By Heather Stringer
An already energetic nursing job market is showing signs of amping up even further, according to nurse recruiters and national data. Still, new nursing school graduates will continue to experience extreme competition, nurse officials say.
One survey of 141 facilities nationwide found that nearly 25% of the hospitals reported a vacancy rate of 10% or higher in 2015, compared with only 5% in 2012, according to a report published by NSI Nursing Solutions, a national nurse recruitment and retention consulting business based in East Petersburg, Pa. Similarly, the turnover rate for bedside nurses jumped from 11% to 16% from 2011 to 2015. The survey included data from 141 hospitals, many in rural areas. “As nurses feel more comfortable about the state of the economy, they start looking for additional job opportunities, and those who put off retirement during the recession are starting to retire,” said Brian Colosi, president, NSI Nursing Solutions. “We are also seeing hospitals spend more money on construction to provide new services, and this creates positions for nurses.”
Demand for experienced acute care nurses has ratcheted up in the past six to nine months, both in rural communities, where there are fewer candidates, and urban communities, said Amanda Bleakney, senior managing director of health services at the Execu|Search Group, a recruiting agency with offices throughout the U.S. Hospitals that previously required two years of prior experience in a certain specialty are starting to consider applicants for the OR, ED and CCU, who have one year of experience in a different specialty, she said. Some employers also offer completion bonuses for short-term assignments.
Even California, which has been slow to recover from the recession, is showing signs the job market is shifting, said Judith Berg, MS, RN, FACHE, executive director of the California Institute for Nursing and Health Care. In the 2014 Survey of Nurse Employers in California, 18% of the respondents reported a perception of high demand for nurses and a difficulty filling open positions, which is double the share reported in 2013. Data were collected from 322 hospitals, about half of the licensed beds at general acute care hospitals in the state. Although the survey found the demand for new graduate nurses was lower than their experienced peers, nearly 83% of the hospitals had hired new graduates in 2014 — a 7% increase from 2013.
“Demand is better than it has been in a long time,” said Dale Beatty, MSN, RN, NEA-BC, CNO, the University of Illinois Hospital & Health Sciences System in Chicago. “This is a great time to be a nurse, even the best time, with the interdisciplinary collaboration and more new roles being developed than ever before.”
New roles, new grads
The University of Illinois Hospital & Health Sciences System filled 252 nurse positions between April 2014 and April 2015, and nearly half were filled by new graduates, Beatty said. While a portion of the jobs were new positions created to meet higher patient volume demands, the majority were replacements for nurses who had left or moved into new roles within the hospital. “Experienced nurses are transitioning into new roles in nursing informatics, clinical documentation, case management, infectious diseases, ambulatory care and community care as we shift toward a model focused on improving outcomes and creating a continuum of care,” Beatty said.
As an example, a nurse who had worked in the post-anesthesia care unit for 30 years moved to the quality-improvement department, where she focuses on improving the hospital’s performance on surgical measures. She learned how to analyze data and deliver technical presentations and has been highly successful so far, Beatty said.
“The new roles for nurses are just developing, which makes it an exciting time because we will see an increasing number of new positions in the future,” Berg said.
While new roles are traditionally reserved for experienced nurses, Beatty believes this will slowly change due to the increasing numbers of new graduates that have baccalaureate training and the benefit of in-depth nurse residency programs. According to Debra McElroy, MPH, RN, senior director of nursing leadership at UHC in Chicago, 240 hospitals nationwide have adopted UHC’s nurse residency program, compared with six hospitals when the program started in 2002. UHC is an alliance of nonprofit academical medical centers. Almost 9,500 new graduates participated in a UHC nurse residency program in 2014, 55% more than the previous year. That increase reflects the fact that more hospitals are adopting the program, she said.
Adventist HealthCare in Maryland recently launched a UHC nurse residency program to prepare for an expected increase in turnover of experienced nurses, said Theresa Mazzaro, BA, RN, CHCR, a nurse recruiter at Adventist HealthCare. The hospital plans to increase the hiring rate of new graduates once the nurse residency program begins, she said. The program was slated to begin in the summer.
New grad competition
Mazzaro acknowledged that competition among new graduates is intense — only one-fifth of the applicants was accepted into the first cohort for the nurse residency program. While a high grade point average and good recommendations will increase the odds of acceptance, Mazzaro said candidates can use other strategies to stand out. “Out of 150 people who applied, only 50 had a cover letter,” she said. “It is really important to do your homework by reading the hospital’s website and articulate in the cover letter how you will make a difference at our hospital.”
Mazzaro previously worked at PeaceHealth Southwest Medical Center in Vancouver, Wash., and was impressed when a new graduate created a video about his journey to become a nurse. He was hired. She also urges nurses to discuss their previous experience, even if outside the field of healthcare, and how these skills apply to nursing.
Although these suggestions may increase the odds, Bleakney says many new graduates simply cannot land a first job in an acute care hospital. She encourages applicants to consider taking intermediary steps that can eventually lead to their dream job. She places them in outpatient clinics and substance abuse treatment centers, as well as group homes for foster care or developmental disabilities.
She placed one new graduate with a local health department, and the job involved providing immunizations. The nurse then moved on to a position in a group home for adults with developmental disabilities. These roles gave her the experience she needed to find a per-diem job on a med/surg unit, where she was eventually hired full time.
Whether a nurse is just starting the career journey or considering a new role after years in the field, the job market is expected to be on an upswing for a while. According to the Bureau of Labor Statistics, employment of RNs is projected to grow 19% from 2012 to 2022 — faster than the average for all other occupations.
Even with this bright outlook, recruiters like Mazzaro believe nurses who are willing to take risks are the ones who will be most satisfied with their jobs. One experienced ED nurse at PeaceHealth in Vancouver, for example, took a chance when she accepted a position as a care coach in the primary care setting, partnering with patients to decrease their chances of readmission. She was so successful that the program expanded to include all ED patients at PeaceHealth in Vancouver, who had been admitted more than once a month.
“She left a secure ED staffing job and moved into a new role that did not have nearly as much job security,” Mazzaro said. “Then she started a brand new program and built something that has become incredibly successful. I think we will have more and more new roles like this as healthcare continues to evolve and nurses show how their skills can change the way we provide care.”
Heather Stringer is a freelance writer.
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