N
ot everyone realizes that the nursing profession has been in decline for the past ten years, but it is true. The National Center for Healthcare Workforce Analysis, the federal agency that monitors the nursing profession, determined that in 2000 America’s 1,890,000 working nurses were not enough to fill the demand for nurses at that time, and that there was a 6% shortfall. Further, this agency estimates that the shortfall will grow, reaching 12% by 2010 and 20% by 2020—barring the intervention of outside factors.
The need for nurses is expected to grow by about 2% per year. The reasons for this are a general increase in population, an increase in the percentage of elderly people within the population (who require three times as much medical care than younger people), a general increase in the ability to pay for health care, and the continued improvement of medical technology (which generates an increase in the nursing help required for a given procedure.) The problem is fueled by the number of new RNs, which increased in the early 1990s but then went into decline (a 26% fall-off between 1995 and 2000.) As demands on nurses increase, their training has become lengthier and more arduous, which is one reason why this decline is projected to continue.
The volume of new RNs has also been inhibited by a relative decline in home-based nurse salaries and the emergence of gender-free new employment options for women, primarily in the information technology sector. To some extent, the problem is growing worse by feeding on itself. With fewer nurses, each nurse is constantly asked to do more, to shoulder more of the load. This has led to an exacerbation of such negative factors as an increase in exhaustion, back pain, and foot pain. The increased pressure on the healthcare system has increased tensions in the workplace, and heightened the practicing nurse’s sense of being taken for granted and not being given sufficient respect. And then there’s the stress.
For these reasons the average age of today’s practicing nurses is increasing, which means the number of years they can be expected to continue to serve is decreasing. One of the reasons for this is the increase in educational requirements, causing the average starting age to rise. But a more-important reason is suggested by the fact that between 1980 and 2000, the proportion of practicing nurses who were under 30 years old dropped from 25% to 9%. And nurses are leaving the profession, through death, retirement, or career change, in greater numbers: between 1996 and 2002 the number rose from 23,000 to 175,000. Between 1996 and 2000 the number of RNs not working in their profession, but maintaining their license, rose from 52,000 to 490,000.
The decline in relative earnings can be seen in the comparison between the average salaries of nurses and elementary school teachers. In 1983 the teacher made $4,400 more, on average, but by 2000 this disparity had grown to $13,600. In addition, the typical wage increase ladder in the nursing profession looks good early in the nurses’ careers, but tapers off afterwards. This has led to an increase in the number of nurses who decide to escape the high stress and low rewards of their occupation and go back to school to learn a new profession.
Can anything be done, or will these trends doom the healthcare field? Well, it’s Travel Nursing to the rescue: the best hope seems to be offered by the rise of the Travel Nurse profession, which promises to revitalize the industry.
Why should this be? There are several good reasons. The first is economic. For some reason nurses’ salaries have not risen at an adequate rate, especially considering their vital, lifesaving function. This is surprising, because the costs of healthcare, as everyone knows, have risen dramatically; it’s almost as if there was a conspiracy between administrators and doctors to keep the lion’s share of the pie for themselves. This might only be broken by the face-saving intervention of the rise of the Travel Nurse.
Whatever the cause, Travel Nurses are currently earning almost 20% to over 62% more than their home-based colleagues doing the same work. This has stimulated an increase in the general interest in nursing. After ten years the number of RNs not working in their field has finally begun to decline, in large part because of this new option. If home-based nurses’ pay starts to rise, as it should, it will be due in part to the better pay earned by the Travel Nurse. A staff nurse is no longer laughed at when inquiring about an employer’s ‘stay-on bonus’ policy.
Another reason why Travel Nursing may save the industry is that the exhaustion and depression that have dogged nurses for so long are easier to handle for a Travel Nurse. At first this might seem surprising, because current estimates are that Travel Nurses do 8% to 15% more work than a home-based nurse doing the same job. But there are other factors in exhaustion, such as the pressure on a home-based nurse to play an intense role in every aspect of the family; these factors are reduced by distance between family and work. And the dejection that a home-based nurse can feel when a patient, well-known through community activities, fails to respond to treatment, can be less severe for the Travel Nurse.
But the most important reason why Travel Nursing may save the industry is the enhanced self-image the Travel Nurse receives. The Travel Nurse is a contractor more than an employee. Typically, employees sooner or later encounter a superior who enjoys reminding them of their inferior position; when this happens, the employee simply has to take it. But the Travel Nurse has another job waiting, and can, and does, demand and receive better treatment.
The Travel Nurse usually lives in a new apartment, drives a better car, and has more time for after-work occupations, including some that are frivolous. Travel Nurses obviously are doing a better job of taking charge of their life. They don’t seem to be ‘stuck.’ A kind of glamorous cachet is attaching itself to this rising profession, and consequently is elevating the public’s opinion of nursing in general.
So those home-based nurses who sometimes belittle their traveling colleagues should take notice and change their attitude, because the simple existence of Travel Nursing has the best chance of revitalizing their profession.
