When Rhys Gibson, RN, received his nursing degree from the University of Illinois at Chicago in 2009, the recession had started and it took him eight months to land a job. “I thought I was the cat’s meow and everything because I’m an African American guy coming out of here,” he told National Public Radio. “I had the grades, had the experience, to an extent but not the practical experience as a nurse working on the floor.”1
Minority graduates from nursing schools are swept up in a nationwide decline in job opportunities that still continues today, forcing job applicants like Gibson to fight to find work. A 2011 survey by the National Student Nurses’ Association found that 36% of RN graduates had no job four months after leaving school.2 The survey further indicated that graduates with associate degrees, who make up most of RN graduates, were having markedly more problems finding jobs than their BSN counterparts. In a follow-up survey six months later, half of those without a job still hadn't found work.3
Mary Chatman, PhD(c), RN, an African American who is chief operating officer and chief nursing officer at Memorial University Medical Center in Savannah, Georgia, says sharp downturns in the nursing job market are not a new phenomenon. “I lived it,” she says, recalling that when she received her RN degree in North Carolina many years ago, “the nursing schools in the area were graduating far more students than the hospitals needed.” She had to work hard to find a job.
The same lopsidedness between supply and demand confronts nurses today––only on a nationwide scale with no end in sight yet. The new glut of nurses came as a surprise, because for many years, nursing supply experts have been predicting the exact opposite—a huge shortage of nurses was on the horizon.
A large segment of older nurses is slated to retire soon, while demand for health care is expected to explode due to an aging population and expansion of coverage under health reform.4 The reform law is poised to add more than 30 million more people to Medicaid or private insurance in 2014.
To head off this shortage, nursing schools have been pushing up their output of new nurses for many years now. A 2009 study inHealth Affairs found that more than 250,000 nurses entered the workforce in 2007-2008––a 30-year record––then schools continued to expand enrollment even as demand for health care services plummeted with the recession.5 There were plenty of enthusiastic applicants. In 2011, nursing schools had to turn away more than 70,000 qualified applicants.6
But as record levels of new nurses graduated, they plunged into a highly competitive job market. “I pursued a career in nursing because I was told there was a high demand and I would always have a job,” a BSN graduate wrote in the NSNA survey. “The large number of applicants makes every position very competitive.”
In addition to competition from other graduates, these new nurses also faced inactive nurses who began returning to work when the recession hit, says LeAnn Thieman, CSP, CPAE-Nurse, a nurse recruitment and retention consultant in Fort Collins, Colorado. She adds that hospitals often prefer hiring these seasoned nurses over new nurses who would have to be trained.
The situation is further complicated by hospitals’ reluctance to hire permanent nurses due to the unstable economy, says Marco Colosi, president of NSI Nursing Solutions, Inc., a nurse-staffing firm in East Petersburg, Pennsylvania. He reports that demand for temporary nurses has risen and hospitals have put existing staff on longer hours.
Colosi adds that hiring has also been stymied by the uncertain future of health reform. The Supreme Court’s decision on the law last June lets states opt out of the Medicaid expansion, and demand for services could be reduced yet further if health reform is repealed.
Under these harsh circumstances, new minority nurses trying to find work have to be resourceful, Thieman says. “Keep in mind that 160,000 U.S. nursing positions went unfilled last year,” she says. Here are some steps new nurses should take to keep their careers on track:
Get job experience. Since employers prefer applicants with previous work, Thieman advises taking any job you can get whether it involves a midnight shift, work in a nursing home, or even volunteering part-time.
Get yourself noticed. “Getting a job is all about visibility,” Chatman says. “Get yourself in front of the people who will make the hiring decisions.” Rather than just sending in resumes, unemployed nurses should visit the units where they would like to work and firmly but politely ask for an interview, she says.
Highlight your minority status. Chatman says hospitals with a high proportion of Medicaid patients may desire minority nurses who can relate to those patients. “Don’t lay it on too thick, but let them know that in addition to your nursing skills, you come from the same background as their patients,” she says.
Attend nursing conferences. “This is a great way to make connections,” says Geneviève M. Clavreul, RN, PhD, a health care management consultant in Pasadena, California. She advises to always wear proper attire and maintain a neat appearance.
Look beyond hospital jobs. Hospitals employ almost two-thirds of all nurses and are the preferred destination for new nurses, but health services are moving away from the hospital, says Diane Mancino, EdD, RN, CAE, executive director of the NSNA.
Be willing to move. Nurses rarely relocate for work, but those who do can take advantage of pockets of strong demand, such as rural areas and certain parts of Florida, Texas, and the Southwest, Colosi says.
Go back to school. Associate degree nurses can enter RN-to-BSN programs, offered at more than 600 schools.7 Study lasts one to two years, and tuition can be as low as $106 per credit hour.8
Take advantage of expanded student loan programs. The health reform law increases borrowing limits for the Nursing Student Loan program as well as the number of programs that can be funded by the Nursing Workforce Diversity program, which helps underrepresented minorities. Diversity grants totaling $3.6 million are now available for students in RN-to-BSN and accelerated nursing degree programs.9
New nurses mapping out their careers have a variety of viable options to choose from. Here is a small sampling:
Long-term care. People over age 84 are the fastest growing segment of the U.S. population, but only 3% of graduates are interested in this field, according to the NSNA survey. Certification requires at least two years in a nursing home and passing an examination. Certified long-term care can earn about $67,000.10
Community health. The NSNA survey shows that only 8% of graduates are interested in community or home health, even though there are a variety of opportunities here, including domestic violence, forensics, HIV/AIDS, hospice, public health, and telemetry. Home health nurses help patients regain physical independence and manage their medication, and their basic pay is about $57,000 a year.11
Dialysis nurse. This position is one of the nation’s fastest growing nursing specialties, according to the Best Schools website, which pegs the salary at $63,500. You'll need at least 2,000 hours of experience to sit for the certification exam.12
Nurse practitioner. This career shows promise due to a growing shortage of primary care physicians. NPs can perform 60%-80% of a PCP’s work, and they make an average of $78,000 a year working in hospital clinics, physicians’ offices, or independent practice. 12 They must get a master’s degree, which normally takes two to three years to complete, and obtain state licensure.
The NSNA survey shows that while unemployed graduates are still committed to finding a job, dissatisfaction is sinking in for many. More than 90% said they remain “passionate about nursing and will continue to seek employment as an RN until [they] succeed,” but 38% said they were not getting support and were disillusioned with the profession.
Thieman advises unemployed graduates to hang in there. “I'd say to them, ‘stay in nursing,’” she says. “We are at the brink of a tremendous nursing shortage of crisis proportions.” Clavreul predicts jobs will become more plentiful within two years, as older nurses retire and the expansion in coverage is slated to start under health reform.
Despite current job woes, Thieman says nursing is still a better option than most other careers. In 2011, 56% of new BSNs had a job offer at the time of graduation, compared with 24% of all new college graduates.13 And the Bureau of Labor Statistics predicts a 26% increase in nursing jobs from 2010 to 2020, while jobs in other occupations will rise just 14% on average.14