In a previous post, I discussed whether nursing is a recession proof profession. Based on the historical data and current trends, I concluded that it all depends. It depends on specialty, location, experience, and the hospital model.  

Previous Post: Is Nursing Really Recession Proof?

Looking back at the 2008 U.S. recession, I found that while both job employment and wages increased for all nurses across the board, growth for the profession slowed. This could imply that with a longer recession, we may see healthcare spending and nursing employment stagnate or even decline. 

Recent data and nursing sentiments have revealed that nurses are beginning to feel the effects of an economic downturn as a possible recession is oncoming. This post is intended to shed light on the current job market trends for nurses.  

Disclaimer: An official recession hasn’t been announced yet. This post is for educational purposes only and is not intended to spark fear, but to encourage professional preparation.  

What are the layoff job reports saying?  

Big Reported Layoff  

According to the U.S Department of Labor work commission WARN act (Worker Adjustment and Retraining Notification), businesses are required to provide a 60-day notice before conducting mass layoffs. As a result, we can see previously reported and upcoming layoffs from different companies, some of which are hospitals.  

Recently, one of the largest and most notable hospital layoffs was in Houston, at Texas Children’s Hospital. This past summer between July and August, Texas Children’s Hospital conducted a 5% layoff, which cut approximately 1,000 jobs. Many of the jobs lost were nursing positions. The hospital attributed the layoffs to lower patient volumes and financial challenges, but whistle blowers have revealed that the hospital may have lost Medicaid funding from the state. 

This crucial loss in medical coverage affects the majority of children treated at this hospital that are covered by the state for health services. As a result, whatever medical services aren’t covered through insurance (Medicaid), the patients’ families are required to pay the difference. Because most families can’t pay out of pocket, the brunt of the unpaid medical bill falls back on the hospital causing financial strain.  

Large hospital layoff

Summer 2024: Texas Children’s Hospital Layoff

1,000 Jobs Cut

5% Lay off

Layoffs Nationally in 2024

As of October 4^th, about 57 hospitals nationwide have reported layoffs since January 2024, affecting almost 8,000 jobs! Many of the layoffs involved clinical positions that were patient facing (i.e. nurses). This is a rough approximation of the hospital positions affected by layoffs due to under-reporting and non-disclosed amounts given by various hospital administration teams.  

Since the beginning of 2024, hospitals have cut positions due to financial strain which has directly affected nurses. This is somewhat contrary to the belief that nurses are insulated from layoffs and protected during a recession. However, in comparison to the tech industry (124,000 layoffs alone in 2024) or the overall national layoff reports (over 250,000 layoffs in the first quarter of 2024), healthcare has been spared from major job losses.  

What does the data say about registered nurses and the job market? 

Based on data, the unemployment rates amongst nurses are estimated at 2.6% as of 2022. This percentage could have changed in 2024 with the current economy. Healthcare jobs and specifically nurses are some of the most desired professions due to their historically low unemployment rates. In comparison, the current (October 2024) national unemployment rate is 4.1% and trending upwards compared to previous years.  

Rising unemployment further indicates a downtown in the economy.  

The low unemployment rates for nurses are likely due to the high demand along with a reported shortage in the profession. There are currently 9 nurses for every 1,000 people in the country. Due to this shortage, there has been an increasing number of rural community hospitals that have closed permanently. As hospitals close this directly affects nursing unemployment rates because most nurses are employed by acute care hospitals. 

Contrary to the national nursing shortages, there are several states that are experiencing an excess supply of nurses compared to the demand. According to the U.S. Department of Health, these states are:  

1. South Dakota 
2. North Dakota 
3. Minnesota  
4. Rhode Island  
5. District of Colombia 

These states have at least a 110% supply adequacy to meet the demand of nurses needed. Additionally, by 2025 it is predicted that both Nebraska and Utah will join (above mentioned list) the states with an excess supply of nurses at 109% supply adequacy.  

Common causes for nursing oversaturation could be: 

• Less Nurses Retiring  
• More Nurses Working Multiple Jobs 
  • Picking up PRN or Part-time positions along with their full-time jobs  
• Previous nurses re-entering the profession 

While an excess of nurses is great for healthcare because more nurses will be available to provide high quality care, this oversaturation could affect wages and job opportunities for nurses.  

By looking at current unemployment rates for the profession along with workforce data and projections (supply vs demand), it gives a conflicting analysis about how protected nurses are during a recession.  

What are nurses saying about being recession proof?  

Looking at nursing forums, there are mixed beliefs by nurses on whether nursing is truly recession proof. However, more nurses are leaning towards the comfort of knowing that they will be fine during another recession.   

Nurses who worked through the 2008 U.S. recession found that they were able to keep their jobs and withstand layoffs. However, while they didn’t experience layoffs, their hours were cut short, wages weren’t increased, and they weren’t offered overtime. 

Other nurses believe in job security because of the aging U.S. population and the poor health of our overall society. Hospice nurses felt that they were insulated, because death is inevitable. In contrast, elective procedure heavy jobs or areas that required majority patient-out-of-pocket payments (not covered by insurance) such as IV hydration bars or urgent cares could risk job loss.  

There are predictions that many hospitals will make cutbacks on nursing positions resulting in less nurses, but increased workloads (higher nurse-patient ratios). Meanwhile, other hospitals may not adapt to the financial/economic changes resulting in hospital closures.  

New grads nurses may have a hard time landing a position while experienced nurses may struggle transitioning to a new position as hospitals will implement hiring freezes. (Hiring freezes refers to the pause in hiring for new positions). This could mean that nurses will have to be flexible in their job search as you may not receive your job preferences. Examples include choosing a night shift position or working in a specialty that you don’t want such as Med-Surg. 

Non-clinical nursing positions that aren’t patient facing may also experience layoffs like nurse/health informatic positions. In addition, there will be less of a nursing shortage as experienced nurses delay retirement, less nurses take extended work leaves for growing families, and more nurses pick up part-time or PRN positions.  

Conclusion  

If you’re finding it difficult to land a job in healthcare, you’re not alone. Many industries are experiencing layoffs, including healthcare. Nurses around the country are struggling to find new positions and have shared their frustrations and concerns during this economic downturn. I’ve noticed job postings on places like Indeed are decreasing as many hospitals are in a hiring freeze. This is causing nurses to question whether the profession is recession-proof.  

As mentioned in a previous post there may be some protective factors for nurses during an upcoming recession. These include working in certain specialties, being intentional about job locations, leveraging your experience, increasing your marketability, having flexibility, and working for hospitals with certain financial models.  

This post with all the information discussed is not designed to evoke fear, but to bring awareness and help nurses and healthcare workers prepare professionally.  

Additional Post: Is Nursing Really Recession Proof?