It's a Myth that it takes thousands of dollars to train a new Grad RN

Guest343211 · Oct 16, 2012

I don't buy that orientation is outlandishly expensive necessarily. Compared to many years ago, many things are loaded in systems so that new hires can go through the material via Intranet. This saves the class time and paying wages per hour for sitting in a classroom. Yes, somethings still require a classroom, but a lot of it has been cutdown.

Insurance benefits are an issue, and it a HUGE part of the hiring freezes and moving from FTE to more PTEs in many hospital over the last several years. Still, if you hire someone, in most cases, you have to provide health benefits packages. This is part of the employee's compensation. But what I've seen places do is constantly rotate people through orientation and eliminate them right at the 3 month mark, when the benefits kick in. Why do that? Well, if you are Magnet and/or looking to become Magnet, you are looking like you care about safe staffing ratios and so forth, but you are making no commitment so to speak. Also, you can still give your preceptors patients while also giving the orientees patients, and after three months, get a new hire and continue with the cycle-supply. I have seen hospitals do this where they staff so many FTEs, PTEs, per diem, some % of travellers, and then they do the ole rotate new-hire RNs through--and it equals about the same time the travellers are contracted. When you have seen the pattern over and over again, it's hard to miss, and you know you aren't making it up.

There's a lot of stuff that goes on that no one really talks about.

About the cost of orienting, it may vary; but suffice it to say most places have really peeled those costs back.

Sadly, nurses are too often treated as disposable units. I mean, as they say, it is what it is. If you work in or with a place that genuinely values you and sees each individual nurse as important to the whole--where you get the love, so to speak, consider yourself REALLY fortunate. I don't think you will see a lot of places trying to at least "appear" that way again until there is a very desperate need for nurses or unless they are trying to receive some kind of PR, advertisement, or recognition. Of course, my loyalty would go to the places that maintained the love in spite of the economy and current dynamics. Finding such places now is like finding a real diamond or bar or platinum on the beach. The one's that are genuine will be functioning this way no matter what, b/c the commitment is truly built into and throughout their values and ethics. It's not just something they say or put on paper. This is determined, more times that not, by the kind of ethos in leadership and administration. If the bigger leadership will not support a CNO in making such a commitment to values and ethics, that CNO will not be at the institution for very long. Well, CNO's get a nice salary, and so too often they go with the admin b/c of the money and title. It's about real integrity though, and integrity can cost you money, power, support in networking, etc. This is why I'm not so quick to judge anyone that has been "let go" or fired. Not fitting into the culture can, often enough, mean you don't play their games--leadership's games are at odds with your integrity--and this kind of thing can be an issue from the lowly staff nurse, all the way to the CNO.

OP, sorry you had to move; but given the overall state of California, as pretty a state as it is, right now you may be much better off.

Oh, also, you are right. As a newer nurse, you are cheaper than a veteran nurse--and this is also part of the reason veteran nurses aren't getting jobs if they left the field for a period of time. If they put an "internship" type program in place, they can still save a lot of money. They run it once or twice a year. In the internship, you may not be entitled to various raises, however small. The new grads that aren't getting jobs need to understand that if they aren't getting positions over experienced nurses that cost more, the spaces for FTEs are mega-tightened at the particular institution--b/c they are being told to limit hiring, especially of FTEs.

And all these companies and hospitals are waiting to see how hard the changes in healthcare coverage are going to hit them. As the economy continues in the current state, businesses will continue to limit hiring and other expenditures. But I fully expect that as more positions open up, a good percentage of them will be filled by new grads, specifically b/c they are cheaper.

andywolfe · Oct 16, 2012

Here is a quote from National Bureau of Economic research about the tax breaks that corporations get for providing so called a valuable health insurance benefit.

"]Currently, employers' spending on health insurance premiums is exempt from taxation for both employers and employees. Premiums paid by employees are exempt as well if the firm has established a Section 125 cafeteria plan; roughly 80 percent of employees with insurance have such a plan. This tax exclusion is extremely costly - it reduces federal and state tax revenues by $260 Billion per year and is the government's third largest expenditure on health care, after Medicare ($400 Billion) and Medicaid ($300 Billion)."

These are straight up Facts not my opinion.

8mpg · Oct 16, 2012

I feel like there is a lot of ignorance by the original poster and he just wants to be right. To take yourself and compare it to the rest of the nursing population is not a good idea. Just because you are a healthy 28 year old, that doesnt mean every other nurse is. My fiance is 27 and her previous policy that went Cobra while switching jobs was $800/month. Her current employer pays $700/month and she pays nothing out of pocket. Cobra insurance numbers are not made up.

Your example of 6 weeks of training is a very low figure. My hospital does 10-12 weeks for most new grads in easier departments such as med/surg. Our critical care staff is 16-20 weeks. They also have to farm out some of their education to other hospitals as they dont have the full critical care educators in house. Combined with turn over rates, healthcare, 401k, taxes, etc. the company can spend $15-20k easy.

apocatastasis · Oct 16, 2012

Part of it depends on what kind of training you get and what setting you work in. Like 8mpg explained above, I had a relatively short (compared to some new grad RNs) 12 week orientation in a high acuity ICU. Some ICU RNs I know at other hospitals were on orientation for 6-9 months with a preceptor FT.

Just in my preceptor's pay alone, that probably ran them between 15-25k. They also had to pay to have us take critical care courses, classes in e.g. ventilator, balloon pump, and dialysis management.

There were about 6 of us on new grad orientation between June 2009 and December 2009... I'm sure it cost over 200-300k when all was said and done. Not exactly chump change.

Home Health Columnist / Guide · Oct 16, 2012

The Costs and Benefits of Nurse Turnover: A Business Case for Nurse Retention..

[TABLE]

[TR]

[TD]Table 1. Nurse Turnover Cost[/TD]

[/TR]

[TR]

[TD]

Advertising and recruitment
Vacancy costs (e.g., paying for agency nurses, overtime, closed beds, hospital diversions, etc.)
Hiring
Orientation and training
Decreased productivity
Termination
Potential patient errors, compromised quality of care
Poor work environment and culture, dissatisfaction, distrust
Loss of organizational knowledge
Additional turnover

[/TD]

[/TR]

[/TABLE]

Decrease New Graduate Nurse Orientation Costs ... - Nursing Center

Direct Recruiting Costs

Advertising

Agency fees

Referral fees

Signing bonuses

Travel expenses

Testing/profiling costs

Indirect Recruiting Costs

Interviewing costs (time)

Employee training (to interview)

Travel expenses

Productivity and Training

Cost to fill in for lost employees

Other employees time

Training/orientation costs

Seminars/conferences/e-learning

Travel expenses

Critical project involvement

Termination Costs

Exit interviewing costs (time)

Severance pay

Productivity losses

Cost of Hiring New Nurses on ADVANCE for Nurses

Labor Costs for a Graduate Nurse in 2011

Pre-employment Costs:

Interviews/paperwork: $450

Drug Testing and Criminal Background Test: $300

Physical Assessment, Lab: $1,000

Employment

1 Week - Mandatory Review: $5,000

1 Month - Classroom and Skills,

Four Nursing Educators Salary and Benefits: $13,500

5 Months - Patient Care with Preceptor

GN Salary and Benefits (1 GN):$27,000
Preceptor (Experienced RN) Salary and Benefits: $32,000
1 Nursing Educator @ 1 Hour/Day/New Graduate: $7,000
Indirect costs - 12% (percentage of overall operating cost of hospital): $10,345

Competency: $96,595

andywolfe · Oct 16, 2012

Part of it depends on what kind of training you get and what setting you work in. Like 8mpg explained above, I had a relatively short (compared to some new grad RNs) 12 week orientation in a high acuity ICU. Some ICU RNs I know at other hospitals were on orientation for 6-9 months with a preceptor FT.
Just in my preceptor's pay alone, that probably ran them between 15-25k. They also had to pay to have us take critical care courses, classes in e.g. ventilator, balloon pump, and dialysis management.
There were about 6 of us on new grad orientation between June 2009 and December 2009... I'm sure it cost over 200-300k when all was said and done. Not exactly chump change.

I will say it again the last line of the 1st paragraph in my original post does state that my figures are excluding specialty nursing unit like ICU, NICU etc etc.

dudette10, MSN, RN · Oct 16, 2012

At my facility and unit, everyone has the same orientation period (the probationary period) and orientation classes, regardless of experience status. It can be argued then that experienced nurses cost more to orient than new grads at my facility.

The claim of $60K or more for a new grad never sounded accurate to me either.

andywolfe · Oct 16, 2012

The Costs and Benefits of Nurse Turnover: A Business Case for Nurse Retention..
[TABLE]
[TR]
[TD]Table 1. Nurse Turnover Cost[/TD]
[/TR]
[TR]
[TD]
Advertising and recruitment
Vacancy costs (e.g., paying for agency nurses, overtime, closed beds, hospital diversions, etc.)
Hiring
Orientation and training
Decreased productivity
Termination
Potential patient errors, compromised quality of care
Poor work environment and culture, dissatisfaction, distrust
Loss of organizational knowledge
Additional turnover
[/TD]
[/TR]
[/TABLE]
Decrease New Graduate Nurse Orientation Costs ... - Nursing Center
Direct Recruiting Costs
Advertising
Agency fees
Referral fees
Signing bonuses
Travel expenses
Testing/profiling costs
Indirect Recruiting Costs
Interviewing costs (time)
Employee training (to interview)
Travel expenses
Productivity and Training
Cost to fill in for lost employees
Other employees time
Training/orientation costs
Seminars/conferences/e-learning
Travel expenses
Critical project involvement
Termination Costs
Exit interviewing costs (time)
Severance pay
Productivity losses
Cost of Hiring New Nurses on ADVANCE for Nurses
Labor Costs for a Graduate Nurse in 2011
Pre-employment Costs:
Interviews/paperwork: $450
Drug Testing and Criminal Background Test: $300
Physical Assessment, Lab: $1,000
Employment
1 Week - Mandatory Review: $5,000
1 Month - Classroom and Skills,
Four Nursing Educators Salary and Benefits: $13,500
5 Months - Patient Care with Preceptor
GN Salary and Benefits (1 GN):$27,000
Preceptor (Experienced RN) Salary and Benefits: $32,000
1 Nursing Educator @ 1 Hour/Day/New Graduate: $7,000
Indirect costs - 12% (percentage of overall operating cost of hospital): $10,345
Competency: $96,595

Again these values don't relate to me or the majority of the hospitals that hire med/surge nurses. We don't get 6 months and 1 week of training as you have indicated in the post above. My training lasted only 6 WEEKS. Only class time I had was for computer training and in house orientation. I already paid out of my own pocket for ACLS, BLS, and PALS!!!!

Please try again.

andywolfe · Oct 16, 2012

I feel like there is a lot of ignorance by the original poster and he just wants to be right. To take yourself and compare it to the rest of the nursing population is not a good idea. Just because you are a healthy 28 year old, that doesnt mean every other nurse is. My fiance is 27 and her previous policy that went Cobra while switching jobs was $800/month. Her current employer pays $700/month and she pays nothing out of pocket. Cobra insurance numbers are not made up.
Your example of 6 weeks of training is a very low figure. My hospital does 10-12 weeks for most new grads in easier departments such as med/surg. Our critical care staff is 16-20 weeks. They also have to farm out some of their education to other hospitals as they dont have the full critical care educators in house. Combined with turn over rates, healthcare, 401k, taxes, etc. the company can spend $15-20k easy.

Again my original post does exclude higher acuity unit like ICU, NICU, etc etc. You can call community hospitals throughout USA and they will tell you that the training for med/surge unit is about 6 weeks and 2 extra weeks if you need it.

Now in terms of Cobra, I have already compared the self insurance and insurance through the employer.

Finally calling me ignorant won't really do anything for the fact that you were wrong about the topic below and your feelings got hurt in the process.

https://allnurses.com/micu-sicu-nursing/weird-but-missing-792124.html

anotherone, BSN, RN · Oct 16, 2012

I don't buy that orientation is outlandishly expensive necessarily. Compared to many years ago, many things are loaded in systems so that new hires can go through the material via Intranet. This saves the class time and paying wages per hour for sitting in a classroom. Yes, somethings still require a classroom, but a lot of it has been cutdown. Insurance benefits are an issue, and it a HUGE part of the hiring freezes and moving from FTE to more PTEs in many hospital over the last several years. Still, if you hire someone, in most cases, you have to provide health benefits packages. This is part of the employee's compensation. But what I've seen places do is constantly rotate people through orientation and eliminate them right at the 3 month mark, when the benefits kick in. Why do that? Well, if you are Magnet and/or looking to become Magnet, you are looking like you care about safe staffing ratios and so forth, but you are making no commitment so to speak. Also, you can still give your preceptors patients while also giving the orientees patients, and after three months, get a new hire and continue with the cycle-supply. I have seen hospitals do this where they staff so many FTEs, PTEs, per diem, some % of travellers, and then they do the ole rotate new-hire RNs through--and it equals about the same time the travellers are contracted. When you have seen the pattern over and over again, it's hard to miss, and you know you aren't making it up.There's a lot of stuff that goes on that no one really talks about. About the cost of orienting, it may vary; but suffice it to say most places have really peeled those costs back. Sadly, nurses are too often treated as disposable units. I mean, as they say, it is what it is. If you work in or with a place that genuinely values you and sees each individual nurse as important to the whole--where you get the love, so to speak, consider yourself REALLY fortunate. I don't think you will see a lot of places trying to at least "appear" that way again until there is a very desperate need for nurses or unless they are trying to receive some kind of PR, advertisement, or recognition. Of course, my loyalty would go to the places that maintained the love in spite of the economy and current dynamics. Finding such places now is like finding a real diamond or bar or platinum on the beach. The one's that are genuine will be functioning this way no matter what, b/c the commitment is truly built into and throughout their values and ethics. It's not just something they say or put on paper. This is determined, more times that not, by the kind of ethos in leadership and administration. If the bigger leadership will not support a CNO in making such a commitment to values and ethics, that CNO will not be at the institution for very long. Well, CNO's get a nice salary, and so too often they go with the admin b/c of the money and title. It's about real integrity though, and integrity can cost you money, power, support in networking, etc. This is why I'm not so quick to judge anyone that has been "let go" or fired. Not fitting into the culture can, often enough, mean you don't play their games--leadership's games are at odds with your integrity--and this kind of thing can be an issue from the lowly staff nurse, all the way to the CNO.OP, sorry you had to move; but given the overall state of California, as pretty a state as it is, right now you may be much better off.Oh, also, you are right. As a newer nurse, you are cheaper than a veteran nurse--and this is also part of the reason veteran nurses aren't getting jobs if they left the field for a period of time. If they put an "internship" type program in place, they can still save a lot of money. They run it once or twice a year. In the internship, you may not be entitled to various raises, however small. The new grads that aren't getting jobs need to understand that if they aren't getting positions over experienced nurses that cost more, the spaces for FTEs are mega-tightened at the particular institution--b/c they are being told to limit hiring, especially of FTEs. And all these companies and hospitals are waiting to see how hard the changes in healthcare coverage are going to hit them. As the economy continues in the current state, businesses will continue to limit hiring and other expenditures. But I fully expect that as more positions open up, a good percentage of them will be filled by new grads, specifically b/c they are cheaper.

Great post. post more often!

apocatastasis · Oct 16, 2012

I will say it again the last line of the 1st paragraph in my original post does state that my figures are excluding specialty nursing unit like ICU, NICU etc etc.

1. For a new nurse, you seem to know an awful lot and are displaying an attitude that is inversely proportional to your purported knowledge base.

2. The med surg preceptorship at the hospital that trained me was the same length as my ICU preceptorship. Med surg is its own animal and deserves a proper preceptorship, just like any other "specialty" setting.

3. The second hospital I worked at as an ER RN provided a preceptorship and training program that was year-long and offered to anyone who met the requirements, regardless of specialty, again INCLUDING med-surg.

The fact of the matter is that, very frequently, it does cost many, and frequently dozens, of thousands of dollars to train a new nurse.

andywolfe · Oct 16, 2012

1. For a new nurse, you seem to know an awful lot and are displaying an attitude that is inversely proportional to your purported knowledge base.
2. The med surg preceptorship at the hospital that trained me was the same length as my ICU preceptorship. Med surg is its own animal and deserves a proper preceptorship, just like any other "specialty" setting.
3. The second hospital I worked at as an ER RN provided a preceptorship and training program that was year-long and offered to anyone who met the requirements, regardless of specialty, again INCLUDING med-surg.
The fact of the matter is that, very frequently, it does cost many, and frequently dozens, of thousands of dollars to train a new nurse.

I am sorry but i am only writing the facts. If you like I can copy and paste the links to job description and names and numbers of the hospitals that are providing 6-8 weeks of med surge training and a max of 3 months of internship for ICU position (even though again I had excluded ICU position from my original comment)