By Marcia Faller, RN, MSN, executive vice president and chief clinical officer, AMN Healthcare

A sense of relief has seemed to prevail in many hospitals during the past few months. After struggling with extremely difficult recruitment and turnover of registered nurses in recent years, the recession has seemingly eliminated the most serious nursing shortage the U.S. has ever experienced. Literally thousands of nurses have returned to the nursing workforce, increased the number of hours they work or delayed retirement. This behavior has led to reduced vacancy rates in hospital staff nurse positions across the country.

 This reprieve from the shortage, however, will be short-lived.

Many nurse leaders are celebrating the improved recruitment and retention and subsequent reduced need for temporary nurses. Acceptance of this new comfortable situation is dangerous because just beneath the surface, there are serious problems with the fundamentals of the belief that the crisis is truly over.

First, many nurses are adding working hours solely because of the economic situation.  Spouses have been laid off or had hours significantly cut back, reducing household compensation and benefits coverage. The mortgage and housing crisis has left many with home loan payments that put an uncomfortable dent in monthly cash flow. Others have been impacted by their past spending habits, contributing to heavy debt and increased interest rates. With a short-term outlook that requires additional income to meet their household financial needs, nurses are prime candidates to add hours, go back to work and even pick up a second or third job.

Second, the reduction in retirement savings accounts because of the stock market’s decline over the past nine months has seriously impaired the ability of many imminent retirees to act on their plans for retirement. These more mature nurses are remaining in the workforce in larger numbers than in the past. However, when the economic recovery eventually does happen, these wannabe retirees will make good on their desires and leave the workforce. Many nurse leaders, including leaders from organizations such as the American Organization of Nurse Executives (AONE) and California Initiative for Nursing and Health Care (CINHC), believe that when this happens, the workforce departures will be precipitous—causing extreme staffing shortages.

As a result of these recession behaviors of nurses, it’s possible that a more significant problem is waiting in the wings. All of the progress made in recent years toward improving the pipeline of future nurses through the educational system could be lost. New graduates are having more difficulty finding jobs this year than they have since the beginning of the shortage. While most are able to find a job after a longer than anticipated search, it is typically not in the area they desired. One California hospital recently reported over 600 new grad applicants for only 50 positions.

In the past, the typical reaction to a lack of jobs is a restriction of student slots and therefore a reduction in the number of graduating nurses. Unfortunately, the recovery from a similar reduced focus on nursing education of the 1990’s took about 10 years (from 2000 to 2009) before the country was graduating nurses in numbers that could eventually reduce a worsening shortage. Putting the brakes on education now will have a serious impact on the future pipeline. As the economy recovers, our nurses will go back to their original plans, whether it be retiring or working reduced hours, and the shortage in nursing will revert to what it was before the recession.

So, what action is needed? It is critical at this stage to not lose sight of the long-term. There are several steps that can be taken to preserve staffing levels and the quality of patient care, even when the shortage worsens once again.

Hospitals should start by taking care of those nurses that have come back to work. Treat them well, make the workplace a positive one, give them flexible job options and value their contributions.

They should also know the age of the nurse workforce in every unit. The Operating Room is typically the place where nurses tend to be even older than the average. Understanding the nurses planning for their retirement can help prevent a sudden drop off in staffing levels.

Figure out how to hire new graduates, whether in residency programs or specialty preceptor programs. Having jobs for new nurses now will help keep the student pipeline open and full for when we need it as the economy recovers.

Finally, don’t abandon the academic partnerships that have been established in the last few years. Instead, get creative with them.

The worst thing to do is to breathe easy and think that things are ok, even better. Inaction now will set up a situation that will cause the future outlook to become grim very fast as the economy shifts back towards growth. As nurses we need to accept our current situation, but fully recognize it will not last. Action now is imperative to prevent a return of the devastating shortage predictions of just five years ago.

We’ve achieved so much. We must protect it.

© 2009. AMN Healthcare, Inc. All Rights Reserved