How many times have you read about the staggering shortage of nurses? It’s routine to see numbers in the hundreds of thousands tossed around ’representing the seemingly insatiable demand for nurses from an aging population. I’ve always been suspicious of these estimates. First, it’s not how the economy works. We’re not really going to have 260,000 unfilled nursing positions in 2025. Either supply will rise, demand will fall or there will be a substitution of other kinds of labor or capital. Second, these numbers often come from interested parties, usually advocates for higher nurse pay and benefit or people who are running nursing schools and would like them to expand.
So I was struck by an article today that mentioned a glut of nurses, even in places like California that mandate minimum nurse staffing ratios. The situation is blamed on the recession, which depresses demand as hospitals and other nurse employers seek to control budgets, and also increases supply as nurses delay retirement, seek more hours, or return to work when a spouse is laid off. I’m sure there’a lot of truth to this, but if there is really such a big shortage it shouldn’t turn into a glut so quickly.
I don’t think employers of nurses are quaking in their boots due to the prospect of a gaping shortage of nurses. Although they might not say so openly (since everyone loves nurses) the forward thinking hospitals are planning for the day when nurses comprise a substantially smaller portion of their costs than they do now. They’ll do it with better decision support systems, workflow tools and robots that will take over many routine and high-skill nursing functions. Hospitals may seem capital intensive now, but I really believe there will be even more substitution of capital for labor in the future.
So if you’re betting on a giant nursing shortage in the year 2025 my guess is you’re going to lose.
By David E. Williams
David E. Williams is the co-founder of MedPharma Partners who writes regularly on the Health Business Blog.Visit website | More posts by Author
AS a Nurse I can say you are right. There never was, or has been a nursing shortage. EVER. What happened is many, many private schools poppued up, way too many for the market, and began cranking out nurses..by the tens of thousands-only one problem. California does not need tens of thousands of nurses. Never did. Never will. A recent report by the University of Chicago stated that California could close EVERY SINGLE NURSE SCHOOL in the state for 10 years, not graduate a single nurse..and there still would be a glut. In 2011, California passed 15,000 nurses through their state boards-less than 9% found a job within a YEAR! A Year! Less than 2% found a job right away.
I am a flight nurse, work in a helicopter. How did I get my job ? I knew someone who guided me through EXACTLY what I needed to do, who to meet, internships, etc..Without that, I would be just another laid off Nurse..
What I see in the hospitals today is truly frightening; Pacific Islander nurses with MARGINAL communication skills working ER or ICU. Young, inexperienced RN's getting hired over older, more experienced one's because they will work for cheap(Patient care skills suck, but hey, what are patients, anyway..just the product, right?) Management that will lay people off on a whim...yes, nursing USED to be a great way to make a living. Now, between declining wages, lowered expectations(Meaning doctors even more dismiss you as "the help") less knowlegable nurses...No wonder old timers aren't retiring..as I have been told many times.."It isn't safe for my patients if I go.."
As with any industry, there are inequities both morally and economically that are responsible for the nursing shortage that started in the 80's. When the cry went out that we had a critical nursing shortage, it was not really a shortage of nurses because there were many nurses "out there," who had left nursing to work in fields that were less frustrating, paid better and were more respectful of their skills. Many of these nurses were the victims of hiring freezes as well as the hospitals tried to increase the profits at the expense of patient care and on the backs of nursing. I fear that the day is coming soon that nursing will be even more undermined and automated and I surely hope I am wrong. Even today, in some of the best hospitals, there is such short staffing that it is a bit scary to be a patient. Aside from being highly skilled, highly educated, critical thinkers, nurses are human beings that have immeasurable value. We are with you when you are born, when you die and when you are in pain, to help alleviate it. We do care but we also need care so that we don't get burnt out and can give patients the care that they deserve. It is the nurse, more than any other health-care team member that is responsible for keeping you alive. I can tell you that there is nobody in the marketing department or working closely with the CEO or CFO who really cares about patient care and certainly robots and less highly skilled workers may make the bottom line look better, but not the care. With such a nursing "shortage," why are my students having a hard time finding jobs?
David, You are correct that the nursing shortage is a myth. There are many reasons that the myth is getting perpetuated by the hospital industry. Many nurses who are experienced and skilled cannot find positions in hospitals. One reason for this is the industry desire to deskill the profession of nursing. One would think that experienced nurses would be a desirable commodity and essential for providing safe, competent care but this is not the case. It seems as though employers would like to erase the collective memory of what patient care should be. The robot nurse may be the vision of healthcare for hospitals but it is not the vision of healthcare that nurses hold.