Nursing was pitched as a recession-proof job sector facing perennial shortages, but the Great Recession has left many recent nursing-school graduates and experienced nurses scrambling to find work.
When Alex McInerney graduated from a four-year private nursing school in the spring of 2010, she was $50,000 in debt and ready to be a nurse.
Every morning, she scoured the vacancies posted online by area hospitals. Over 15 months, she applied for more than 100 openings.
“When I went to nursing school they said, ‘As a nurse, you’ll never be without a job,’ ” says McInerney, 24.
Nursing was once viewed as a recession-proof field with a chronic labor shortage. But there’s a new reality for nurses: It’s hard to find a job.
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A decadelong recruitment effort beefed up the supply of nurses, but the Great Recession has curtailed hiring as older nurses work longer, fewer nurses quit, and financially pressed hospitals and clinics find ways to get more work done with lower-paid medical assistants.
Working nurses have found themselves laid off, too. Public Health — Seattle & King County laid off 12. And Swedish Medical Center recently announced it was closing its home-health program, which will eliminate the jobs of about 50 registered nurses.
The changes have left hospitals and clinics with fewer openings and intensified the competition: There were 1,800 nursing-job vacancies statewide in 2010, while in-state nursing schools awarded 2,850 associate’s or bachelor’s degrees in nursing.
“We feel really bad because we as an industry promoted nursing as a great career,” said Kim Giglio, director of recruiting at Tacoma-based MultiCare Health System.
But she says young graduates shouldn’t lose heart: “At some point we will go back into a shortage.”
That could happen by 2017 or sooner, a recent University of Washington study found, as baby-boomer nurses retire, the population ages, and broader federal insurance coverage begins in 2014.
In 1980, when the nation had a dire nursing shortage, Rose Raintree was recruited by a Florida hospital before she had completed her associate degree or obtained her nursing license.
“You could get a job anywhere,” said Raintree, 68, who now lives in Skagit County. “My first job was as a charge nurse of a busy surgical floor.”
Here in Washington state, the shortage reached epic proportions: By 2001, more than half of Washington state’s emergency departments were redirecting ambulances to other hospitals due to nursing shortages. That year Washington had a shortage of 2,000 registered nurses at hospitals.
In response, several local hospitals, the state hospital association and the Workforce Development Council of Seattle-King County banded together in 2002 to recruit more students into the pipeline and expand training programs. Millions of state and federal taxpayer dollars went into the effort.
It worked: The number of new RN students graduating annually in Washington state doubled during the 2000s. They could find jobs easily because vacancies opened when experienced hospital nurses retired or worked part time.
“We did what we set out to do: We increased the supply, we increased graduation rates, we attracted more people to nursing … Then boom, we got hit with the economy,” said Barbara Trehearne, a vice president at Group Health Cooperative.
When the financial crisis hit in the fall of 2008, the turnover rate at Swedish Medical Center fell by half, dropping below 6 percent, said June Altaras, chief nursing officer at Swedish’s First Hill campus in Seattle.
Nationally, unprecedented numbers of former nurses returned to work, including many over age 50, according to the Center for Interdisciplinary Health Workforce Studies at Vanderbilt University. The center chalks that growth up to married nurses re-entering the workforce when their spouses lost their jobs.
At the same time, patient visits declined at Swedish and other health-care centers, as people lost their health insurance.
“People are being really careful about seeking medical care, which affects volumes in clinics,” said Kim Williams, chief nursing officer at Providence Regional Medical Center in Everett.
Fewer patients and cutbacks in government health-care spending have led to layoffs, or more drastic moves.
In 2008, two small hospitals in Redmond and the Spokane area closed their doors.
Anticipating billions of dollars less in government money over the next decade, hospitals, nursing homes and medical offices are looking for ways to become more efficient, experts say. Among other things, they are delegating some nonclinical work to lower-paid medical assistants that was previously done by nurses.
“I feel horrible for these new graduates,” Altaras said.
Shock for grads
For their part, new graduates never expected this, either.
McInerney said she thought she had an edge when she graduated in 2010 because she had worked at a mental-health facility while in nursing school.
She said she was shocked when hospitals told her they preferred more experienced nurses, since they can cost $30,000 more than new graduates.
“They say, ‘We want two years of experience,’ but how do you get two years’ experience when you’re a new graduate?”
Barbara Hack, director of the nursing program at North Seattle Community College, said these days employers can insist on experience.
“When there’s a nursing shortage, they’ll take someone who’s breathing, and train them,” Hack said. Now, “there’s a lot of people with experience taking the spots that new graduates would have been taking if the economy hadn’t changed.”
Even nursing-school graduates with strong credentials have felt the impact.
“I graduated with a 4.0 with honors and it still took me six months to get employed,” said Maple Valley resident Heather Browning, 33, a former stockbroker who graduated from a 13-month accelerated program at the University of Buffalo last May.
Browning said she too was told by hospitals they were looking for nurses with job experience.
“Becoming a nurse does not guarantee a job,” she said. “You start to get a little desperate.”
Last October, McInerney reluctantly accepted a desk job at a consulting firm that processes insurance claims. It wasn’t where her heart was, but she needed the money.
Three weeks later, Swedish called and McInerney traded her full-time office job for a part-time job in its short-stay unit on the First Hill campus.
“You don’t want to quit a new job,” McInerney says, “but at the same time the only way your nursing career will ever happen is if you get that foot in the hospital.”
Browning landed a job in the short-stay unit too. She’s part of Swedish’s first class of nursing residents — 125 of them — who will receive extensive mentoring and attention from central nurse administrators in hopes they will stay with Swedish after their one year of training is complete.
The residencies help nurses learn what it takes to care for patients, how to track them and which doctors to call. Browning calls it “tribal knowledge of the hospital.”
Without a job
Even some nurses with work experience are unemployed. There are nearly 800 registered nurses across the state who are currently on unemployment benefits — a sixfold increase from 2007, state records show.
Among those collecting benefits, older nurses are disproportionately represented — those 55 or older account for nearly half of the unemployed, though they are only 39 percent of the state’s licensed nurses, according to the state Employment Security Department. By contrast, those under age 34 make up 17 percent of licensed nurses but only 10 percent of those collecting unemployment benefits.
Raintree, the 68-year-old Skagit County nurse who’s worked in hospitals and as a nursing-home administrator, said she left an employer last spring because it wouldn’t deal with her concerns about patient safety. She qualified for unemployment benefits and drew them for six months as she applied for hundreds of jobs.
“I went through three recessions and never had to worry about finding jobs,” she said.
Students are still banging down the doors of nursing schools: Tacoma Community College reports up to 300 qualified applicants for 24 seats in each admission cycle. Experts say these nursing schools need more faculty and resources to fill the nursing shortage they think will reappear as the economy strengthens.
“There’s going to be a huge demand for registered nurses,” said Jennifer Stewart, a managing director at The Advisory Board, a health-care consulting firm in Washington, D.C. “I think the long-term outlook for folks with an R.N. degree is really positive.”
Raintree says students should look beyond hospitals for jobs. Her work options limited by two shoulder surgeries, she took a job as head nurse for a school district.
“Most of us at the age I’m at hope to retire by now,” she said. “I recognize I’m going to have to work as long as I can.”
Sanjay Bhatt: 206-464-3103 or firstname.lastname@example.org