The ease in finding a job seems to vary from state to state and from urban settings to rural settings, but the bottom line is that some nurses are unable to find a job where they reside.
We may be in the eye of the storm. The severity of the projected shortage may not have hit us yet. As the recession becomes a bad memory, many older nurses may retire, opening up jobs for new grads who are currently unemployed. On the other hand, the measures that have been taken in the last decade to meet the demands for new grads may actually be working, such as increasing the number of nursing school graduates. Perhaps we have achieved a delicate balance.
In an article that appeared in the New England Journal of Medicine this year, the authors Staiger, Auerbach & Buerhaus state that policymakers and employers “should not be lulled into complacency by the current absence of a nursing shortage. Instead they should anticipate that the current positive effect of a weak economy on the RN labor supply is likely to evaporate as the economy improves … shortages of RNs may reduce access to care and increase costs as employers raise salaries to attract nurses, potentially imperiling the success of health care reform.”
The Supreme Court ruling on the ACA and various new studies indicate that the nursing workforce will continue to grow, and that a nursing shortage is more likely than a nursing surplus. Ideally, of course, an ideal balance will be achieved where every employer is able to find all of the nurses they need, and every qualified nurse can find a job.