Recent staffing cuts at hospitals in Indiana and around the country are forcing nurses and other health workers to shift the focus of their job searches and leaving them wondering about their futures.
IU Health, St. Vincent Health and Franciscan Alliance have cut nearly 2,000 jobs this year, about a fourth of them in nursing. Nationally, the health-care industry has lost more than 41,000 jobs this year.
The cuts are the product of declining admissions and falling revenue, and they're making it more difficult for nurses to find hospital jobs and for nursing students to get their first break, The Indianapolis Star reported.
The new climate is a seismic change for many who got into nursing because for generations it had been a recession-proof career.
"I knew going into school I was choosing a safe major, because all you heard is how badly hospitals needed nurses," said Lily Bush of Irvine, Calif., a junior at Indiana University's School of Nursing.
The changes are forcing nurses to look outside hospitals for jobs, often at lower wages. Outpatient and walk-in clinics, rehabilitation centers and patients' homes are becoming popular employers.
"Times are changing, and the venues are changing," said Kim Harper, executive director of the Indiana Center for Nursing.
Blayne Miley, director of policy and advocacy at the Indiana State Nursing Association, said the shift is creating new opportunities.
"The changing landscape is basically creating the opportunity for a business model that wasn't really there before," he said.
Marion Broome, dean of the IU School of Nursing, said the industry has seen similar shifts in the past.
"We have been through this before in the nursing profession," she said. "Every time there's a change in the way health care is financed, there's usually some repositioning of health systems, and a portion of that always affects nurses."
Broome said the current changes mean many nursing graduates spend an average of six months searching for a job. In the past, they often had multiple offers before graduation.
Nursing advocates say expect demand for nurses to rebound as the current generation retires and demand for care rises as Americans age and the Affordable Care Act brings millions more people into the health-care system.
"The future looks very bright," said Peter McMenamin, an economist and senior policy fellow at the American Nursing Association in Washington, D.C., "but the present looks very uncertain."