I see more and more new nurse practitioner graduates talk about the difficulties with finding work after graduation. Some are waiting months or longer to land their first job. I imagine that the pandemic and ramifications of it aren’t speeding the hiring process. Regardless, I would think there should be a significant uptick in the rate of hiring, even for new grads. Family nurse practitioner students in certain geographic locations seem to be having a tougher time than students in other specialties with finding work. One of the common themes I hear from new grads with difficulty finding work is “market saturation.”
Is market saturation really happening?
Market saturation means there is too much of something, so the value of it falls and with that, standing out from the crowd becomes difficult. There are likely many variables at play, but I’m not convinced the market is “saturated.” The need for more providers only increases as the human population increases.
By 2030, economic models projecting future health workforce demands predict that global demand for health workers will rise to 80 million workers, while the supply of health workers is expected to reach 65 million over the same period1. This difference between supply and demand would result in a 15 million net shortage of healthcare workers worldwide1. These global models are more dramatic in higher-income nations such as the U.S.
Supply isn’t meeting demand
It seems that APRNs (Advanced Practice Registered Nurses) became increasingly needed 15 to 20 years ago as it has become clearer that there aren’t enough physicians to meet the demand for patients who need to be seen. As a result of this need, more APRN programs have sprung up around the country to meet this demand.
Fast forward several years, and in 2017, 28,000 new NPs graduated in the United States that year2. You might say the increasing number of new NP grads is evidence of market saturation, but patient needs are still not being met. Nurse practitioners are valuable, much needed, and will continue to be needed in healthcare for years to come.
Scarcity mindset and the fight to feel valuable
Employment difficulties are a complicated issue. One factor at play is a scarcity mindset and a fear of feeling less valuable because as time continues, there are more of us. I think this is what is happening with physicians and why some are so adamant that nurse practitioners do not belong in the same playground. While it’s the case we didn’t have the same training as physicians, studies show that patient outcomes are similar, so competence shouldn’t be an argument3,4,5. But this argument does come up, and I think that has to do with this scarcity mindset that seems universal.
Distancing oneself and making oneself sound scarce adds perceived value. With an increase of perceived value comes higher status and higher salary at times. I don’t mean to pick on physicians because this push and pull between groups occur in all sorts of circumstances, even among ourselves. Nurse practitioners are experiencing this now with the fear of APRN programs churning out so many new grads that finding work is becoming increasingly difficult.
Patients aren’t being seen
The fear of becoming less valuable due to the increasing number is understandable. However, we need to zoom out a bit to look at the full picture. There are still so many patients who cannot receive various healthcare services, from general wellness checks to specialized appointments, and some of this has to do with a lack of available providers.
Finding work as an NP
One way for new NP grads and final semester MSN students to find work is to use creative, less than traditional ways of finding work.
- Recruiters
Using a job recruiter is one not-so-common way to find employment. Recruiters are used across industries, but they aren’t often utilized by nurse practitioners, possibly because there isn’t enough talk about using them. Recruiters’ jobs involve connecting providers with short-staffed agencies. They often have relationships with various hospitals and organizations that you might not be aware of.
- Practicum experiences
Another way to secure employment occurs before you graduate and is much more proactive. In your final semester (or semesters) of your MSN program, while you are doing your practicum hours, it’s helpful to treat these clinical experiences as job interviews. It would help if you made it known through your actions that you are eager to learn, get along well with patients and staff, and basically could be a really good fit for the organization.
At the end of your clinical rotation, it should be known to the agency through your actions that you are a great candidate right under their nose who would transition well from NP student to NP within the organization. Obviously, you want to make sure you could see yourself working there as you do your practicum hours, but don’t rule them out or not even consider them in the first place. Employment from clinical rotations is a great way to find employment.
- Cast a wide net
You might already be doing this, but applying to multiple jobs is important as well. Casting a wider net and considering working in other settings, locations, or patient populations that you hadn’t initially considered can help you diversify your employment opportunities, too.
Easier said than done, especially after incurring potentially significant debt in school, but p a t i e n c e in the job hunt process is key, too. Have patience, and remember that you have value and will find the right job for you because you are very much needed now more than ever.
References
1 Liu, J.X., Goryakin, Y., Maeda, A. et al. Global health workforce labor market projections for 2030. (2017). Human Resources for Health. https://pubmed.ncbi.nlm.nih.gov/28159017/
2 Faraz, A. & Salsbert, E. (2019). From education to practice: What we can learn about the workforce from a survey of new nurse practitioners. Journal of the American Association of Nurse Practitioners, 31. https://pubmed.ncbi.nlm.nih.gov/31348144/
3 Horrocks, S., Anderson, E., & Salisbury, C. (2002). Systematic review of whether nurse practitioners working in primary care can provide equivalent care to doctors. Br Med J, 819-823. https://pubmed.ncbi.nlm.nih.gov/11934775/
4 Martinez-Gonzalez, N., Djalali S., Tandjung, R., Huber-Geismann, F., Markun, S., Wensing, M., & Rosemann R. (2014). Substitution of physicians by nurses in primary care: A systematic review and meta-analysis. BMC Health Services Research. https://pubmed.ncbi.nlm.nih.gov/24884763/
5 Stanik-Hutt, J., Newhouse, R. P., White, K. M., Johantgen, M., Bass, E. B., Zangaro, G., Wilson, R., Fountain, L., Steinwachs, D. M., Heindel, L. & Weiner, J. P. (2013). The quality and effectiveness of care provided by nurse practitioners. The Journal for Nurse Practitioners. https://www.sciencedirect.com/science/article/abs/pii/S1555415513004108
