For years, the common wisdom has been that because of a nursing shortage, newly graduated nurses are practically guaranteed a job in their desired field.

But the job outlook for nurses in Connecticut and nationally has changed dramatically in recent years because of the economic downturn and health care reforms. Some hospitals have been coping by moving nurses between different hospital units, while others have had layoffs or hiring freezes.

The roughly 1,300 new nursing graduates Connecticut produces every year will likely find that it will take a little longer to get a job, and they probably won’t get their first choice. Moreover, the job will more likely be in long-term care, home care or some other place than the traditional hospital setting.

“Tradition held that when nurses graduated, they would get a job right away in a hospital. But that changed when the economy got into trouble. There has been almost no turnover,” said Elizabeth Beaudin, director of nursing and workforce initiatives for the Connecticut Hospital Association.

In the late 1990s and early 2000s when federal officials warned of a huge nursing shortage, hospitals often had double-digit job openings, and most graduates could take their pick of jobs.

“Most hospitals will say, yes, they are hiring some new graduates, just not anywhere near what they were because there just aren’t vacancies,” Beaudin said.

Nurses with some experience, particularly an expertise in a particular unit, are more in demand that those fresh out of college.

These days, some hospitals are coping by floating nurses between units, while others have laid off nurses or implemented a hiring freeze.

“When nurses leave, the hospital doesn’t fill that position,” said nurse Lisa D’Abrosca, president of the nurses’ union at Lawrence & Memorial Hospital in New London.

The change in the nursing market is due to a combination of the weakened economy and changes in health care.

When the economy tanked in 2007, many nurses saw their husbands and significant others lose their jobs and their retirement nest eggs dwindle, said Marcia Proto, executive director of the Connecticut League for Nursing.

To pick up the slack and keep their households afloat, nurses who might have thought about retiring put it off, which has slowed down normal attrition in nursing jobs, she said.

The economy has had a broader dampening effect on patient demand.

“With people losing their jobs and not having their insurance or being underinsured, people who would normally go for preventative care, or normally go for routine care are putting it off,” Proto said.

Meanwhile, major shifts in health care, along with state and federal funding cuts, are affecting hospital budgets.

Gov. Dannel P. Malloy has cut more than $500 million from the current fiscal budget for hospitals, and Medicaid and Medicare have never paid hospitals for the full cost of a patient’s care, Proto said. Also, insurance companies and federal payers are now not reimbursing hospitals for patients re-admitted to the hospital within 30 days, Proto said.

Nurse union officials, however, question how much the hospitals are actually suffering financially and warn that cuts in nursing staff will directly affect patient safety.

“Hospitals need to recognize when you layoff or don’t fill positions, you have a direct impact on patient safety,” Joanne Chapin, president of the nurses’ union for New Milford Hospital and vice president  for health care for AFT Connecticut.

The slow nurse market is hardly limited to Connecticut.

“People are having trouble getting jobs all around the country. It’s a national phenomenon,” Beaudin said.

Despite the slowdown, experts predict the job market for nurses will eventually strengthen and even usher in a future shortage. As the economy improves, those older nurses who have been putting off retirement will eventually leave their jobs. And, as the baby boomer population ages and more newly insured patients enter the market through the Affordable Care Act, more nurses will be needed to take care of them.

“There will be a continued demand for nurses; it just won’t be that dramatic anymore,” Proto said.

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