We keep hearing about a nursing shortage. And we keep hearing that the Affordable Care Act will increase the need for nurses.
Yet the American Association of Colleges of Nursing reported a 47% job-offer rate at graduation last year for baccalaureate-prepared nursing graduates in the West, and 59% nationally. Why aren't newly minted nurses landing jobs?
Equally strange, qualified applicants to nursing schools are being turned away in California. This comes at a time when the average state has 921 nurses per 100,000 population. California has 743 nurses per 100,000 people, one of the bottom five states, according to the National Center for Health Workforce Analysis.
We have two main problems, one structural and one, perhaps, temporary.
The structural problem is that nursing schools have to turn away qualified applicants to their four-year and graduate nursing programs because they don't have sufficient numbers of teachers.
If you're a nurse practitioner with a master's degree earning $125,000 a year, why would you go back to school to move into teaching when the average salary nationally is $102,000?
Many states have created incentives to encourage nurses to make the leap from clinical nursing practice to teaching, such as loan repayment or forgiveness programs for graduates who go on to teach for three years at a state college or university.
Clearly, Gov. Jerry Brown, legislators and nursing schools will have to explore other solutions.
And what about students who manage to get a scarce slot in a nursing school but can't find work when they graduate?
This may be a temporary problem, part of the Great Recession hangover. Many nurses at retirement age stayed on the job as they saw their 401(k) plans shrink. As the economy recovers, they will retire.
In the highly competitive market, open nursing jobs go to experienced nurses. More than half of nursing jobs are at hospitals, which favor experience for safety reasons and cost.
While training an experienced nurse into a particular hospital system costs about $15,000, training a new graduate costs about $60,000, according to Debra Brady of the California State University, Sacramento, School of Nursing. That expense for training new graduates becomes more worthwhile as older nurses retire.
The good news is that the California Employment Development Department forecasts that 10,500 new nurses a year through 2018 will be needed to replace retiring nurses and meet increased demand under the Affordable Care Act. The American Association of Colleges of Nursing reported that in 2012, 82% of nursing graduates in the West were employed four to six months after graduation, so persistence matters.
The December class of nursing graduates throughout California will find experience where they can, in nursing homes, home health care, the military, schools and clinics. But the teaching pipeline needs attention. The Legislature ought to address the question of credentialing for nurses who teach nursing students.
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