In a time of nationwide high unemployment and economic uncertainty, job forecasts have consistently pegged nursing as a promising sector largely immune to the woes of the recession. Technological advances, a greater focus on preventative care and the aging baby boomer population have triggered rapid growth in healthcare, and the latest report by the Bureau of Labor Statistics predicts that employment of registered nurses will jump 26 percent from 2010 to 2020.
But one study of recent nursing graduates suggests career prospects in the field – particularly for young professionals – may not be as rosy as they appear.
Thirty-six percent of nursing graduates in the class of 2011 had not secured positions as registered nurses (RNs) as of last fall, according to a survey conducted by the National Student Nurses’ Association in September. Respondents claimed that employers are seeking more experienced RNs, older nurses are slowing turnover by taking longer to retire, and new graduates are inundating the market.
“Because everyone was predicting we’d have this nursing shortage the schools increased their enrollments,” said Diane Mancino, executive director of the NSNA. “I don’t know what the number is, but there are a lot more graduates now, so that’s exacerbating the problems of new graduates not getting jobs.”
An April follow-up survey sent to those who reported having no nursing position as of September found that roughly half still did not have jobs. The initial survey was administered to the 16,442 members of the NSNA graduating in spring or summer 2011, and 22 percent of those students responded.
Inability to find a job in the nursing sector was most prevalent among RNs who earned accelerated baccalaureate degrees or associate degrees, while those graduating with bachelor’s degrees and diplomas fared slightly better. Mancino, an RN who attended nursing school at the University at Buffalo, said the disparity is particularly problematic for students who attend community colleges – which tend to offer two-year associate degrees – rather than the often more expensive four- or five-year bachelor’s degree programs at other colleges and universities.
Ellen Cram, assistant dean for undergraduate and pre-licensure programs at the University of Iowa’s College of Nursing, said employers in the state have expressed a clear preference for nurses with baccalaureate degrees or higher qualifications. The state trend reflects a larger shift in the nursing sector, she said.
“In my mind this is very much like what happened in the field of education, and how it used to be that teachers were good students themselves … and now in order to get an education certificate you must have a baccalaureate degree and particular training in teaching,” Cram said. “I think nursing is moving to the same place, particularly with the research that’s been done that patient outcomes are better … the greater the proportion of nurses with a baccalaureate.”
Cram said Iowa is working to establish relationships between two-year and four-year schools that will help nurses with associate degrees continue to baccalaureate studies. Associate degree graduates are currently three times more common in the state than baccalaureates, she added.
The job shortage facing young RNs is not a new phenomenon, and has somewhat improved since the years immediately following the recession, according to the NSNA. The organization’s prior studies showed that entry-level nursing positions declined across much of the nation during 2009 and 2010, while employment of young RNs ticked up by 10 percent in the 2011 study.
There were more than 2.7 million jobs for RNs in 2010, based on the latest BLS information available. The BLS also states that nursing positions are expected to increase rapidly alongside rising demand for outpatient care, long-term care facilities and home healthcare.
Mancino argues that growth in outpatient, or ambulatory, care does not necessarily help employment prospects for young nurses, cautioning that those treatments are less reliant on nurses than inpatient procedures.
“When they were making projections for workforce needs for RNs, I’m not sure they took into account the shifting workforce needs,” she said.
But those shifting workforce needs might alternately be an area of untapped employment potential. Nursing jobs in hospitals are tougher to come by today, as institutions tighten their belts and employees postpone retirement, said Judy Honig, associate dean of student affairs at the Columbia University School of Nursing. Outpatient care and other less traditional settings, on the other hand, have a need for nurses with innovation, creativity and command of their field.
“When you get out there in a home, you really do have to have better decision-making skills and a bigger toolbox then you do in a hospital where you can just hit the call button. You have to know your material, you have to know what nursing is,” Honig said. “The nurse in those situations in rural areas may be the most educated health professional in the near area … That’s a challenge but I think that’s a big area that will be developed as we move forward.”
Cram said she thinks the aging population and other factors will keep employment opportunities for nursing graduates strong. Certain regions and cities are more competitive than others, she said, but the market always needs well-prepared nurses with critical thinking skills. She added that she does not foresee a shortage in nursing services as long as economic uncertainty discourages current employees from retiring.
The 26 percent increase in nursing jobs between 2010 and 2020 predicted by the BLS far exceeds the average for all occupations, which is 14 percent.