August 8, 2011

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Are we jeopardizing healthcare’s future by not hiring our new grads today?

August’s guest, Donna Cardillo, MA, RN, looks at how not hiring new graduate nurses now will create serious shortages later.

 You’re probably aware that many hospitals (and other healthcare facilities) across the country are not hiring new graduate nurses or are hiring very few. This has resulted in the newest members of our profession being forced to work in non-clinical settings right out of school, not finding any employment in health care for over a year after graduation, or leaving the profession entirely.  Hospitals cite that they do not have the funds, the personnel, or the desire to hire and train these new nurses. But, while as much as half of the current nursing workforce is poised to retire en masse and the healthcare system is increasingly stressed by the aging population, this trend will likely result in a catastrophic lack of experienced nurses over the next decade.   

To compound matters further, if a new nurse has been out of school for over a year, most hospitals will not place that nurse in its new graduate nurse orientation program, even if he or she does not have hospital experience. Additionally, it takes years for a new nurse to gain the valuable experience he or she needs to work independently, safely, and competently.  In other words, it takes a village, and time, to mold a newly minted nurse.

The impending nursing shortage is real and is predicted to be the worst one we have ever experienced. We had a similar situation in the 1990’s when hospitals were downsizing and laying off experienced nurses and not hiring new nurses. Then the need expanded and suddenly there weren’t enough experienced nurses to meet the demand. Patient care suffered. The next shortage will likely hit like a tsunami and where we all be then? We already know what happens when there aren’t enough experienced nurses at the bedside: mortality and morbidity rates soar.

What’s maddening to me (and even more so to new grads) is that many recruiters are telling these newbies that they must have one year’s nursing experience. This is confusing and frustrating to the new nurse. It’s better to just say that you are not hiring new nurses and leave it at that. And even though you may not want or need these nurses today, you will likely be begging them to come work for you in the not so distant future. So be kind, professional, and compassionate; they are your future workforce.
 
None of this is meant to imply that every nurse must start out in a hospital or even an in-patient setting because that simply isn’t the case. In fact, much care is rapidly shifting out of the hospital into the ambulatory and primary care setting and alternative in-patient settings. Some nurses entered the profession with the intent of working immediately in alternate areas such as public health, rehab and so on. Likewise, others and I are encouraging new grads to seek alternative work settings rather than stay unemployed. But that is easier said than done.

And for those of you who still think the problem lies in new nurses being too picky about shifts, specialties, and salaries, there are hordes of new nurses who would do just about anything for any type of nursing work on any shift, in any specialty, at any salary at this point in time. The new nurse job shortage is much more severe than many experienced nurses realize.

Healthcare/nursing administrators need to have a long-range plan for providing expert nurses at the bedside in years to come. You must prepare novice nurses to carry the torch when your current staff is ready to retire or move on. Each in-patient facility should commit to hiring a good number of new graduate nurses annually, support them in their professional development, and maintain a healthy balance of new and experienced staff nurses. New nurse orientation programs need to be extended to a two-year period of time post graduation. Facilities should consider offering fee-based refresher courses and internships for those who need or want them, regardless of how long it’s been since they’ve graduated. Otherwise, we will all pay the price in the future and the biggest loser will be the patients, who could be any of us or our loved ones.   

Donna Wilk Cardillo is the Career Guru for Nurses and “Dear Donna” columnist for Nursing Spectrum, NurseWeek, and www.nurse.com. Donna is also an ‘Expert’ Blogger at DoctorOz.com. She is author of The ULTIMATE Career Guide for Nurses, Your 1st Year as a Nurse, and A Daybook for Beginning Nurses.
Ms. Cardillo is creator of the Career Alternatives for Nurses® seminar
and home-study program. You can reach her at www.dcardillo.com.


36 thoughts on “Are we jeopardizing healthcare’s future by not hiring our new grads today?”

  1. Anonymous says:

    While it’s easy to say “nursing administrators should do this or that…” why not provide some concrete, realistic suggestions for action? Where is the money going to come from? To igonore current funding realities … to essentially stand outside and throw stones … without considering the view from the other side … is unfair and irresponsible. This is a complicated issue that won’t be helped by such superficial and inflamatory commentary.

  2. Anonymous says:

    Dear Donna,
    I thank you for saying the truth and thinking about us new grads. This has really been a tough time for us. I am a new grad since Jan. i passed the boards and cannot find a job. I have to work as an aide which is really frustrating. Sometimes i wonder if becoming a nurse was a good decision only god knows. I have applied in almost all the hospitals in my state (PA) to no avail. Some recruiters are nasty, they dont respond and the ones that respond tell you, you dont qualify

  3. Anonymous says:

    I will always be grateful to the manager who hired me on my first unit. It was a med-surg unit and was very difficult. I learned a lot about wounds, tubes, drains, feeding tubes and medicating for severe pain. Although I did not stay on the unit, it was a good education, and I still benefit from that experience today – even though I have switched to psychiatric nursing. The work was hard and I was always exhausted, but I am better the experience, and my patients receive more holistic care.

  4. Mike says:

    What is the ANA doing about this problem? Has anyone proposed legislation to fund new grad programs? Isn’t that appropriate if there is a clear and present danger of huge staffing shortages? Why isn’t the ANA supporting new grad nurses?

  5. Anonymous says:

    I’ve been an RN for 30 yrs., and since relocating, have found that hospitals are hiring far less experienced nurses before they even inteview me. Age discrimination is alive and well!

  6. Kim says:

    I passed the boards 2 months ago and have applied to nearly 40 positions with no luck. Meanwhile, many of the hospitals I am applying to have more than 50 open RN positions. What’s more, even the skilled nursing facilities are not hiring. Surely ensuring adequate staffing ratios both now in the future is something worth the scant resources available at present. I’ll also ask the question, “What is the ANA doing about this?”

  7. Paul says:

    Unfortunately this also reflects that hospitals have been burned in the past when they hire new grads, orient them and get them to a competent level incurring a great deal of expense only to have the new grad leave for greener pastures now that they have experience and are marketable. Unfortunately the new grads of today are paying for the follies of their predecessors. Nursing is generally not in control of hiring-it is HR and Finance who are the biggest barriers to getting a new job.

  8. sky says:

    New grads you are not the only ones not being hired. I have 8 years experience and have been looking for 3 years. I can’t employ myself, then HR says we need more recent experience. Is there some discrimination in hiring those over 30? i believe i sent out 200 resumes in different states.

  9. sardoc says:

    I completely believe with what is published here. As with anything the best way to learn is from someone with more experience. Nurses are already short staffed. You look at how hard the job is going to be to train or preceptor a new nurse while taking on more Patients because 5 nurses just retired or moved on on one floor. I understand money is tight for Hospitals. Imagine how tight money is going to be when they are sued because they have a poor Nurse/Patient ratio and poorly trained staff

  10. Andrea says:

    I went back to school in my 40’s (after raising my kids) to fulfill my life-long dream to be a RN. When I started my pre-req’s, the hospitals were shipping RN’s in from other countries and offering them bonuses for housing here in the Bay Area. I graduated this past June from a ADN program in Contra Costa County in California. I have applied to so many jobs that I lost count. Only “travelers” get jobs. More education guarantees nothing in this job market-many of my BSN friends can confirm this.

  11. Sac CA New Grad says:

    I graduated in May 2011 and I am having the same problem as everyone else. It’s absolutely ridiculous that hospitals are providing their local new grads such limited opportunities (7 position with 400 applicants!) while hiring from out of state AND out of the country! (yet, they were happy to have us work hundreds of clinical hours during nursing school) I would actually work for FREE just to get RN experience!

  12. Anonymous says:

    As a nurse recruiter everything in this article rings so very true. We are a small facility and can only absorb a few new graduates each year as we do keep them in a program for a year. 1. Added education you can get after graduation that may help land the first job includes ACLS and Basic EKG course. 2. Consider small towns around your area. Some are in need of staff – others not so much but it is worth looking. 3. Volunteer in free clinics & network with other staff. You are the future!

  13. Anonymous says:

    I was accepted into an ADN program for the Fall of this year( 2012). But Im wondering if I should give up a fulltime decent paying job to pursue my life long dreams of becoming an RN, upon hearing that they won’t hire me as a need grad. What would you do?

  14. kelly new grad says:

    I read this article with tears in my eyes. I am so frustrated that I cannot find a job after spending two years becoming an RN. I am a compassionate person that really wants to help people. I would pretty much take any job at this point just to get some experience so that I could pursue what I set out to do which is Hospice.

  15. Anonymous says:

    I also graduated with a BSN in May 2011 in new jersey. I have not been able to obtain a hospital job. I have been working as a nurse in non-clinical areas, but fear I will lose my skills. I am currently looking out of state for a job now.

  16. JulyGirlSherry says:

    I went to nursing school for 2 years and am sick of hearing “you need one year experience”. Where do you get it if no one will hire you? I finally took a job for a non-medical home health care agency as their supervisory/visiting nurse. The pay is okay, but I am not using my nursing skills. I am still searching for my “ideal” nursing job and am frustrated to the point that I am sorry I wasted my time, energy and $12,000+ to go to nursing school. What bullshit!

  17. NancyNurse says:

    I have 25 yrs RN and 13 yrs LVN experience. I am a CCRN and PCCN. No BSN. I did home care for the past 1+1/2 yrs for friends who passed away, now the hospitals won’t hire me. They say I don’t have recent experience. They say “We have identified other candidates who more closely match the qualifications and current experience we are looking for.”
    They don’t want to pay for someone with yrs of exp.+ is 59 yrs old. It’s all about the $$$. New grads cost to train. That’s their excuse. Keep Trying.

  18. shopthegiftbasketstore says:

    What can be done to try and reverse this trend? We need hospitals to hire and train new nurses. Is there a grassroots effort that we can join to have our voices heard?

  19. karenpsychrn says:

    I feel the pain of new nurses trying to get jobs. They are told that every place hiring wants nurses who have “experience”. Well, how is a new nurse going to get experience if no one hires them to get that experience????? I started telling new nurses to apply to the Army Nurse Corps, which was what I did years ago. New nurses are already in leadership positions from day one and learn along the way. It’s called OJT, and happens to work very well.

  20. Faculty in waiting says:

    I earned a PhD in nursing so I could help fill the faculty shortage. I am in the same boat as the other new grads–we read everywhere about the critical need for us, yet no one will hire us without experience. So I have $50 in student debt that I address with the degree I’ve earned.

  21. Denise G. says:

    It is the same scenario for those of us who have been out of direct patient care for any length of time. I have maintained my ACLS & BLS, took an RN refresher course last year, obtained a CCM (case management certification), and am in the process of completing my BSN (4 more months!); however, because I have been out of patient care/acute care for 10 years, nobody will interview me. I get the same message as the new grads “we have identified others who meet our qualifications”.
    Frustrating!

  22. KToverV says:

    Donna, I cant thank you enough for writing this article, this is unfortunate that there is a missing link at the very start in the continuum of professional development in nursing.I have reached the point after 5 years of searching to give up the coveted nurse career as all I feel I have been doing is fulfilling the definition of insanity (doing the same thing and expecting a different result). Please keep this awareness alive until a solution can be found.

  23. Deb says:

    Donna, Thanks so much for this article. My husband is one of these new grads. He is a VERY experienced paramedic,volunteers as a RN with our states medical response corps and free clinc, yet no one will give him a chance. It is possible his gray hair has an impact, but even the one opportunity he had expected total proficiency after 16 weeks, including electronic charting!!!! I doubt that many of their senior nurses were proficient with electronic charting after 16 weeks with only that to learn.

  24. Deb H. says:

    Denise,Similar situation here, BSN,working on MSN ACLS instructor,looking for non clinical position. I don’t even get called for interviews, They don’t want education people because they don’t train anyone!It is appalling what has happend to our profession. I encouraged people to go into it and they now can’t get a job at all, they are stuck with loans, being treated like dirt.Patients can’t get a nurse to care for them, it’s always some kind of tech. Where have all the nurses gone??

  25. Carole RN says:

    Hi Donna,
    Wonderful and timely article! I recently went to a nursing career fair at Universal City, Calif. The new grads were not allowed to enter intil 2 hours after the experienced nurses spoke with the hiring hospitals. The message was always the same. “We only hire those with one year’s acute nursing experience.” My question is, if no CA hosp will hire new grads,then how will they get their experience? So, many new CA grads have no choice but to go to states like TX for their 1st job.

  26. Lucy Dombovy says:

    Thank you for this article! It made me feel as if I am not alone. I moved to Colorado after I graduated from an ADN program in Minnesota. I figured with 5 years of medical/surgical LPN experience where I even mentored new RN’s on my unit although I was a LPN, I would not have such a difficult time finding a RN job. I have been in Denver for 5 months and have applied to approximately 200+ jobs. I have not even gotten an interview. I feel as if they are missing out of a great investment.

  27. Anonymous says:

    thank you so much for this article my son has been out of school for 6 months with a nursing degree and has been unable to locate a position in any hospital in the long island new york area.they all say they require experience so he has been only been able to locate work with temp agencies and is 80.00 in debt this is so frustrating

  28. Mandy says:

    Donna, Thank you
    I am not a new grad but as a new grad found it difficult to get a hospital job. I took the first job that called apon me in a nursing home. Now I am unable to get a hospital job because they will not train me and want acute care experience. I live in NYC and find this frustrating, unfair and yes dangerous for our future. I hope hospitals “get with the program’ before its too late. I know nurses who have considered getting out of nursing because of this.

  29. fustrated new rn grad says:

    just passed the nclex a few months ago and reside in nyc…this is beyond ridiculous in terms of the lack of opportunities for new grads, everyone says must have at least year of med surg and whatever experience,this is leaving a bitter taste in my mouth, the system is a joke, and I definitely believe and know for a fact a lot of it is “who you know” which shouldn’t be the case but it is, nepotism is a live and well too.

  30. Anonymous says:

    Its all a scam; take your money for training and not open to hire. It is “who” you know.

  31. BrokenurseNYU says:

    Graduated cum laude from NYU College of Nursing in May 2013 and passed my NCLEX in June. Still looking for a job and about to default on my $80,000 loan. Welcome to the new world of nursing. =(

  32. IMANRN2 says:

    my daughter graduated in May 2012 and is very happy with her job as a school nurse. It took about a year for her to land this job and pays less than half the salary of a hospital based RN, hardly enough to make a living in CA with a debt more than double her annual income. At this point I’m concerned she will lose her clinical skills not be able to work in acute care setting. My son started nursing school in 2012 but has decided to pursue other path midway into his soph year and I say YES!!

  33. Anonymous says:

    This RN job shortage has been ongoing since 2007! Shows a lack of coordination of efforts between nursing schools and hospitals. Demonstrates a lack of “big picture” awareness that members of other professions have. Doctors realize that they will have to repay enormous student loans, so they don’t allow job shortages to happen- they control the numbers of graduating students so everyone will have a job. Can you imagine doctors defaulting on million dollar student loan debts? Yikes.

  34. Anonymous says:

    When this terrible, awful “tsunami” nursing shortage hits, let’s use it to our advantage this time to gain salary advances, not try to “help solve” the shortage by flooding (excuse the pun) the market with new grads minted like bulls through a chute. What we really need is a strong union behind us- like the Teamsters!

  35. Nancy says:

    There is a massive saturation of RN’s in many cities throughout the US. I hear this over and over from many nurses on different forums.
    Too bad the new grads “bought” into this, hook, line and sinker.
    Even experienced nurses can’t find jobs anymore.

  36. Sherre Yurenko says:

    Nursing jobs have been taken away from us by foreign nurses who will work for cheaper wages.
    I am an LVN. I worked for 28 yrs in Critical Care/Cardiovascular Critical Care and the Cardiac Cath Lab. Then I went into teaching 11 yrs age. I taught EMR/EMT and Long Term Care Nursing Assistant.
    I lost my teaching job because our Wonderful Governor cut funding to our programs.
    I lost my job Aug 2015 . Have applied for over 220 jobs. I have been told by people at the state that foreign nurses are taking our jobs. There is also age discrimination.
    These foreign nurses do not know what they are doing. They cant do skills,dont know what the drugs are for they are giving,cant answer questions,cant take B/P’s,if they are on a monitored unit they cannot read the monitors. It is very scary. And the mistakes I have seen. Oh,my. But they will coverup and lie for each other.
    These new nurses in Calif that are attending these private nursing schools are only being taught “Who to Chart”. They cannot even make a bed. It’s terrible.
    Something really needs to be done.
    Please write our new director of Health and Human services. I have written to several members of the Congressional Nursing caucus and never received any response. Please also write the President.

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