Education, Job Satisfaction Drive Nursing Changes for 2013

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What’s the outlook for nursing in 2013? Will nurses increasingly need advanced degrees? What's causing the high turnover rate among nurses? What will drive the nursing shortage, if it occurs?
A recent Q & A with Carol Brewer, published in The Buffalo News, provided some answers. Brewer, a professor of nursing at the University at Buffalo School of Nursing and the associate dean for academic affairs is a member of the New York State Regional Action Committee for the Future of Nursing. She is also co-leader of the RN Work Project, which studies career changes and work attitudes, and the director of nursing for the New York State Area Health Education Center System Statewide Office, which develops nursing policy and workforce development programs.
On the subject of higher education for nurses, Brewer referred to a 2010 Institute of Medicine Report, which cited the benefits of a BSN on patient outcomes, and that graduates are not only younger but remain in the workforce longer and continue on to pursue advanced degrees.
In regard to turnover rates and how to reduce them, Brewer noted that just over a quarter of hospital-trained nurses leave their first jobs within three years, and over half do so within six years. Most simply move on to another hospital. Reasons vary from changing clinical interests, a healthier work environment, or better work-life balance (shifts, stable hours, etc.).
To retain nurses, Brewer points to the success rate enjoyed by Magnet hospitals, which concentrate on improved nurse satisfaction, practice autonomy, and offer better career opportunities. If nurses feel their contributions are valued, they tend to stay. Also helping to retain nurses are “dedicated education units.”
Will healthcare reform expand the role of RNs? Brewer suggests that nurses don’t need to expand their roles as new healthcare systems kick in. Nurses know how to move patients through the health care system to produce better outcomes. For example, nurse practitioners can provide safe and effective primary care in a variety of settings. Independent practice nurses have the same patient outcomes as those who practice in collaboration with doctors. It all comes down to money for physicians who want to bill for collaborative services with nurse practitioners.
As for the current job shortage for new RNs, Brewer was optimistic. Having lived through three acute shortages of varying lengths (one that lasted nearly 10 years), she notes that the growing numbers of aging nurses leaving the workforce may produce a shortage and trigger more hiring. She indicated that while new nurse graduates may not be getting their first choice jobs, they are landing nursing jobs. 
While nursing schools are being flooded with applicants, they’re turning away many. The reason, says Brewer is a shortage of nurses with teaching credentials. It takes up to seven years to produce a doctoral-prepared nurse. That, plus faculty to student clinical ratios have been mandated at 1 to 8. 
There’s no doubt that big changes are coming to nursing—both in the numbers and types of jobs. Education and job satisfaction will become the drivers in improving the lives of nurses and ultimately the healthcare they provide. 
Image courtesy of Sira Anamwong/

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  •  Carolyn B
    Carolyn B
    I have been nursing for over 30 yrs. First as LPN for ten then RN-ADN the remainder of the time. I have recently moved from a large city to my home town. I had a job for nine mos. after the move and the treatment I recieved was disgusting. I am 53 and have been looking for a job now. It is hard enough to find a job now at my age , who wants to go back to school now?! Experience means nothing to any of the employers out there. It's how long they can work you, how little they can pay you and how much BS they can give you now. There is NO respect out there for any of us!! So why would I want to become homeless and go back to school for more of the same ole stuff. I personally have made many patients comfortable and gave my best and what do I have now? Nothing, no job!!! Thinking about changing my career now!!! someday employers are gonna miss those of us that were in 100% and not  just a paycheck!
  • emily m
    emily m
    most nurses 55 and older cannot financially afford  to pay for BSn and be saving for retirement.These people have dedidcated their life to service but now have to be tossed asside as if useless.There have to be another alternative  for these nurses.They have held and delivered healthcare and all of a sudden they are not vallued anymore?Afterall,they offred their hearts and souls to yhe profession.Money was a bonus.Put people who are comming in focused on the $ sign,they will not hold through the stress of nursing.Hence  the shortage in med/surg because noone wants to deal with that stress.However,veteran nurses deserve to move to specialty areas with less patients.They have the experience  and have earned that by being there all these years.
  • Gudrun M
    Gudrun M
    Nursing shortage!!!!!!!!! They talked about that 30 + years ago when I was in nursing and the Midwest is not a place where I see this happening. In fact most do not treat you well!We also are not utilizing our "older" nurses well.  Some have given their lives and now have some form of disability, however we have experience and BRAINS left.  We need to figure out how to put these people to good use.  We are still a very valuable asset to everyone!
  • Alex Kecskes
    Alex Kecskes
    Thank you for you comments. There's no substitute for experience and a kind heart. But with so many nurses chasing fewer jobs, the gatekeepers in HR have decided that advanced degrees will help thin out the ranks of inexperienced applicants. It's not fair, but whoever said life was fair?
  • Alex Kecskes
    Alex Kecskes
    Thank you for you comments. There's no substitute for experience and a kind heart. But with so many nurses chasing fewer jobs, the gatekeepers in HR have decided that advanced degrees will help thin out the ranks of inexperienced applicants. It's not fair, but whoever said life was fair?
  • virginia f
    virginia f
    there is no shortage! hospitals are laying off nurses. New grads cant get jobs and older nurses cant get hired. I have 32 yrs experience and cant find a job, I have given up working . I cant afford to go to school for a doctorate.
  • Margaret L
    Margaret L
    I believe the nursing field would benefit by first stop down grading LPNs, second why not grandfather LPNs with 25 years and up experience or let them challenge the RNs exam, Third our profession has to become united. There are many LPN that can run circles around RN with their BSN so we really need to unite and stop the battle between RNs and LPNs.Now more education will not bring back compassion and care that many nurses RNs and LPNs lack. All new nurses need to be told this profession is not about making big money.
  • Judy W
    Judy W
    I have been a nurse for 40 years. I began my career as an LVN in 1973. In 1980 I received a Bachelor's degree in nursing and obtained my RN license. In 1991 I became a nurse practitioner in Women's Health, graduating from Harbor UCLA. I have worked full-time for 40 years in a variety of settings and specialties. I believe I have much to offer new nurses but I cannot teach because I do not have a Master's degree. I cannot get a Master's degree without repeating much of my NP curriculum. Why?-I am told the course content is simply "too old." Nursing students are being turned away nationwide because there are not enough qualified faculty. I simply do not have the right letters after my name to guide the next generation of nurses. What a shame.
  • Tricia M
    Tricia M
    Wow, I thought I was an alone 25 year plus LPN. I feel what many other LPN's wrote but was afraid to speak thanks for being my voice. I like to add a couple of comments. I became a nurse because I love the contact with my patients and wanted nothing more. Most old school nurses are not interested in spending years in college. I honestly feel if the nursing diploma schools still existed, these shortages would be obsolete. I have disabilities and I am always in school. It took many years to receive all the of the required courses to enter into a RN school.(I did this to maintain employment). I struggled, repeated some, yet passed all only find out after 25 years I was  "not capable to be an RN, but make a fine LPN. I did not understand then or today. I never lost my LPN license or made any clinical mistakes and passed all test. I was told that my clinical tools-care-plans, etc. were not acceptable. Nothing worked, even after receiving help from peers, submitting exactly word for word what was expected. I took my final and was explained that no matter what the grade, I would receive a D so I could not advance to the next year. Yes, I appealed it to the board which included, "the first and second year instructors." I am sure you can conclude who's side they favored. :(
  • Denise B
    Denise B
    Living in an area with school providing the AD & the BSN nurses, the nurses graduating from the AD school are better than the BSN nurses.  Many nurses are in it for the money & not for patient care.  
  • CarolM
    For many CNO's the new grad issue is an  economic one.  The time it takes to bring a new grad to independent practice is expensive and extensive. As tho the concerns of the LPN's ,most hospitals still pay at least partial tuition and try to schedule with the nurse's school schedule in mind . LPN's are not independent in acute care settings and the RN's are responsible to oversee the care provided by the LPN's . In my experience , it has been difficult to adjust assignments to reflect the additional responsibilities of the RN.
  • Karen M
    Karen M
    Believe me, nurses are not rich. We make much less than what people think we do. Those not in the medical field have no idea the stress, hours and physical work a nurse does. We don't just pass pills and wear high hills.
  • Karen M
    Karen M
    I think the author totally missed the mark on why nurses are leaving their jos. Lets stop being PC and tell the truth. It is nurse to patient ratio and the pay for the amount of work and responsibilty placed upon the nurse.
  •  Marie B
    Marie B
    I have been an RN for 34 yrs. I have recently relocated back to Pittsburgh after being in Florida for 30 yrs. Even with my yrs of experience I am finding it difficult to get back into the "system" that I started my career in.   I have completed several courses towards my BSN  but never finished ...I am now contemplating if I should complete my BSN or go in another direction.   Schooling is expensive and I have found it does not lead to more money in your paycheck ... would just be another step towards ....maybe more oppurtunity and maybe not.I am frustrated that some hospitals are more concerned with letters behind one's name than their experience !   And on another are we going to encourage people into nursing (hands on) when we do not want to hire new grads either ?
  • Nina F
    Nina F
    Just what is needed . More education . That  should take care of all  the nursing problems. Ask the nurses who take care of the patients what will make their jobs better, not the nurses who sit in a office and are so far removed from  the reality  of what we really do. Please tell me why anyone would  even think  a nurse who does not  or has never done bedside care  would know  what we bedside nurses need  or that a higher education would make a  difference.
  • Brian H
    Brian H
    What is the point of going for a BSN? The pay scale does not increase and not everyone wants to become an NP or another cog in the healthcare administration wheel. The only thing a BSN does is teach you to write papers. Very little in the way of pathophysiology or better patient care is taught. Again, as was mentioned previously, all of the hospitals and clinics want people with years of experience, but how do you ever get a chance if you have no experience. What happened to the Master/Apprentice programs? Five years with my RN and not too excited about the future of nursing or my career.
  • Keri B
    Keri B
    All the comments I have read re: this article should all be taken into consideration because they are all true! As an LPN at the age of 42 wanting to obtain my RN, I feel is an overwhelming task weighing the options to go for it, or forget it and change careers! As an LPN I have had many fellow nurses mistaken me as an RN because of my knowledge and experience I have in the medical field. However, we LPNs are still looked down upon as the"long term care nurses" who make less money, but do all the actual work and more than most RN's.  We Little pee ones should be able to have a crack at the RN NClex!
  • Fabio A E
    Fabio A E
    I agree with you 100%,"Nurse satisfaction" in their job,educational assisitance,freedom to choose schedule, and being able to have a family life is an essential part to success in the nursing profession."
  •  Cynthia L
    Cynthia L
    Yes I agree, However, people are entering nursing for the wrong reason. Many chose it for financial gains only. Therefore, they are not delivering the care all patients deserve. I have been a nurse for over thirty years, receiving my RN at 20 years of age. Most nurses today are not devoted.
  • Linda H
    Linda H
    The is a plethora of RN/BSN trained nurses waiting to get into this country. Why are hospitals not pursuing this avenue. The Philippines has nurses that want to come to the US.
  • Wayne S
    Wayne S
    Thank you for the article on changes in the role of nurses. One thing I did not see what role the LPN would have in the future of health care. Why are they so limited in what they are allowed to do? I have been an LPN for over 20 years, 15 of those years working as a traveling nurse. In almost all states we are allowed to do almost 90% of what a RN can do. Why not let the LPN take part of the load off the RN and let the RN do what the LPN is not allowed to do? By doing this, the nursing shortage could be eased in most hospitals without any comprise in the quality of care the patient receives. From what I have seen, it is the insurance that is calling the shots as to who the hospitals can have and have the care covered, but as it can be seen THIS IS PART of the problem that is causing the “shortage”. Just something to think about.Wayne Shrock, LPN
  • Siobhan K
    Siobhan K
    I have been a nurse for over 20 years. I see nurses struggling everyday. They work two jobs and go to school and try to take care of their families. We have to think about the tremendous stress they are putting on themselves. What can we do to make their lives less stressful while they care for others loved ones? This is what the administrators and hospital managers should be working on to assist in keeping the standard of care at a high level and the nurses who give the care a support for their services.
  • Dr. D
    Dr. D
    While there are many areas of nursing responsibilities are drastically changing, it is important for us to recolonize the  essential and emerging role of Electronic Health Record in nursing practices. Nursing is about direct caregiving, the medical and nursing community is acutely aware of the monumentally increasing demand in patient care that we are experiencing. As a faculty and medical informatics professional I feel Information Technology, Mobile Health, Electronic Health Record and Bedside Technologies are expanding in use within all health settings to automate and clinically document patient conditions at admissions, progress and discharge stages.  I feel all nursing curriculum and Continuing Nursing Education must recognize the new technological dimensions that would allow nurses to be technically savvy and find more time to be with patients.
  • Veronica  J
    Veronica  J
    I have been a diploma school graduate for 32 years, and have worked in various nursing settings since. I expect to continue to work until my heart tells me to stop. That's what makes an effective nurse not a  doctorate.  I truly believe that an experienced nurse with without a doctorate can teach nursing just as well.  They know the ins and outs, and are willing to pay it forward.  Any nurse with such experience is worth it.
  • MARY M
    MARY M
    I  t has been my pleasure to be an RN BSN/APRN FNP for 32 years. Was school easy? It shouldn't be! Healthcare changes over time as does economics and for that matter technology and people. There is a difference between a AD and BSN.  Technical vs Professional. Not everyone that applies for RN school is a good fit. Just as similar to other professions. Nursing is rewarding; however, it is a complex profession. I have worked through many shortages. We do the very best we can with what we have....knowledge, skills, staff, patients, education, and more!  

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