Wednesday, December 12, 2012

Hang in There, Nurses--The Tsunami is Coming!

Many new nurses and nursing students are voicing a great deal of concern over the lack of positions and competitive salaries in the current job market. While this may be disconcerting to some, I encourage all nurses to hang in there as we wait for the economy to rebound and the "Silver Tsunami" to reach its peak.

With a lackluster economy and many older workers having lost considerable percentages of their retirement investments, it has appeared over the last few years that many aging nurses are postponing retirement until economic conditions improve. Meanwhile, schools of nursing keep churning out graduates who enter the job market and are dismayed at the level of competition (and relatively low salaries) that make up the current job landscape in healthcare.

These stark realities are indeed sobering, but my "nurse sense" (sort of the nurse equivalent of Spider Man's "Spidey sense") says quite clearly that, within four to five years, there will again be a surge of jobs in the nursing sector, jobs that will seek to fulfill two things: the phase-in of health care reform that begins in 2014, and the exponentially increasing number of Americans turning 65.

The so-called "Silver Tsunami" that's beginning to break upon the shores of American healthcare is only going to increase in intensity over the next few decades, with perhaps as many as 10,000 Americans turning 60 every day. In fact, approximately 90 million Baby Boomers are expected to need senior healthcare services over the next fifteen years or so, and one in five Americans is projected to be over 65 within the next 40 years. To boot, the 85-plus age group in the US will increase to more than 15 million in the next fifteen years.

With many of us living longer and the plain fact that there will be even more older and retired Americans than ever, the need--and true demand--for nurses is only going to increase. It's inevitable.

Now, many of us--even us nurses--are culturally programmed to imagine hospital-based jobs when we think of the nursing job market. But we need to remember that many healthy but aging Americans may not necessarily need a great deal of hospital care as they age (with exceptions, of course), but there are many services that they will need. And as pharmaceutical research and disease prevention continue to bring various chronic diseases under control, outpatient and ambulatory care will play an increasingly important role in the health of older Americans.

Think about it: hospital stays are shortening and chronic diseases are often better managed at home. Meanwhile, many Baby Boomers will potentially have the money (in the form of retirement investments, savings and pensions) to remain at home with the help of outpatient (and home-based) medical and nursing support. Additionally, nursing homes and assisted living facilities will need to be expanded or built in order to accommodate the masses of aging Boomers seeking an alternative to remaining in their own homes, especially if they're infirm or in need of multiple services and supports.

And when it comes to prevention, with the coming of health care reform and the hopes for increasing funding for preventive services, we can also hope that nurses will be needed in many areas of healthcare, from specialized "nurse coach" positions designed to reach out to patients in need of extra support, to entrepreneurial ventures with missions to fulfill the unmet needs of some aging Americans.

Although the job market may be comparatively bleak at this point in time, it's my hypothesis that nursing jobs--and jobs throughout the healthcare sector--will grow exponentially over the next ten to twenty years, although the next few years may still prove to be somewhat unstable and unpredictable.

The last thing we want is for many nurses to jump ship just before the going gets good, but we can also understand that nurses without work cannot support their families and some may need to move on in order to do so. However, my hope is that certain nurses who leave the fold may only abandon the profession temporarily, choosing to return to nursing when we need them the most.

The times may be uncertain and the economy may still be faltering (especially in the midst of a "Fiscal Cliff" crisis unlike any of us has ever seen before), but I predict that the future will be bright for nurses, as long as we can hang in there until things begin to perk up.

So, for you wannabe nurse entrepreneurs out there, now is the time to begin ruminating on what your specific skill sets are, and how you might leverage those skills in the very near future, especially where the elderly are concerned. For instance, do you want to create a concierge nurse service that caters to the wealthy elderly in their homes? Do you see yourself becoming certified as a nurse coach who specializes in the specific needs of the elderly? Can you picture yourself working for an insurance company that creates specialized support programs for their older customers or opening your own home care agency? Or would being an independent elder advocate float your entrepreneurial boat?

And for those of you interested in bedside nursing, consider what milieu would work best for you. Are nursing homes your thing? Or do you prefer the hospital or assisted living centers?

Some of you may disagree with my predictions, while others may simply not want to hold their breath while waiting for things to improve. For myself, I'll stay on track, hold onto my few part-time jobs (which happen to focus on the elderly and disabled, mind you) and wait to see how the future unfolds.

Nursing has faced greater challenges in the past, and I hold firm to my belief that better days are ahead, and nurses are poised to benefit greatly from the economic and demographic changes that are just around the proverbial corner.


Unknown said...

I agree 100% with every word of this!! I agree that thinking 'out of the box' is a great alternative right now. We are getting ready to see major changes in helathcare!

Gloria Attar RN BSN said...

I have to disagree, almost 100%. We've been waiting for this "silver Tsunami" since I graduated from nursing school in 2007. The hospitals were already not filling vacant positions then and were simply increasing the nurse to patient ratio.

Yes, nurses are leaving the profession at a slower rate, but people aren't getting as sick for long periods of time either. Since more people have taken an active role in their health, they aren't getting sick as often. Yes, they are living longer.... AND healthier lives.

Hospital admissions are down overall. My last job was at a county-owned hospital (which is turning non-profit in July). One wing of that hospital was only partial filled when I was hired and when I left, it was completely closed. People just weren't coming to the hospital and it had virtually no competition.

The jobs that are opening up, are filled immediately by the current glut of graduates.

What I would like to see is students being given more of a realistic view of what the nursing profession is... ALL aspects of it. I'd rather scare them in the beginning than to see students get to the end, graduate, get their first job and decide the profession is not for them because they don't want to do the dirty work. Yes, as a nurse there are a wide variety of positions available, BUT usually the first job post graduation is in direct patient care. I'd like to see more students ready for the shock of the real world of nursing vs the bubble of nursing school. That could also open up more spots in the programs for people that understand that nursing is a good profession, but not typically a glamorous one.

Keith "Nurse Keith" Carlson, RN, BSN, NC-BC said...

Well, I'm glad to see differing opinions on this subject, and all opinions and thoughts are always welcome here on Digital Doorway.

I hear your desire for nursing students to be told the real story about the profession. That is indeed imperative.

Let's see how things develop over the next few years.

Thanks for commenting!