Nursing is one of the most physically and emotionally challenging professions and consequently many nurses are quite ready to retire in their 50’s. When the economy really began to sour last fall, and retirement plans such as 401Ks took a nose dive, many nurses decided to delay their retirement.

In addition, many nurses found themselves returning to the profession because their spouses had been laid off. As a result of these two factors coupled with lower hospital censuses, the shortage of nurses has actually begun to shrink.

This may be a fix to the nursing shortage right now, but it’s quite temporary. When the economy recovers, there may be an even larger mass exodus of nurses than previously expected.

Take for example the fact that the average age of nurses in California is 47, and 45% of those nurses are actually over the age of 50. Potentially 45% of the nurses in California could be retiring very soon.

California is near the bottom of the number of nurses per capita at 647 RNs for every 100,000 persons. The national number is 825 per 100,000. Only Utah, Arizona, Nevada, and New Mexico rank lower than California. California is also one of the states with a mandatory nurse-to-patient ratio. Arizona is considering this type of legislation as well.

The number of new nurses cannot keep up with the number leaving the profession, even with the slower pace of retirement. It’s certainly not for lack of potential students as many thousands are turned away each year because of the lack of nurse educators. Schools just cannot compete with the salaries nurses can earn working in a hospital versus teaching.

Some hospital groups have invested in nursing programs to help them expand and accept more students in an effort to forestall the shortage which will be presented by a mass exodus of nurses. This has helped, but it’s going to take a lot more to make a dent in the potential crisis.

As health care reform efforts make progress, the potential for an additional 46 million currently uninsured Americans to have improved access to health care will also make a dramatic impact on the nursing shortage as demands for care increase.

So for those nurses who are having some difficulty finding jobs right now, don’t get too discouraged. As the economy begins to recover, there will soon be no shortage of jobs for nurses.

Opportunities for travel nurses should begin to pick up again and those nurses who have a large repertoire of skills and experiences will be able to command offers like never before.

Nurses should take advantage of these times and expand their knowledge base and skills set to prepare for the future.

By Kathy Quan Rn BSN. ©2009 by UltimateNurse.com All Rights Reserved. By Kathy Quan RN BSN. Kathy is the author of four books including The Everything New Nurse Book. She is also the owner/author of TheNursingSite.com.

Currently the Great Recession and the move to reform health care in the U.S. have impacted the nursing profession in many ways and will continue to do so for quite some time.

Hospitals and other health care facilities have long been impacted by the shortage of nurses, and now the economic factors are causing administrators to cut back on staffing.

Most nurses have weathered the seasonal call offs due to a low patient census and sometimes it’s nice to have a few unexpected days off, but when you’ve used up all of your personal time for these furloughs and face even more time off because of cutbacks, it isn’t fun anymore.

When you do work and are expected to give quality patient care to twice as many patients as you should have, that isn’t fun either. But administrators seem to expect nurses to work miracles under the worst of circumstances, and never ask nurses for an opinion on how to improve conditions and make the care more cost effective.

At the same time the nurses are expected to provide the quality of care needed to ensure reimbursement isn’t affected such as preventing decubs, pneumonia, UTIs and DVTs that are on Medicare’s Do Not Pay list.

A recent study of infection-control specialists published June 9 on Modern Healthcare.com pointed out that education about hospital-acquired infections has been significantly reduced due to budget cuts.

The Association for Professionals in Infection Control and Epidemiology (APIC) surveyed 1943 members in March 2009. Forty four percent of the responders said that they attend fewer meetings at their hospitals now because of cutbacks, and 42% said they no longer conduct as many walking rounds in their facilities. Hiring freezes and staffing cuts have caused them to spend more time on other duties than focusing on prevention.

In the long run, APIC thinks that hospitals will spend more money treating these infections than they would have in preventing them in the first place, but administrators haven’t figured that out yet. Again they don’t talk to or listen to the nurses.

Meanwhile health care reform measures will (hopefully) make it possible for many more Americans to have health insurance coverage and to afford health care. On the other hand, there is a serious shortage of health care workers, most notably nurses. This shortage is growing and will reach crisis levels in the next few years. Increasing the number of potential patients who can afford health care is going to make the demand for nurses even greater.

Anne Zieger from FierceHealthcare.com said a few weeks ago that from her observations, “nursing unions are on the verge of revolution.” Two of the most powerful nursing unions, CNA/NNOC and SEIU have even set aside their fierce rivalry to work together on the issue of health care reform. The two issues at the forefront are mandated nurse-to-patient ratios and required overtime.

It certainly is an interesting time to be a nurse.

©2009 by UltimateNurse.com All Rights Reserved. By Kathy Quan RN BSN. Kathy is the author of four books including The Everything New Nurse Book. She is also the owner/author of TheNursingSite.com.

Here is the synopsis:

Nurse Jackie is a half-hour dark comedy that is at turns wicked, heartbreaking and funny. Edie Falco stars as the title character Jackie Peyton, a strong-willed and brilliant — but very flawed — emergency room nurse working in the complicated and frenzied environment of a New York City hospital. A lapsed Catholic with a weakness for painkillers to get her through the days, Jackie keeps the hospital balanced with her unique bedside manner and own brand of medical justice. Every day is a high-wire act of juggling patients, doctors and fellow nurses along with her indiscretions. Jackie

It is going to be interesting to see what kind of light Nurse Jackie will shine on the nursing profession.

Please go here for Nurse Jackie Discussion.

The legislation known as the National Nursing Reform and Patient Advocacy Act (S1031), would amend the Public Health Services Act to protect the rights of nurses to advocate for patients. It would set minimum registered nurse-to-patient ratios in hospitals and it would invest funds for training new nurses and nurse educators.

The bill (S1031) has been read and sent to the Committee on Health, Education, Lab and Pensions for review and sponsorship. Nurses should contact their legislators to help sponsor this bill and push the legislation through Congress.

This legislation “builds on the success of California’s historic law that set Registered nurse-to-patient ratios.”  When passed, this bill will extend those ratios to all acute and long term care hospitals across the U.S.

The specifics of the bill include provisions to improve work conditions for nurses by:

• Establishing nurse-to-patient ratios to improve the quality of care and save lives. By doing so it is hoped that more nurses will enter and stay in the workforce.
• Providing whistleblower protections for nurses to advocate for patients and report violations of minimal standards of care.
• Creating a standard of care regarding lifting patients to help protect nurses from on-the-job injuries as well as promote better quality of care.

The bill also addresses funding for workforce development by creating a Registered Nurse Workforce Initiative within the Health Resources and Services Administration that would invest in the education of both nurses and nurse educators by providing grants for:

• Nursing nursing educational assistance and living stipends for nursing students who agree to work for safety-net health care providers for a minimum of 3 years.
• Graduate education assistance for RNs who commit to work as nurse educators at an accredited nursing school for a minimum of 5 years.
• Training and mentorship demonstration projects.

As nurses, we know better than anyone that we are the backbone of the health care system and any health care reform must include provisions for meeting the challenges of the critical nursing shortage by improving working conditions for nurses as well as helping to grow the numbers of nurse educators so that more qualified students can enroll in nursing programs each year and become nurses.

©2009 by UltimateNurse.com. By Kathy Quan RN BSN. Kathy is the author of The Everything New Nurse Book and the owner/author of TheNursingSite.com

Like any other day (or week) of the year, it’s up to you to find your own rewards in your nursing career. Nursing isn’t like a lot of other professions where you often see the end result of your efforts.

Your patients are usually with you for a very short term basis and then they go back to their own lives. You don’t get to see them recover fully, or even continue to struggle with a chronic disease. If you live in the same neighborhood, you might run into them at the grocery store or local shopping mall, but that can be an awkward moment, especially with HIPAA regulations.

So it comes down to the here and now and making the most of it. Some nurses prefer settings such as the ER because they don’t want to get too attached to their patients, but they do remember some who end up there often or who stick out in their mind for one reason or another.

Some nurses love the hospice setting because they want to help patients transition from life to a peaceful, dignified death as well as to offer support to their loved ones through this unhappy time. Others love the challenges of home health care and teaching patients to assume responsibility for their own care such as post acute care needs.

Some like the ICU for its fast pace and life or death critical thinking challenges. And God love them, there are those who love the NICU where they can help the tiniest babies with a multitude of tubes and wires find a way and a will to live.

There are those who love to teach and choose to educate nurses so that they can provide the best quality care possible, or maybe become nurse educators themselves.

Some nurses prefer to work behind the scenes in fields such as research, forensics, information technology, quality assurance, or as insurance case managers. Some become life or health coaches, and long term care managers.

Nursing offers such a wide variety of specialization and caregiving opportunities. The challenges are many. The working conditions are not always pleasant or supportive. This is one of the most physically and emotionally challenging professions. But nurses are also repeatedly found to be some of the most ethical and trusted professionals.

As you take a moment in your busy day this week. Don’t grumble about how no one noticed it was Nurses Week, or maybe how they gave you some silly token gift. Pat yourself and your colleagues on the back and say Thank You for a job well done!!

Nurses are the backbone of the health care system. Take pride in who you are and the job you do everyday. Know that you matter and that someone’s life is better today because you cared. Happy Nurses Day everyday!

©2009 by UltimateNures.com All Rights Reserved. By Kathy Quan RN BSN. Kathy is the author of The Everything New Nurse Book and is the owner/author of TheNursingSite.com.

Hospitals have been hit hard in the pocketbook by the fact that many patients are putting off elective procedures and anything that isn’t of an urgent nature. It has been a slow flu season and therefore the number of children, elderly and chronically ill have not required hospitalization for complications of flu.

Jobs are in Middle America
The number of nurses available for travel assignments has grown and therefore with simple economics of supply and demand, those who are more flexible and have more experience are getting the premier travel assignments. The east and west coasts have been more affected by the economic crisis than middle America and consequently the opportunities in these regions have been affected as well. The jobs now are available in the middle of the country, not Florida and California.

The good news is that the economy will turn around. How soon is being debated. Some predict a few months and others at least a couple of years.

The other factor is that in the next few months, we will see more nurses taking time off from taking on extra shifts or returning to work and being overworked and burned out. This will open up more opportunities.

Gain Experience and Improve Skills
For nurses who are employed or have current travel assignments, make the most of what’s available to you. Extend travel assignments as possible and look for opportunities to polish skills or to gain more experience in specialty areas. Continue your education.

Some travel nursing companies are looking for a minimum of 2 years experience in a specialty area, and making changes right now might even be a negative, but think further into the future and get the experience you want and need. The one thing that is happening across the board for nurses looking for permanent or travel opportunities, is that nurses with very little experience beyond basic med surg are having a harder time finding jobs.

As the economy improves, all those patients who have delayed procedures and care are going to need to have it done and the system is going to be overwhelmed. The nursing shortage has not been solved. There is still going to be a shortage of nearly one million nurses by 2020. Nurses who have positioned themselves to meet the challenges of the next couple of decades will be way out in front.

Post Acute Care Will Grow
Post acute care, especially home health care, is expected to be the fastest growing branch of the nursing profession over the next few years according to the Bureau of Labor Statistics. Nurses who have excellent skills in a wide variety of patient care will be able to make this transition more easily.

For older nurses who cannot stand for eight to twelve hours a day, home health care may offer a new career path for many years past what they could serve in an acute setting. The key to survival in home health is being confident in your skills, having strong critical thinking skills and being able to work autonomously. Documentation skills are a very important issue in home health care as well.

© 2009 by UltimateNurse.com All Rights Reserved.
By Kathy Quan RN BSN. Kathy is the author of four books including The Everything New Nurse Book and author/owner of TheNursingSite.com.

Nursing student enrollments more than double in eight years

by Janet Goetz

Friday April 24, 2009, 6:00 AM

When Allison Frazeur graduates from the University of Portland in May, she won’t worry about finding a job. She knows she will be a nurse for the Providence Health System.

Frazeur, 21, is one of 30 UP nursing students selected annually for the Providence Scholars Program, which paid her last two years of college tuition. In return, she agreed to work full time for three years for the Providence system in Oregon.

The program, started in the 2002-03 academic year, is one of several efforts developed in the past eight years by a coalition of educators, health systems and professional organizations to increase the number of nurses and nursing educators in Oregon.

In that time, enrollment has more than doubled in nursing programs at community colleges and private and public universities, said Kristine Campbell, the executive director of the Oregon Center for Nursing.

“I don’t believe any other state has doubled its enrollment,” she added.

The nonprofit center was created in 2001 by the coalition, the Oregon Nursing Leadership Council, with a succinct mission: provide the leadership to solve the nursing shortage in Oregon.

A 2001 Northwest Health Foundation report indicated the state would have 20 percent fewer nurses than it would need by 2010, given changing demographics and population growth.

In 2000, Oregon had 1,325 nursing students, Campbell said. By 2007, the state had 3,009 nursing students.

However, as Oregon increased the number of nursing students, Campbell said, the faculty numbers expanded by only 20 percent.

“The big issue right now is the faculty shortage,” she said, noting that nurses who teach receive about half the pay of those in other positions.

Another concern is retirements fast approaching among the more than 44,200 registered nurses in Oregon. Nursing faculty members’ average age is 52 and the average age of other nurses is 48, Campbell said.

Although more nurses are graduating, local hospitals are hiring cautiously in all fields because of the national economic slump. That makes many of her classmates nervous, Frazeur said.

“I feel really fortunate to have a contract,” she said.

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