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Managing Your Career
“I Thought There Was a Nursing Shortage!”
Author Donna Cardillo, RN, MA, on why you may be unable to find a hospital job—and what to do about it.

RealityRN member Auntymai writes, “I haven't been able to find a nursing job and the situation doesn't look good. I've been in contact with my professors at school, and I've been told that the new graduates are not able to find jobs either,”

It’s a sentiment voiced repeatedly by our RealityRN community—and the phenomenon is perplexing. After all, nursing students have been told there’s a nursing shortage: a hospital job in nursing should be a slam-dunk.

But the reality is the market is tight in some parts of the country. And different regions of North America, as well as the UK, Australia and the rest of the world experience the shortage differently. In some places, there is a glut of new nurses.  Nursing expert Donna Cardillo, RN, MA, author of new book The Ultimate Career Guide for Nurses, offers advice on how to find a job—even when it feels hopeless.

RealityRN: Why is there a sudden shortage of new jobs for graduates?

Donna Cardillo: First, many nurses predicted to retire aren’t retiring.  Some are working because they still need the money and the benefits.  Others just don’t want to retire – they want to stay engaged.  There are even some nurses who retire and then return because they miss it.

The sluggish economy is also part of the reason new nurses are having difficulty finding jobs. Some experienced nurses who were part-time are looking to pick up additional shifts to make more money.  Other nurses who temporarily left the work force to raise a family have spouses who have been laid off or just need to boost their family income--so they are returning to the job market to make ends meet.

And because many hospitals have a shortage of experienced nurses on staff, they don’t even have enough staff to orient new nurses, so are opting to hire only experienced nurses.

Is this happening everywhere?

No. It is not universal. I’ve heard California, the Boston area, parts of NJ/NYC and the Philadelphia area are the worst. But even in those tight job markets, it doesn’t mean that some of the hospitals aren’t hiring.

There’s no reason to panic. Don’t despair; things change. I’ve been in the nursing profession for over 30 years, and I’ve seen a lot of ups and downs. But new circumstances require a new approach to the job search.

What does this “new” approach entail?

It all starts while you’re a student nurse.

Look for summer internships at local hospitals where you can work as a student nurse. It’s a great way to get your foot in the door and become known by the staff.  Also, students might consider working at a hospital (especially a facility you are interested in working at post graduation) as a nurse’s aide or a tech. You not only build confidence but also become familiar with the facility and people.  If you do well and people like you, you’re going to have a much better shot at being hired as an RN once you get your license.

Just sending in a resume with a cover letter is an ineffective and tough way to market yourself in a tight market.

Once you’re a grad, what then?

It’s very important to get out to the career fairs and out to local chapter meetings of your state nurses associations.  You should join the association but if you don’t belong yet, go as a guest.  If you’re interested in a specialty, such as Operating Room or ICU, you should also attend meetings as well as join the associations of the related specialties, such as the Association of periOperative Registered Nurses (www.aorn.org).

These gatherings are geared for networking. And when you’re looking for a job in a tight job market, it’s all about networking. It’s how you find mentors and role models, build a support system, tap into a pipeline of information, and find people to refer you. Networking is the number one way to find and get a good job.

What is the worst mentality a new grad can have about finding a job?

Believing there are no jobs out there and that new grads can’t get hired anywhere.  Generalizations are dangerous and are rarely true.

It might be a challenge to find the type of job that you want in your local market, but if you’re not finding what you want you have to:

A) Change your approach—what you’re doing isn’t working; and,

B) Look in new directions—there are plenty of opportunities for nurses; they may just not be your first choice.

So perhaps nurses need to shift their expectations for their first job?

Here’s the reality: You might not be able to find a position for yourself right away in a hospital.  That doesn’t mean you’re never going to work in a hospital. But it means initially you may need to look for employment in an alternate care setting—a rehabilitation facility, a sub-acute care facility, a long-term care acute facility, an outpatient facility, a psychiatric hospital, a cancer care patient facility, or an outpatient chemo/dialysis center.  There are so many options.

Or say you want to work days in the emergency room.  You may start out on nights to get your foot in the door. You can do something different afterwards.

So there’s hope?


Yes! Stick to the basics: good self marketing, networking, flexibility. Don’t be afraid to consider your other options.  It’s a great profession and there are many interesting and exciting opportunities out there.

Donna Cardillo, RN, MA, has been referred to as the ‘guru’ of career development for nurses. Donna is a professional keynote speaker, author, consultant, and coach. She is author of “The Ultimate Career Guide for Nurses” and "Your 1st Year as a Nurse –Making the Transition from Total Novice to Successful Professional". Her accomplished career combines over 20 years of clinical, managerial and business experience, not to mention her stint as professional singer. She also operates Nurse Connections, a free online newsletter (http://www.nurse-power.com/). Donna’s clinical experience includes emergency and psychiatric nursing. Donna received a diploma in nursing from Holy Name Hospital School of Nursing and holds a BS in Health Care Management from St. Peter’s College and an MA in Corporate and Public Communication from Monmouth University.


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17 Responses to ““I Thought There Was a Nursing Shortage!””

  1. jeni Says:

    I have just experienced the same dilemma. I am a new grad and the hospitals are inundated with new-grad applications. They are just not responding, so I changed my focus. The long term care centers hire on the spot. Maybe a nursing home is not the place you want to be, but they pay more than the hospitals and it’s a good place to get some initial experience. Most of them are skilled nursing facilities. Unless you have the time to wait for these hospitals to call you back, I suggest alternative settings to hospitals as well.

  2. Auntymai Says:

    I don’t understand why people assume that new grads want to work in hospitals. I actually want to work in long-term care or public health nursing. I have talked to DON of a number of nursing homes and they tell me that they are not hiring because they have “too many RNs on staff.” What do you do when you face with type of opposition? I am finding out that the jobs I apply for are being filled with more experienced nurses. As a new RN it is very hard to compete with that. I’ve been to a nursing fair and found out that no one was hiring!!!

  3. Lauren Says:

    I graduated a little over a week ago. I have been looking for a job for months and have been nothing but discouraged after countless GREAT interviews. As stated above, they are going to more experienced nurses. But keep trucking new grads. I got my dream job when I least expected it, at a hospital I didn’t think there was a chance of me getting my foot in. Just do your best and make an impression! Good Luck!!

  4. DIXIE Says:

    COME ON DOWN!!! CONSISTANT SHORTAGE HERE IN “TEXAS, YA’LL COME, YA HEAR.” LOL!!! THERE ARE LOTS, OF GOOD PAYING JOBS/ RELATING TO COST OF LIVING, HIRING BONUSES AND RELOCATION MONEY, $2,000.00 TO $15,000.00 DEPENDING ON EXPERIENCE AND OR AREA OF TEXAS. HIRING GNS/RNS/GVNS/LVNS ALIKE. OR SIGN ON WITH A TRAVELING SERVICE TO GET A TASTE OF THE AREA WITHOUT A LONG TERM OBLIGATION.

  5. Candy Says:

    I have been a nurse for several years, and have been in several focus areas in nursing- including that of an instructor. Please know, there is absolutely nothing wrong, or insignificant, if you choose to work in long term care. The LTC facilities are now challenged and the work can actually be more acute skilled based and face paced than that of the hospital setting. Multitasking and working in difficult situations is something that you would be, or could be potentially be faced with. Not to mention, LTC nursing is extremely rewarding. Don’t sell yourself short by believing hospital nursing is the only path to take. Remember, nursing is one of the most, if not the most, diverse profession there is. Look around, explore.

  6. Jennifer Says:

    For any new grads who really want to work in a hospital, don’t turn down the opportunity at a long term care facility. That’s not my first choice either, but in many hospital settings you are bound to get patients from these facilities, and your previous experience there will help A LOT, believe me.

  7. BabyRN Says:

    I just stumbled upon this article as I was looking on the net for a job in almost two months since passing my boards. I am discouraged but also encouraged that I will still get to use my skills and hopefully camaraderie in being a new grad when I start looking into SNF/LTF’s. Thanks for the “shot in the arm”!

  8. katie Says:

    No texas isnt having a shortage. I too am a graduate nurse, and many people in my class are having a hard time finding jobs here in the Houston area. I didn’t want to stay in Houston, so I looked into the rest of the state, and Austin is on a hiring freeze. Some parts are, but it’s not as great as the other lady made it out to be. especially if you want to specialize like NICU, ICU, ER, etc… Hurricane Ike and the economy we’re in just isn’t helping things for new grad’s.

  9. EdwardRN Says:

    My prediction, which admittedly is an uneducated one, is that anyone in nursing school now, and any new grad now, can expect to eventually find a decent job doing what they want if they are willing to relocate or work nights, or some such thing. But we are at the end of the nursing shortage. Everyone always knew that if an economic downturn happened the nursing shortage would end. Well, the downturn is here.

    Now, every construction worker, auto worker, financial advisor and real estate agent is trying to get into nursing school where the “old” news is that there are pleanty of high-paying jobs just waiting for them (not to mention the halo you get when you become a nurse). And hospitals, even with open positions aren’t filling them.

    Eventually, this will have another effect: the long awaited BSN as an entry level educational requirement. Depending on how tight the market gets, an MSN may be required one day to be an RN. Just look at physical therapy or nutrition.

    One has to look at the reasons for the nursing shortage: As much money, if not more, could be made outside of nursing. But now, when there are more people willing to be nurses than there are jobs, the playing field changes.

    But consider this, perhaps nurses will get together and start home health businesses. Perhaps LTC will get quality people for once. Perhaps nurses will become more professional. Perhaps while some nurses are not able to get their dream job, the actual practice of nursing will get a tremendous shot in the arm. I hope so.

    Ed Gordon, RN
    http://www.lastnursestanding.blogspot.com

  10. Olaf Garcia Says:

    I agree with Ed Gordon(Interesting blog by the way). Although I am not happy about it, this difficult job market has forced me to step up my game. Instead of counting my ‘signing bonus,’ I’ve been doing some valuable self-assessment, and putting much more thought into how I want to shape my career than I would have otherwise. While I do have my moments when I’m bitter about this job market, I think this adversity is ultimately going to make for a lot stronger group of nurses, myself included.

    Great article too! I have intuitively started doing a lot of the approaches that Donna Cardillo writes about. I feel like I’m at least adapting to whats happening in an effective way.

    Cheers

  11. Angie Rn Says:

    I’m not a new grad, but only have one year experience. Let me give a word of advice. If you do get a job, don’t just up and leave it for the promise of a job with better pay. The pay might be better, but I can guarantee there is a reason. This is what I did and wound up losing that job because it was a horrible job where I was in charge of the LPNs and they weren’t really into having anyone supervise them b/c they mostly worked on that shift with no RN supervising them. It was a bad situation and I have now been out of work for 3 months. I only had one job offer and it was 2 hours from my house with horrible hours for commuting. Other hospitals have been advertising for positions, but aren’t actually hiring. Good luck to all you new grads out there. You will find a job and hopefully it will be a good one!

  12. unsinkablemb Says:

    One word of advice for new grads: NETWORK. In my experience, this is a great way to find a job. Not every job opening makes it to the hospital website AND not every recruiter is good at following up to online applications. A tight job market calls for a more aggressive approach. Talk to friends and family who might know someone who works for the hospital you want to work for.

    Not only is networking a great way to get a foot in the door, sometimes you’ll be lucky enough to get the inside scoop on the working environment (keep in mind every unit in a hospital has its own “culture”).

    Another thing… Look at specialities such as Peri-Operative Nursing which don’t get a lot of coverage in nursing school. Because of the lack of publicity, we are hurting for OR nurses! A lot of big hospitals hire new grads — some even offer tuition reimbursement with a 2 year commitment.

    And by the way, Ed made an interesting point about nurses starting home health businesses. I’ve been hearing about lucrative opportunities in that area. If I get sick of the OR, I think that’s the way to go.

  13. dawn Says:

    I graduated as a PN in June of ’09. I went back to school after being a stay at home mother for five years. After I passed boards, I expected to find a job within the month. I couln’t have been more wrong. Here I am months later still looking for ANY job. I’m not being picky. I feel like I wasted mine and my children’s time going to school. I’ve now had to move my family in with my mother at 25 years old. How is a new grad to get experience if no one will hire you? Catch 22 from hell. So much for a new start.

  14. Joe Roberts, RN, BSN Says:

    Hospitals and especially the administration are always finding ways to cut costs. Unfortunately, they are choosing nursing positions. I’ve seen units with open positions for 1 nurse, yet they are in actual need of 4 or 5. Administrators are reluctant to hire this many nurses for a) their salary and b)the benefits that go along with it. I’ve witnessed first hand (and left the situation) where there was such an OR RN shortage that instead of hiring nurses, they utilize their “emergency call” nurses to run elective cases after their usual shift. If the economy wasns’t so bad, these nurses would leave, but since they need the job, they continue to work these long hours despite the complaints of the nurses, as well as the surgeons. The fact that these non-clinical management personel only see dollars and not the patient risks. Believe me, there are plenty of spots for new nurses. Administration just doesn’t want to pay the price, nor given the state of the economy, they don’t have to. They use productivity as the basis. The number of patients related the the number of nurses to care for the patient. They don’t take into account of the acuity of the patient. They have been told over and over about it, but if they can get what nurses they have to cover more and sicker patients, they will do so.

  15. Dawn Says:

    It is an awful catch 22 and it is happening here in Albuquerque too. People say it is only in certain parts of the country but I keep finding more parts of the country where this is happening!

  16. Jeremy Says:

    I live in Michigan. I graduated from a RN program last April. I relocated to the city thinking I would have a better chance of finding work. I am having difficulty even at LTC facilities. I’ve had two job interviews and I just get denial letters in the mail. I got a call today and I flat out told the lady I do not have any experience in LTC and she said I’m not what they are looking for. I’m sick of wasting gas that I can’t afford to drive to places that aren’t going to hire me. I’ve applied to volunteer at a Free Clinic and I do have a meeting on Friday. I’m also starting an online BSN program and am willing to relocate, but I do not want to move, pay the $200 for my license in that state, just to encounter the same problem.

  17. Irene Says:

    The situation is not clearing up, only getting worse. My plan is to lose the 80 lbs I gained from working night shift and going back to office work. There are about 10 qualified applicants for every nursing job, and employers, knowing that fact, will gyp you and treat you like dirt. It is not worth it.

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