When Vicki Phangrath started nursing school, she stepped on a path virtually certain to end with a good-paying job.
That was three years ago.
Today, Phangrath, 24, has a nursing degree from Fresno State -- but no job.
Since October, she has applied at about 20 hospitals with no luck. "I've been applying all over California," she said.
Once seen as a lucrative and recession-proof career, nursing has hit hard times. Nursing-school graduates across the San Joaquin Valley and the state face frustrating job hunts.
Hospitals that only a few years ago were desperate for new nursing graduates now pick and choose whom they hire. Plenty of experienced nurses are clamoring for work.
Blame it on the recession. Experienced nurses who were expected to retire have just kept on working, said Deloras Jones, executive director of the California Institute for Nursing and Health Care, a statewide nonprofit organization. They may need to work because of the hit their retirement accounts have taken or a spouse may have lost a job or had hours reduced, she said.
Hospital officials and health educators say the state's high unemployment has created a temporary glut of nurses that will disappear when the economy rebounds. When that happens, a nurse shortage will return, they say.
Meanwhile, they worry that recent graduates will quit the profession or leave the state.
"As soon as the recession softens and unemployment drops, our aging work force is going to retreat," Jones said. "And we need to be prepared for what's going to happen."
The Valley will be short as many as 20,000 nurses by 2020, according to a 2007 report by the Central California Center for Excellence in Nursing at California State University, Fresno.
An expensive pipeline
Since 2005, the state has invested millions to expand nursing programs and train new nurses for the shortage -- and Californians looking for good jobs have flocked to take advantage of them.
About $260 million in public-private money has been pledged statewide over 10 years, Jones said. And more nurses were trained, she said. This year, 10,000 nurses will graduate, compared to about 6,000 who earned nursing degrees in 2004, she said.
But hospital nursing recruiters aren't offering many jobs to new graduates. Training new nurses to be fully ready to function in a hospital is costly, for one. And hospitals have had to tighten their belts in the recession. Fewer people can pay for expensive elective surgeries, and more need care but don't have insurance to pay for it.
But hospitals don't want graduates to stop applying for jobs.
"I would not discourage individuals from coming into nursing," said Ginny Burdick, senior vice president of human resources at Community Regional Medical Center in Fresno. "It's one of the best careers out there."
Hospitals need to keep a pipeline open for new graduates to enter the workforce and develop programs to help them smoothly transition into the jobs, said Nancy Hollingsworth, chief operating officer at Saint Agnes Medical Center in Fresno.
Both hospital executives said the nurse surplus is a temporary consequence of the recession.
And they say there still are jobs -- just not in hospitals. Nursing homes, for example, are hiring, but those jobs tend to pay less than hospital positions, and the work is less desirable.
That's no comfort for unemployed nursing graduates.
At Fresno City College, up to 70% of the most recent crop of graduates have told the school they were employed in health-care institutions, said Stephanie Robinson, director of nursing. Two years ago, 95% of graduates had jobs upon graduation, she said.
It's a similar story at College of the Sequoias in Visalia. The college used to see its entire class hired, said Karen Roberts, director of nursing. "Now half the class is offered jobs -- and not all full-time jobs," she said.
Demand for enrollment in nursing programs remains strong, however.
More than 900 applied for 184 slots in the Fresno City program for spring 2010, Robinson said.
Health experts worry that enrollment could decline if economic troubles continue much longer and employment for nurses remains tight.
"If grads can't find jobs, schools of nursing will decrease their enrollment, and the last time that happened, it took California 10 years to recover," said Jones of the Institute for Nursing and Health Care, which focuses on solutions to the nursing shortage.
Fresno State officials have told their departments -- including nursing -- to cut enrollment by 9.3% next semester. Michael Russler, chairman of the nursing department there, said he is trying to divert some students into an extended education program to maintain enrollment.
Meanwhile, there has been a shift in funding for health-worker training -- away from nursing schools, and to such allied-health professions as physical therapy assistants and pharmacy technicians, said Roberts of College of the Sequoias.
"We're kind of coming to the end of where the big dollar grants have helped," she said.
A long wait for jobs?
Economic forecasters predict California will be one of the last states to recover from the recession, which is not good news for nursing students just beginning their studies.
Karla Charlson, 41, of Los Banos is in her second semester of nursing classes at Fresno State. She needs a job when she finishes her degree in May 2012. She is a widow and is raising four children on Social Security and student financial aid.
She considered a psychology major before her husband died. She switched to nursing for the job security. "We're not just doing this for the fun of it," she said Thursday, outside a nursing class laboratory.
Jeanette Wierman, 36, of Fresno is raising a 31/2-year-old son as a single mom. When she graduates from Fresno State in two years, she will have about $30,000 in student loans to pay off. "I am concerned about the job market," she said.
Rose Yang, 24, a Fresno State nursing student, is applying at hospitals now, before she graduates. Before the recession, hospitals were eager to hire student nurses. Now, paid work-study jobs are scarce. "I'll just have to keep looking," Yang said.
Phangrath, who received her degree from Fresno State in December, said she is expanding her job search beyond hospitals to public health agencies and correctional institutions. But her clinical experience at school was in hospitals, she said.
She has $8,000 in student loans to pay.
She may go back to school. She has a bachelor's degree from Fresno State, but a master's degree "might expand my horizons in choices I can make to get a job," she said. To teach, a nurse needs a masters degree or higher.
If she doesn't go back to school, Phangrath said she may "just work somewhere else, outside of nursing."
The state can't afford to let nursing graduates take jobs outside of nursing, said Jones of the Institute for Nursing and Health Care.
"The longer they're out of nursing school, the harder it's going to be for them to feel confident to go after a job," she said. "We need to keep them engaged."