When Adrienne Stretch started her nursing studies, hospitals were offering signing bonuses of up to $5,000 for incoming nurses.
Ad after ad offered jobs of every kind, along with enticing incentives. Local hospitals promised to pay for new employees' schooling and moving costs. They hired people on the spot at job fairs, where they offered free food and child care. They hired nurses from as far away as the Philippines and Canada.
A nursing shortage had gripped the country and nurses were in the driver's seat, able to pick and choose from the best opportunities.
Those days are over, at least for now.
Stretch, a 30-year-old recent graduate of the Lancaster General College of Nursing & Health Sciences, said she has applied for close to 500 nursing jobs in the past few months.
She has sent applications to hospitals, doctor's offices, nursing homes, outpatient clinics and prisons all over the state. She has decided she would accept a commute of up to two hours. She even considered working a week that would include several long days in Philadelphia, staying with her in-laws on work nights, if she could get a job at a hospital there.
But the Palmyra resident and mother of three has had just one interview, for a position in a local doctor's office. One of 30 candidates, she made it to the final three. She didn't get the job.
"I'm getting kind of desperate at this point," she said.
The nursing shortage has turned into a nursing glut in the past year.
The slowdown in the economy has affected hospitals, as patients have put off elective surgeries and declined to seek health care. A recent state report showed local hospitals' profits dipped between 30 percent and 75 percent last year.
"Hospitals have gone into a retrenchment in hiring in general," said Adam Sachs, spokesman for the American Nurses Association, based in Washington, D.C.
At Lancaster General Hospital, inpatient volume has decreased almost 8 percent over the past 11 months, spokesman John Lines said. The occupancy rate has dropped from 78 percent to 72 percent over the past year.
The hospital closed an entire patient unit this week due to the drop in business.
Fewer patients means fewer nurses are needed. And the sagging economy has led older nurses to postpone retirement and pushed other nurses who had left hospitals to return to work.
Now it is a buyer's market and jobs, when they are available, often are going to experienced nurses.
Ephrata Community Hospital has just a 2 percent vacancy rate for nursing jobs these days. At the peak of the shortage, local hospitals said between 10 percent to 30 percent of their nursing positions were open.
Peg Newcomer, Ephrata's chief nursing officer, said she gets a steady stream of applications from newly minted nurses, but has few jobs to offer.
"I think I have probably signed at least 150 letters that said, 'Congratulations on your graduation but, unfortunately, I do not have a position.'
"It is my policy that every RN who applies, I owe them that respect," said Newcomer, who also is vice president of nursing services. "I hate to turn them down. I wish I had the positions."
LGH is advertising openings for seven registered nurse positions on its website, but just two are full-time and both require experience.
Finding a nursing job here is even harder because positions are being sought throughout the Lancaster General Health system for the 20 RNs who worked on the recently closed unit, 8-West.
That closing also played a role in the cutback of some hirings at LGH.
Six recent nursing graduates from Lancaster General College had been offered jobs at the hospital, and expected to begin June 9.
But less than 48 hours before they were to start, the hospital informed the graduates that the jobs were no longer available.
"I didn't see it coming," said one graduate who found out she no longer had a job. "Everybody was shocked and upset."
"We're really in a different kind of a world, with regard to nurses," said Mary Grace Simcox, president of Lancaster General College. "There really is still a nursing shortage. The freaky thing is you can't tell it from the data out there."
Simcox said nurses will find employment. About 80 percent of the college's December nursing class have found employment, she said.
But graduates will need to be patient, search farther afield and look in different environments, she said.
In its 2010-11 outlook for registered nurses, the U.S. Bureau of Labor Statistics said that employment of registered nurses still is expected to grow, by 22 percent from 2008 to 2018. But many nurses may not find jobs in hospitals, which traditionally have been their largest employer, the bureau found.
Instead, the need for nurses is predicted to grow the fastest in doctor's offices, home health care services and outpatient clinics.
"Just two years ago, nurses could pick and choose and have the best of everything," Simcox said. "That's changed. Now they need to look at what's available."
The overall situation will improve, experts believe, but it may take some time.
The population is aging and will require increasing health services, said Cheryl Peterson, director of nursing practice and policy for the American Nurses Association. Health care reform is going to add 30 million people to the insurance rolls, providing another boost in the need for care.
The future is bright for nurses, believes Bob Moore, chief executive officer of Lancaster Regional Medical Center.
The College Avenue hospital has about 10 nursing openings a month, Moore said. Six, mostly full-time positions, were advertised on its website Wednesday.
Moore said the hospital hires new graduates as well as experienced nurses.
Nursing jobs are cyclical, said Moore, who has seen tight markets in the past. He's encouraged that the patient census at Regional has increased over the past year, he said.
"I think the market will improve as more patients come in," he said. "That always creates new jobs."
But the wait will be hard for some.
The recent nursing graduate whose job disappeared at LGH said she got a nursing degree to improve her life and her family's life. Now she wonders if and when she will get a job.
"I'm going to keep applying," she said. "There's nothing else to do."