In another time, Sandra Jeffreys might not consider herself lucky. She works two days a week at a nursing home and does contingency home-care work that can give her as much as four days a month or none.
She's applied for hundreds of full-time nursing jobs after graduating in December 2009 with an associate's degree and passing her state board exam last March. Jeffreys also worked in a nephrologist's office for five years before going to school and is now enrolled in a master's program to become a nurse practitioner.
It's still a good time to look for work in health care, one of the most reliable job generators through the lengthy recession. But job seekers may be surprised to find fewer opportunities and longer job searches than they anticipated, depending on their location and particular occupation, as high unemployment and state budget cuts squeeze employers.
A recent interview for a hospital job left Jeffreys disappointed again.
"I was so excited because I found out it was mostly dealing with infectious disease. That's always been very interesting to me," said Jeffreys, 29, of Troy, Mich. "I called back after sending my thank-you letter. Nothing. They didn't even return my call."
She's doing most of her classes online so she can be available if she finds steady work, and her goal is to complete her advanced degree by 2013. Jeffreys, who was a single mother for most of her adult life, said she feels fortunate to be back in school.
"A good thing with not having much of an income last year is I qualified for a full Pell grant," she said. "I've also taken out more student loans, which I'm not so excited about, but it's got to be done."
She's hopeful that her income will increase once she has her master's degree and the economy improves. "When I finished school, I had been told to expect anywhere from $25 to $28 an hour, and now I'm making $23."
The diverse health care sector has held up well through the recession, despite the decline in demand for services as more people lost their incomes and health insurance when they lost their jobs. Health care employs nearly 14 million Americans, and the sector added an average 21,000 jobs every month through November last year, slightly higher than the average 18,000 jobs added monthly in 2009, according to the Bureau of Labor Statistics.
Many health care occupations are projected to grow much faster than average in the next decade as the population ages.
One state economy that's been buttressed by health care is Florida, where more than 17 percent of the population is age 65 or older.
"We had all other industries losing jobs," said Rebecca Rust, chief economist for Florida's Agency for Workforce Innovation in Tallahassee. "Health services was the only one to maintain growth, although it did slow down."
Health care is the third-largest industry in Florida after trade and government, she said. Despite having a 12 percent unemployment rate as of December, the fourth highest in the nation, health care has continued to add jobs there. About 948,400 Floridians worked in health care as of November 2010, up 2.7 percent from a year earlier. Most of the gains have come from outpatient care centers and doctors' and dentists' offices.
Here's a snapshot of what job seekers are finding around the country.
PHYSICAL THERAPISTS: It took about five months before Dan Riddick found a job doing physical therapy after he graduated with a doctorate from the University of Vermont-Burlington. He was surprised to lose job opportunities to athletic trainers who command lower pay, he said, because he didn't know his state allowed trainers to perform and bill for physical therapy work.
So he cast a wider geographic net and finally got a full-time offer from Lynchburg General Hospital in Virginia, where he helps cancer patients and those recovering from falls, fractures or joint-replacement surgery. His starting salary? About $70,000 a year, enough to put a dent in his $112,000 student-loan balance after three years of school. His new employer also contributes annually to cutting his debt load.
Riddick, 40, originally wanted to work in an outpatient facility but said he's getting more comfortable with acute care.
"I went a different direction than I was expecting to," he said.
But the career change suits him and was worth the risk, he said. "If I had not gone back to school, I'd be breaking my back in hard labor and construction jobs and not in a job that gives me satisfaction at the end of every day."
Another recent physical-therapy graduate, Nata Salvatori, said job offers are abundant in her area. She relocated to Florida to pursue a residency program at Brooks Rehabilitation in Jacksonville after graduating from Virginia Commonwealth University last summer.
"It's always easier to get a job in a hospital setting or home-health setting than in an outpatient setting, but there are still plenty of jobs out there," she said. "I'm still getting phone calls and e-mails about job offers, and this is six months after I graduated."
Salvatori, 28, says she has "no fear of not having a job" in future recessions. "People always get hurt and they'll always need help."
NURSES: Many new nurses, however, may have to recalibrate their expectations. Hospitals are trying to do more with less staff as their patient volumes decrease, and they have their pick of more experienced candidates, said Marianne Hattar-Pollara, director of the nursing program at California State University-Northridge.
"Saturation in the job market is making it more difficult to immediately find a job," she said. "This creates a major problem for recent graduates because if they don't find a job right away, after a year they're no longer considered recent graduates. Since more than a year passed before they started practice, they will be considered less marketable and they may require remediation so they have currency in their knowledge and clinical skills."
This year, a few nursing students at Cal State-Northridge have decided to extend their time on campus with clinical lab work to retain their student status until job-market conditions improve, Hattar-Pollara said. "They are trying to be creative."
Still, the softening hasn't deterred many would-be nurses from seeking to make a career change. Cal State-Northridge received 300 applications for 36 summer semester positions in its bachelor's degree nursing program for people who already have a bachelor's or master's degree in a different field.
Pepper Black, 40, of Lancaster, Ohio, knows the frustration of looking for work that doesn't materialize. She passed her state boards last October and has applied to every place she can think of in her five-county area that uses nurses, including pharmacies that administer flu shots.
"All you hear about is the nursing shortage. When I first started school, they were still hiring nurses with big sign-on bonuses. That I don't see any more, for sure," she said. "I definitely didn't think it would be this difficult."
Black graduated from a local associate's degree program with a 3.5 grade point average and great references, she said. But in following her friends' job-search progress, she wonders if she should have spent more time doing part-time work at a hospital instead of focusing on her grades.
"So far the only ones I know who got jobs who were the ones who worked as techs or nurses' aides before they graduated," Black said.
IN-HOME HEALTH AIDES: Near-term prospects aren't as uncertain for privately-paid home-health aides. The job market for them is still strong despite the recession, and the starting wage of $10 to $12 an hour in the New Jersey area is unchanged, said Ethan Kassel, co-owner of Garden State Elder Care in South Orange, N.J.
"There's more and more opportunity for somebody who wants to be a home-care worker," he said.
Though it's a low-wage job, educational requirements are minimal. Some states require home-health aides to get certification, which in New Jersey takes only a few days, Kassel said.
Since Kassel opened his doors in 2007, many more agencies have opened up. His outfit only hires people with a minimum of two years of experience. "As the industry grows, it's more difficult to find people with a lot of experience," he said.
The recession has caused some clients to request fewer hours of home-health assistance, Kassel said. But aides often work for multiple agencies.
"They certainly are finding work if we don't have it," he said. "The difficulty for us is making sure we can keep people and give them the hours they want or else they'll go somewhere else."
Source: McClatchy-Tribune Information Services.