Nursing: Hot Job, High Pay -- So Where Are the Takers?

In a time of ceaseless layoffs, nursing bucks the trend with empty slots.

January 13, 2009, 5:25 PM

Jan. 14, 2009 — -- As the recession continues, layoffs batter industry after industry, from banking to auto manufacturing to construction to retail.

But for at least one occupation, demand is still high -- so high that job candidates have been plied with incentives that range from gas cards to $20,000-signing bonuses to an opportunity to meet a celebrity. (News cameras recently captured former "Love Connection" host Chuck Woolery participating in a recruiting event.)

These sought-after candidates are nurses, and experts say the lavish efforts to recruit them are symptomatic of a desperate industry.

Despite relatively high salaries -- nurses earn an average of more than $62,000 a year, about $36,000 more than the mean U.S. salary, according to the Bureau of Labor and Statistics -- the United States is facing a dire nursing shortage. By 2015, the country is expected to be short at least 300,000 nurses, according to some projections.

"We have older people who are requiring more health care, and so we have more demand. We need more nurses, and we expect that as the nurses retire they won't be replaced by new graduates," said Christine Kovner, a nursing professor at New York University.

Even the nation's crumbling auto industry has taken notice of the nursing shortage. The Henry Ford Health System, established by Ford Motor Co. founder Henry Ford, has partnered with a university in Rochester, Mich., to establish a new nursing training program specifically for laid-off auto workers.

"There is a nursing shortage out there nationally," said program spokesman David Olejarz. "We felt this was an opportunity to provide these people who were going to be impacted [by auto layoffs] to pursue a new career."

The lack of nursing graduates may be only a part of the problem. Because of poor working conditions, hospitals in particular also struggle to retain the nurses they've hired. Veteran nurse Dean Caputo, 52, remembers working at a hospital where the staff was so thin it compromised patient safety. Caputo, who lives in Beverly Hills, Mich., said there were supply shortages that left nurses scrounging, and that overall, the nurses felt ignored by management.

"It's sad," he said. "The majority of nurses want to do the right thing, but when you're not offered the resources to do your job, it's very hard."

"We have a revolving door with nurses," said Diana Mason, a registered nurse and the editor in chief of the American Journal of Nursing. "If you don't fix the workplace, we will never fix the shortage because the new nurses will leave."

And because of the overall nursing shortage, she said, unhappy nurses have plenty of options when it comes to finding new work.

Older Patients, Older Nurses

There are about 2.5 million registered nurses in the United States, about 700,000 more than there were in 2000, according to government data. But the rising number of trained nurses isn't keeping up with demand: As the general population ages -- a trend driven largely by the aging wave of baby boomers -- more nurses are needed to serve the needs of this population in one way or another.

"Some parts of the country are so challenged for nurses that they are recruiting nurses internationally from places like India and China," said Mary Walker, the dean of the Marcella Niehoff School of Nursing at Loyola University in Chicago.

The nursing population, as a whole, is aging. Recent statistics, Walker said, show that the average age of a registered professional nurse is 47.3 years old, and just 10 percent of nurses in the United States are under the age of 30.

Kathleen Dracup, the dean of the School of Nursing at the University of California at San Francisco, said the average age of nurses has been rising since the 1980s.

Nursing is a historically female profession, but the number of women opting to enter the field, she said, began dropping as they found a growing array of other career opportunities.

Still, according to some people in the profession, the shortage of nurses isn't for a lack of people who want to go into the field.

In recent years, Dracup said, media attention to the plight of the nursing profession, as well as an increased emphasis on values in the post 9/11 era, has helped raise interest in nursing.

The problem, experts say, is that there aren't enough open slots in nurse training programs to accommodate those interested in the profession.

In 2007, nursing schools turned away more than 40,000 qualified applicants, according to the American Association of Colleges of Nursing.

A lack of nursing faculty plays a major role in limiting the size of nurse training programs, Dracup said.

Salaries for nursing faculty, she said, haven't kept pace with salaries for nurses in general, and that's discouraged nurses from pursuing teaching careers. She said nurses with master's degrees earn, on average, $8,000 more in clinical practice -- $82,500 -- than they would if they were nursing school faculty members.

Good News for Nurse Training?

Nurse training programs receive less in the way of government subsidies than do medical programs. A 2007 study by the PricewaterhouseCoopers' Health Research Institute found that "nursing education programs often lose money for colleges, limiting colleges' willingness to expand their programs and raise faculty salaries."

But Dracup said there is some good news on the nurse training front: Some not-for-profit groups are tackling the issue, including the Robert Wood Johnson Foundation. The foundation is offering scholarships for would-be nurse faculty members and is also providing money to subsidize their research.

Some prospective faculty members don't need new programs or incentives to get going.

Maja Djukic, 29, who has worked as a staff nurse for 10 years, said high stress on the job is part of what's prompted her to pursue a career in academia instead.

"You go to work and you try to take care of the patients, and you are just not able to do that the best way you know you can," the New York woman said.

Dean Caputo, the Michigan nurse who scrounged for supplies at his last hospital, once felt the same types of frustrations voiced by peers like Djukic.

Today, Caputo is happy working as a nurse manager at Beaumont Hospital in Royal Oak, Mich. The hospital has been recognized for its nursing programs by the American Nurses Credentialing Center.

But Caputo said he still hears horror stories from nurses who recently left other hospitals to join Beaumont.

The conditions that Caputo and other nurses faced explain why, experts say, hospitals often have a hard time retaining hard-to-get nursing talent.

The challenges facing hospital nurses are, in part, budget-related. Even when they don't cut nursing staff, hospitals facing a cash crunch may choose to cut other positions, including housekeeping, janitorial and dietary staff. That means it's up to nurses to do more in the way of keeping track of patients' meals, changing sheets and cleaning rooms -- duties that take away from the time they have to provide patient care.

But other issues are more philosophical. Nurse satisfaction often depends on whether nurses are viewed as active members of the medical team, or just another pair of hands, said Loyola University's Walker.

Hospitals "need to think of them as thinking people. ... That's been the challenge these days," she said.

Tackling Nurse Turnover

At Beaumont Hospital, Chief Nurse Executive Valentina Gokenbach said the hospital has been able to improve nurse satisfaction by creating a nursing council that ensures that nurses play a role in hospital decisions. The hospital is also providing leadership training to nurses who ascend to management positions.

The hospital's efforts have had a great effect, Gokenbach said: In six years, the nurse turnover rate at Beaumont's emergency department has dropped from 52 percent to below 10 percent.

Though the training programs cost money, the decline in turnover saves more, she said. Recruiting and training each new nurse, she said, costs tens of thousands of dollars.

"It's 'pay me now or pay me later,'" Gokenbach said.

ABC News' Barbara Paulsen contributed to this report.