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Expertise helps nurses stand out — nursing shortage or not
Value-based skills are what employers look for in med-surg nurses
Marcia Frellick
With employers scrambling to fill critical nursing positions as baby boomer nurses retire, med-surg nurses may find themselves more in demand.
Peter Buerhaus, RN
Peter Buerhaus, PhD, RN, FAAN
, a professor in the College of Nursing and Director of the Center for Interdisciplinary Health Workforce Studies at Montana State University in Bozeman, said the nursing shortage will be felt more in experience than in numbers.
Shortages are more likely in certain areas
This nursing shortage is not as severe as in previous cycles when hospitals had to shut down units — causing threats to quality, he said. Still, he acknowledged some pockets of the country always will struggle to fill spots.
“Big, mega shortages? I don’t think we’re likely to have those going forward,” Buerhaus said. “Employers just can’t find adequate replacements with young people (who lack experience) coming in.”
Nurses wanting to land jobs in the med-surg sector should make sure they know the meaning of
“value-based medicine”
as the health system evolves from a fee-for-service model. They should be able to articulate how they create value for an employer, Buerhaus said, adding the concept of providing value is not commonly taught in nursing school.
“My view is that most nurses don’t know what value is,” he said. “Nursing students in their care plans for patients don’t generally, if ever, write about or think about ‘how can I improve the quality of care and how can I lower the cost of care?’”
Value could come from enhanced education, an added certification or a skill that could make nurses more flexible in coverage or from knowledge of ways to streamline a process, reduce waste or lower cost.
“I would advise med-surg nurses to look at what outcomes you can improve upon or produce more of and know what outcomes are important to the organization,” Buerhaus said. “And make sure that when you see the CEO or CFO in the elevator you are able to talk with them about how you improve outcomes and lower costs.”
In turn, organizations reward nurses who provide value, such as approving nursing requests for more equipment or staffing.
“I would advise med-surg nurses to look at what outcomes you can improve upon or produce more of and know what outcomes are important to the organization.”
— Peter Buerhaus, RN
Med-surg nurses also will find opportunities opening up outside the hospital setting, he said. Patients with multiple chronic conditions are being transitioned out of hospitals and into ambulatory clinics and outpatient settings.
“They are going to require substantially more intense nursing than we have seen,” he said.
Michael Spellman, a marketing executive with Fortus Travel Healthcare Resources in New York, which recruits nurses nationwide for temporary and permanent staffing, said although the increase in demand has been slight compared with the demand for nurses who work in catheterization laboratories, radiology departments and ORs, the need for med-surg nurses has inched up over the past two years.
Though Fortus works with many outpatient centers, most of the demand in his own experience is coming from the hospitals.
Some may need to travel to find work
“If you’re working in a bigger city, you’re going to find work right where you are, but if you live in a more rural area with one or two critical access hospitals within a few hours of you, there’s a good chance you may have to travel to find work,” Spellman said.
Critical access hospitals are looking for med-surg nurses who can work in additional capacities such as the emergency department, he said.
“They’re going to need someone who has a better ability to work with higher acuity patients in different areas to really flex and meet their scheduling needs.”
States such as California and New York that aren’t a part of the 29-state contract licensure states (where licensure in one state means licensure in many others), have a harder time finding nurses quickly because it’s not as easy to find med-surg nurses outside the state when they have to go through a licensing process.
According to the Academy of Medical Surgical Nurses, it is the intense level of coordination from patient arrival until post-discharge transitions that sets the med-surg specialty apart.
Special skills are valued, Spellman said, such as being familiar with telemetry even if a nurse hasn’t worked on a telemetry unit.
Employers look for something extra
Josh Albucker
Josh Albucker, director of PRIDE Health, a national recruitment and staffing firm in New York, said he is seeing more clients ask for med-surg nurses who have something extra, such as someone who has volunteered in the field before they have become nurses or an exemplary academic record. “Some won’t consider a graduate with a GPA under 3.5,” he said. “They are looking not just for the education skill, but dedication to nursing in general. Those requirements can save the hospital money in the long run in terms of training and successful performance of the hospital itself.” Albucker said he also sees a push for med-surg nurses in medical homes, home health, urgent care and outpatient care. “There is never going to be a lack of demand for strong med-surg nurses — ever,” he said. “There’s not a single institution out there that will say we have enough strong med-surg nurses.” According to the Bureau of Labor Statistics’ projections from 2014-2024, registered nurses are among the fastest-growing work sectors. The RN workforce is projected to grow from 2.7 million in 2014 to 3.2 million in 2024—up 16%. However, the Bureau also projects the need for 649,100 replacement nurses—bringing the total number of job openings for nurses attributed to growth and replacements to 1.09 million by 2024. The
American Association of Colleges of Nursing predicts
the RN supply will increase demand in 34 states, with 16 states likely to experience a shortage through 2025. These include Alaska, Arizona, California, Colorado, Georgia, Hawaii, Maine, Maryland, Montana, Nevada, New Mexico, North Carolina, Oregon, Rhode Island, South Carolina, and Washington.
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Marcia Frellick is a freelance writer.
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