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The new era of nursing

Photo by Renee Takara

Joshua Buenavista, a first-year nursing student at the UW, is more concerned about being denied classes he is required to take than he is about the job market.

But the state of the nursing profession in the United States is changing. After years of being in a high-demand field, nursing school graduates are finding the jobs they want are not as easy to get as they once thought. The new job outlook is encouraging UW nursing students to adapt to changes in the job market and determine where their fears, goals, and aspirations lie.

Joining the field

In 2011, U.S. News and World Report tied Johns Hopkins University, the University of Pennsylvania, and the UW for the No. 1 nursing program in the nation. Buenavista decided to go into nursing based off this ranking as well as his desire to help individuals.

“The big part of deciding to go into nursing was that nursing here is one of the few professional degrees you can get as an undergraduate,” Buenavista said. “[The] second reason is definitely about helping people — having more facial interaction and looking at the patients as a whole.”

During his first year with the program, Buenavista is focused on completing basic courses, but he also wants to gain experience in the emergency room, operating room, or intensive-care units. As for his future goals as a student, Buenavista wants to spend time mentoring and educating students about other opportunities in the nursing program aside from being the traditional nurse-practitioner, such as the job of a surgical technician.

“[The decline] looks towards the traditional nursing jobs, such as providing family care,” Buenavista said. “But what they didn’t consider are the research positions, teaching positions such as faculty administrative.”

Phillippa Kassover, senior director of advancement with the UW nursing program, stated that many seniors have already had jobs before they graduated. Therefore, those students seeking careers as registered nurses will have had created strong bonds with potential employers while completing clinical experience as nurse technicians.

“As student nurses, they are hired as nurse technicians,” Kassover said. “Typically they then get hired as registered nurses at the health-care facility where they work or where they do their last quarter of clinical experience.”

Buenavista said many nursing students disregard the variety of positions the UW nursing program tends to offer by focusing on work they wish to pursue, rather than gaining the practical experience elsewhere in positions that are undergoing shortages.

Pathway to women’s health

Much like Buenavista, Jillian Eaker, a first-year nursing student with a passion for women’s-health nursing, said the decline in nursing positions is due to an influx of graduates and their desires to pursue a popularized field.

“What a lot of people don’t realize is that there are nursing shortages in areas that nurses don’t want to work and have an overflow in others,” Eaker said. “It is essentially work that people don’t want to do, and it’s getting harder, especially with the baby-boomer generation getting older.”

Nurses are needed, for example, in nursing homes, as the number of patients increases there with the aging of the baby-boomer generation. However, Eaker said nurses are seeking out jobs in hospitals instead of nursing homes where they are most needed right now.

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Eaker has plans to continue with the UW graduate program and obtain a Doctor of Nursing Practice (DNP), specifically in women’s health or nurse midwifery. After hearing about the possible shutdown of the UW midwifery nursing program in January 2012, Eaker thinks there is a bigger need for midwives than the nursing industry gives credit for.

“To me, it’s upsetting because I think women’s health is already just put on the back burner so often, and it’s not something we take seriously enough because there is very poor access to women’s health,” Eaker said.

Eaker noted the United States has a very high infant mortality rate. For 2008 — the most recent statistic produced — the Organization for Economic Cooperation and Development (OECD) estimated there were 6.5 deaths per 1,000 live births in the United States. In 2007, the OECD estimated the United States had 6.8 deaths per 1,000 live births, ranking it at No. 31 among all developed nations.

Eaker is concerned about not being able to gain the experience in women’s health and midwifery if the program is cut. She finds it discouraging that speculation to cut the midwifery program was based on lack of necessity, and that a large part of the population will be ignored if their medical needs are not treated, based on the lack of experienced midwives.

“There are huge disparities when it comes to health-care quality and access for women, within the U.S. and globally, and yet it’s still constantly viewed as an unimportant issue,” Eaker said. “Women’s health care is an absolute necessity, particularly maternal/child-centered care.”

Although not pursuing the midwifery route, Buenavista believes the possible cut could have adverse effects on the UW nursing school’s reputation.

“It will also affect the nursing school itself as its credibility to maintain its various diverse programs withstands adversities,” Buenavista stated. “Student satisfaction in the UW School of Nursing will also be maintained as it appears that the student cohort’s voice is heard before implementing a huge decision within the school.”

The changing economy

Another reason the decline in nursing positions has received attention is due to a changing economy. Older nurses with greater experience are returning to work part-time, making it more difficult for newer nurses to find jobs. However, Eaker is confident things will turn around and nurses will always be the help the industry needs.

“As far as the economy goes, it always works out because I know it’s very scary for a lot of people as it is a terrible reality right now with any certain financial insecurities,” Eaker said. “No matter what, we are always going to need nurses, and that is not something that is going to go away anytime soon.”

With the elimination of the midwifery program still being discussed, the economy plays a large part in state-school funding.

“Just like all the other nursing schools around the country, the economy and the budget have really forced us to look at all the offerings that we have,” said Mayumi Willgerodt, UW associate professor of family and child nursing. “We are financially strapped, and what people do when they are financially strapped is they take a look inside and say, ‘OK, how can we be more efficient? How can we be more effective?’ while we still address the needs of the citizens of the state.”

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With previous experience in nurse, adult and radiation oncology, public health nursing, Hall-Health nursing, and certified school nursing in the early 2000s, Willgerodt found it easy to get a nursing position upon graduation.

“You didn’t have to work very hard to get a job; the job market was really in our favor,” Willgerodt stated. “Now it is a different story, and I think that what we tend to forget is that there are short-term changes in demand, which is why we might be experiencing a short-term difficulty in getting jobs, while there is a long-term demand for nurses.”

A new market

Due to demographic changes, the difference between rural and metropolitan areas, and an aging population, Willgerodt said there is an increased number of people who have chronic illnesses and multiple health problems that need to be taken care of. This contributes to a long-term demand for nurses, with hopes that the number of retired nurses will increase as the economy gets better. Currently, nurses are not leaving the workforce as predicted, and jobs are not being vacated.

Willgerodt wants her students to focus on obtaining the practical skill-sets in various nursing positions that will help them apply to their “dream jobs” in the future.

“What I have always told the students I teach every year is that they might not necessarily get the first-choice jobs that they want, and that they may have to look at previous experiences and frame them in such a way that highlights the skills and the strengths that they have to apply into a nursing job,” Willgerodt said. “But you have to be willing to move, be willing to work nights, and be willing to work in underserved rural areas.”

As the economic downturn exacerbates economic disparities, nursing shortages are increasingly prevalent in these rural areas, nationwide and worldwide.

Regardless of the status of the job market, Willgerodt wants her students to gain experience as nurse technicians because it will allow them to develop their assessment and critical-thinking skills. Willgerodt emphasized employers are seeking students who have had a variety of work experiences.

“They don’t necessarily care about the setting in which you worked but more about what kinds of skills you learned in that job,” Willgerodt said.

With the education they are receiving through one of the nation’s top nursing schools, both Buenavista and Eaker are confident they will be well-prepared for whatever the future brings.

“I know right now, as a first-year nursing student, you will always be worried about post-graduate at a respective level,” Buenavista said. “I am pretty confident that I will be able to successfully receive an education that will advance my career. … I definitely learned a lot more than what I was expecting.”

Eaker said she looks at any opportunity with optimism and knows it will benefit her in the long run.

“I feel like any experience is good experience, so this might push me to enter into something else that I like, and I might fall in love with something I didn’t even think I would have even considered,” Eaker said. “It kind of gives me a reason to be a little adventurous.”

Willgerodt wants her students to walk away knowing they have chosen a great profession and that they will make a difference in people’s lives, regardless of the speculated decline in nursing positions.

“At the end of the day, we want our graduates to have a great education so they are able to be excellent nurse clinicians, scholars, and leaders,” Willgerodt said. “How we go about doing that is something that we continue to work on.”

Reach reporter Katherin Loh at features@dailyuw.com. Twitter: @KEL_2138

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