California Nursing Grads See Job Choices Wilt in Broken Economy
Monday April 6, 2009
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Both Doctors Medical Center of Modesto and Emanuel Medical Center in Turlock had only a few openings last year. This disappointed many of the 72 new Modesto Junior College nursing grads, who could count on being hired locally in the past. Doctors hired about 20 recent graduates, 10 fewer than usual. The facility’s nursing turnover rate is down, which has left fewer open slots for entry-level nurses.
In the San Francisco and Sacramento regions, which are dominated by large healthcare systems like Kaiser Permanente and Sutter Health, job openings exist mostly for RNs with experience, which has sent new grads to smaller and more rural settings for work.
Stephanie Robinson, RN, MHA, director of nursing at Fresno City College — the largest community college nursing program in California — says the most recent graduating class of 323 associate degree students found fewer jobs at local facilities than their predecessors.
Community Regional Medical Center in Fresno is the biggest employer of entry-level grads. It hires 80 and 60 applicants, respectively, at its two campuses.
Most Central Valley hospitals are being conservative in hiring nursing grads because of fewer insured people seeking acute-care services as unemployment rates rise, Robinson says. Jobs are even tighter in major metro areas, where hospitals can choose the cream of the crop from schools that turned out 10,000 new nurses last year, up from 6,000 RN grads in 2003. The ramp-up continues amid government reports of a growing nursing shortage predicted to reach 74,000 by 2030.
“One reason the nurse workforce can flex up is because 40% of California nurses work part time, which means it’s easy to take on an extra shift if there’s an economic hardship in the family,” Jones says. Also, many RNs work three 12-hour shifts, and some can take a second nursing job, she adds.
Assuming the state’s nursing shortage has abated because new grads are having trouble finding jobs is “really, really dangerous,” Jones says. “We’ve built a 54% increase in educational capacity over the past four years, and we can’t afford to lose those gains.”
As the surge of baby boomers hits age 65 next year, the need for nurses will accelerate and generate more jobs, both inside and outside of the hospital setting, according to Jones. The institute is doing an urgent survey on nursing demand in home care and alternative settings for a timely report due out in June.
When the economy rebounds, the need for new RNs will grow, as many employed nurses will “flex down” — return to part-time work, reduce hours, or retire, Jones says.
Nursing students graduating with master’s degrees should have enough clinical practice to enter the job market ready for certification, she says. They should also understand cost-benefit analysis in managed care and be ready to work in a multidisciplinary team environment.
“Many healthcare organizations are reducing the number of beds in hospitals and transferring the care of a growing number of patients to other types of facilities or settings,” Dracup says. “In light of this trend, it’s best for the master’s program student to gain experience in a variety of settings, including homes, clinics, and community-based facilities.”
The transformation of the healthcare industry in the last five years has changed hiring patterns, so it’s difficult to pinpoint regions with the best job opportunities, she says.
Generally, nurses with master’s degrees will be in demand in all regions of the country, she adds. “The demand for high-quality care will continue to grow.”
“At our facility, we are continuing our Work-to-School program, but it is a bit more difficult to place these new graduate nurses,” Dobbs says. Employees in the program receive tuition and a full-time salary and benefits for half-time work if they agree to stay with the two-hospital system for three years after earning an RN degree.
However, there has to be a good skill mix of new grads and experienced nurses in each unit to assure safe care for patients, Dobbs says. This requirement sometimes makes it difficult to place entry-level nurses because quotas fill quickly.
Nursing grads from the Work-to-School program have as much to learn as any new nurse, but they have an edge when it comes to being hired because they’re familiar with the hospital setting and staff. Also, as future staffing shortages occur, the hospital will have a pipeline of home-grown nurses to fill the vacancies, Dobbs says.
“How nursing is truly impacted by the recession is anyone’s guess, but what we are seeing is more underinsured or uninsured patients, which will put a strain on the entire healthcare system,” she adds.
“I’m not sure how widespread this is,” she says. “A lot of new RN grads are coming out, so there could be a bit of a flooded market.”
Her concern is that a perceived dip in nursing demand could trigger a diversion of government funding for nursing programs, of which UCSF is a large recipient. “About one-third of the slots in nursing schools are grant-funded, and it doesn’t take a lot for those to disappear,” Spetz says.
John Leighty is a freelance writer. To comment, e-mail editorCA@nurseweek.com.
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