Even in nursing, jobs are scarce, but change is coming

SEATTLE — 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,' " said McInerney, 24.

Nursing once was 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.

A decade-long 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.

"We feel really bad because we as an industry promoted nursing as a great career," said Kim Giglio, director of recruiting at Tacoma, Wash.-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, Wash. "My first job was as a charge nurse of a busy surgical floor."

When the financial crisis hit in the fall of 2008, 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 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, Wash.

Fewer patients and cutbacks in government health care spending have led to layoffs, or more drastic moves.

Anticipating billions of dollars less in government money in 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," said June Altaras, chief nursing officer at Swedish Medical Center's First Hill campus in Seattle.

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 center 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, Wash., 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 said, "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."

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."

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