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Is Nursing Really Recession Proof?

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Heading towards the end of the year and leading up to the presidential election concerns about the economy and stability are arising. In the mist of economic uncertainty and predictions of a possible recession many have questioned whether their job will be secure.  

Nurses and healthcare workers historically have been protected from job loss, but will that change with the unprecedented times? How will nurses be impacted by another recession or even depression? Are nurses truly in a recession proof profession?  

In this post I am going to dive into the topic of nurses during a recession and discuss whether nursing is really recession proof. 

What is a recession? 

Many of us nurses are not well versed in economics. Our extent of math stops at medication calculations. However, with a quick search on Google a recession is defined as a period of economic decline (production and exchange of goods and services) paired with rising unemployment.  Simply put, less people buying and selling things along with less people who have jobs. 

While data is pointing towards an impending recession it hasn’t been officially announced although there have been speculations and predictions.  

What happened to healthcare during the last recession?  

The last marked recession in the U.S. was during the housing market crash from 2007 to 2009. This is helpful because we can look at historical data to predict what could possibly happen with a predicted recession.  

It is also something to note that during a recession, while the government cuts back on certain spending, they typically continue to allocate resources to provide healthcare as a social service.  

This includes funding programs like Medicare (medical coverage for people over the age of 65) and Medicaid (medical coverage for people of limited income and recourse, i.e. children).  This is important because the majority of the patients (over 50%) that we see and treat as nurses are covered by Medicare and Medicaid! So, government spending on these programs is crucial to the stability of healthcare as an industry.  

However, during the 2008 recession, healthcare spending increased but at a MUCH SLOWER rate compared to previous or subsequent years.

This could mean that with a longer recession, government spending could possibly plateau or even decline.  

Other data showed that in the 2008 recession, elective procedures declined due to the lack of coverage from Medicare causing more patients to pay out of pocket. Elective procedures are surgical interventions that are not lifesaving but help with quality of life. Examples of elective procedures are cosmetics, bariatric surgery, joint replacements, etc. This meant that nurses working in settings that provided mainly elective procedures had a higher chance of job loss.

When looking at hospitals and their financial models the data is also interesting. Compared to for profit hospitals (that prioritize maximizing profits for their stake holders), non-profit hospitals (committed to providing accessible and affordable care) had smaller profit margins. This can be concerning because during times of economic instability (i.e. during COVID), non-profit hospitals are more likely to conduct layoffs and pay cuts to protect profits. While there are more non-profit hospitals compared to for profit currently in the U.S., many hospitals are changing their financial model to for profit/investor owned.   

What happens to nurses during a recession? 

According to the U.S. Bureau of Labor Statistics, during the 2008 U.S recession both job employment and wages increased steadily over the course of the recession for nurses. All registered nurses (including post-graduate nurses such as nurse practitioners, nurse midwives, and CRNAs) across all health care industries saw an increase in employment and wages. The top nursing specialties that provided the majority of nurse employment were acute care hospitals, physician offices, home health care, and nursing facilities.  

During the 2008 recession, data showed less of a nursing shortage, meaning there were more nurses to meet the demands of healthcare. That is likely because seasoned nurses delayed retirement or returned to the workforce by coming out of retirement. In addition, many nurses picked up part-time or PRN employment to supplement their full-time job.    

Data also showed that larger metropolitan areas continued to employ a huge portion of nurses.

These top metropolitan areas were:  

  1. Los Angeles 
  1. Chicago 
  1. Philadelphia  
  1. Boston 
  1. NYC

Typically, during a recession, higher education enrollment occurs as people strive to improve their workforce marketability. Data during the 2008 recession showed that nursing school enrollment increased across the board for all programs. In contrast, recent 2023 data concluded that nursing school enrollment has declined compared to the previous 20 years of program growth. This could be explained by the shortage of qualified nurses to teach and the lack of program funding.  

Is Nursing Recession Proof?  

It depends. While previous historical data supports the typical stance that nursing is a recession proof profession, current data and trends could disrupt this belief. As mentioned before, we are living in unprecedented times with lots of uncertainty. Looking at how nurses navigated previously during times of a recession paired with recent data, there could be some protective factors as we are heading towards a potential recession.  

These Factors depend on:

  1. Location  
  1. Specialty  
  1. Hospital System  
  1. Experience  

Consider working in a major metropolitan area or for-profit hospitals. Focus on acute care hospitals, physician offices, home health care, and nursing facilities that are not primarily centered on elective procedures. Continue to advance your knowledge (go back to school) and versatile your experience to increase your marketability. Lastly, think about working at universities and colleges as a nursing educator.  

Other considerations; while you may not lose your job, you might not receive any raises during a recession. As you’re searching for jobs, they may not be in the department, specialty, or have the scheduling that you prefer. This is a reminder to remain flexible and find ways to have gratitude.  

Conclusion

Although no one can accurately predict the future, looking backwards can help navigate you forward. While it is unclear whether we are in a recession and it has not been officially announced, nurses can begin to think about how to protect their careers during a recession. This article isn’t intended to evoke fear, but to urge us all to consider the times and prepare professionally.    

All conclusions were drawn from historical data, healthcare data, and recent trends. Please refer to hyperlinks to review sources.