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

Nurses New Nurse

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Let me begin by giving some background about my situation. I graduated from a nursing school with an ADN in May 2012 from a school in California. Academically I was # 2 in a class of about 60 students. I looked for a new grad RN position in CA; but, no one would hire me. I would like get some feedback on this myth that hospitals spend thousands of dollars in order to train a new Grad RN (here I am not talking about Versant residency or any training into special units like ICU, NICU etc).

I was hired by and I am currently working in a medical school affiliated hospital with a level 1 trauma center in the state of Texas. The unit that I am currently working in is the Cardiac Step down unit. It's one level below Cardiac ICU and one level above regular Med-Surge floor.

My current wage level is in the mid 20s with differential for nights, weekend, and afternoon. I have received a total of 6 weeks of training. I was signed off on almost all my skills during the first week of hire (Vent, Trach care, Med pass, Blood draws, IV start, Foley, NG etc, etc). During the last 5 weeks of my training my preceptor has been mostly reviewing my charting and helping other Nurses. Here are the hard numbers. I have received total wages of less than $6,000.00 for the 6 weeks of training (this also includes house orientation and computer training (lasted only 6 hours). I don't know how much my preceptor has earned in those 6 weeks; but, I can assume it wasn't more than 9k (70,000/52weeks X 6weeks). I have handled the same pt load as an experienced nurse after my first week on the unit. While most of the time my preceptor has been helping out other nurses on the unit.

I am not including the wages for the instructors for house orientation because there were more than 30 individuals including nurses, techs, dietary, HUC (secretary of the units), maintenance etc, etc. Moreover, since the hospital is in the process of going to computer charting, there were about 35 nurses including new hires and veteran nurses that were present during the computer training.

So the way I look at it, this hospital has spent about a maximum of 10K (wages that my preceptor received during the training) training me. If I wasn't there, the same number of pts would still be cared by an RN. The only difference is those pt were cared by a rookie RN rather than a veteran RN. Also again my preceptor was usually helping out other nurses during this training. It wasn't like she was hovering over me while I was providing care to the patients. Since very few hospitals will hire a new grad, for providing me 10K worth of training for 6 weeks, I will be working for this hospital for at least a year and the hospital will be saving about 20-30K in wages paying me instead of a veteran RN. So for this scenario in the end, the hospital comes out making a profit of at least 10k-20K. Furthermore, I will be replacing an expensive nurse from resource department along with decreasing the overtime wages for the whole unit. So that just goes to increase the profit margin for the hospital.

Finally, I have purchased independently and the hospital also provides for malpractice insurance for nurses. So again I would like to know where is this myth of hospitals spending thousands of dollars to train a new grad coming from. What am I missing here????

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

lol... Ignorant seems correct. Again, your single instance at your hospital with your single age and health status is simply bogus. Please look into many hospitals such as Parkland which has an amazing education system in which some departments get 6 months of straight classroom education then orientation to the unit.

You are simply arguing to be correct. You do not want to take any information given to you by people who have been a nurse longer than you (18 months?) with a little more experience in these areas. Again with your first job, you need to realize every situation is not yours. Until you let your guard down and listen to some others insight, you will simply bang your head against the wall arguing a mute point.

lol... Ignorant seems correct. Again, your single instance at your hospital with your single age and health status is simply bogus. Please look into many hospitals such as Parkland which has an amazing education system in which some departments get 6 months of straight classroom education then orientation to the unit.

You are simply arguing to be correct. You do not want to take any information given to you by people who have been a nurse longer than you (18 months?) with a little more experience in these areas. Again with your first job, you need to realize every situation is not yours. Until you let your guard down and listen to some others insight, you will simply bang your head against the wall arguing a mute point.

I would encourage you to look at the training for community hospitals. My original post did exclude hospitals that have Versant training programs and other programs that are similar to it.

Here is an example of one of them

"Looking for a company that will train you upon graduation from college? If so, IASIS Healthcare could be the one for you! We hire new graduates into many different areas of our hospitals; if you are a recent graduate from a nursing, physical/occupational therapy, laboratory sciences, respiratory tech, surgical tech, anesthesia tech or pharmacy program, give us a call today.

IASIS places great emphasis on training and transitioning new graduates from the academic to the clinical/hospital setting. For example, our orientation program for newly graduated registered nurses is structured to last between four to 12 weeks. The length of the training varies from facility to facility and may take place in the classroom and/or clinical setting. Each hospital structures training based on unit needs, structure and the individual progression of the employees in the program. Rest assured if you were hired into one of our programs as a new graduate, you would receive the training you need to start your career.

In addition to training, IASIS Healthcare offers competitive salaries and benefits, opportunities for career advancement, education programs and a variety of locations spread throughout the country. We have a total of 19 hospitals (18 acute care facilities and one behavioral health facility) located in Arizona, Colorado, Florida, Louisiana, Nevada, Texas and Utah.

To learn more about our new graduate opportunities, contact the Human Resource department at the hospital you are interested in, or go to that hospital website and apply for a position today. Congratulations on graduating and welcome to the exciting and rewarding field of healthcare!"

lol... Ignorant seems correct. Again, your single instance at your hospital with your single age and health status is simply bogus. Please look into many hospitals such as Parkland which has an amazing education system in which some departments get 6 months of straight classroom education then orientation to the unit.

You are simply arguing to be correct. You do not want to take any information given to you by people who have been a nurse longer than you (18 months?) with a little more experience in these areas. Again with your first job, you need to realize every situation is not yours. Until you let your guard down and listen to some others insight, you will simply bang your head against the wall arguing a mute point.

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[TD=class: form, bgcolor: #F5F5F5]4 West Medical Surgical Renal[/TD]

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[TD=class: formOffsetColor, bgcolor: #C0C0C0]Schedule:[/TD]

[TD=class: form, bgcolor: #F5F5F5]Full time[/TD]

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[TD=class: form, bgcolor: #F5F5F5]Nights[/TD]

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[TD=class: form, bgcolor: #F5F5F5]7p-7a[/TD]

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[TD=class: formOffsetColor, bgcolor: #C0C0C0]Job Details:[/TD]

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  • 4 West is a 39 bed Medical Surgical unit practicing individualized care of the adult patient. 4 West nurses are experienced in the care of a wide variety of chronic and acute medical conditions and receive special training for the care of renal patients. Nurses collaborate with interdisciplinary teams and a variety of specialists including: palliative care, cardiology, neurology, urology, oncology, and orthopedics. 4 West is team- oriented and has been successful in providing our patients with superior quality and outstanding customer service. Our unit is an ideal place for nurses looking to optimize their clinical expertise, time management, and critical thinking skills.ORIENTATION •UMC General Hospital Orientation •UMC General Nursing Orientation •Electronic Documentation training.
    Individualized Unit Specific Orientation •Unit specific orientation is in addition to UMC’s General Hospital Orientation and General Nursing Orientation •Orientation consists of observation, classroom, and clinical hours over a 6-8 week period. •Medical Surgical classroom orientation takes place over 2 days. •During clinical orientation you will be paired with an experienced nurse preceptor. The preceptor is chosen to best fit your personality and learning style. •Unique training includes Peritoneal Dialysis and care of the Renal Transplant patient. •Clinical orientation may be conducted on days or nights, depending on the shift the nurse is hired for. •Professional growth and development opportunities are available and encouraged including: committee participation, educational, and leadership advancement. Committees are available at unit level as well as hospital wide. •Other opportunities include: mentoring and a mix of core and flexible scheduling to optimize staffing and balance for our employees.
    Qualifications •Graduation from an accredited School of Nursing •Valid Texas Graduate Nurse Permit required. •Current CPR certification from American Heart Association. •Customer service abilities including effective listening skills. •Critical thinking skills, decisive judgment and the ability to work in a fast paced environment. •Ability to perform work that requires walking, sitting and standing most of the time while on duty. Occasional lifting or patients with assistance is required.
    Benefits •Full-time benefit package inclusive of health and dental coverage •Competitive compensation based on education and experience •Relocation assistance package if relocating > 75 miles / To reside in Lubbock, Texas •Educational Reimbursement for BSN / MSN •Eligible for overtime pay after 40 hours per week •Eligible for yearly annual increase •Eligible for Career Ladder after 12 months •Uniform Payroll deduction •Certification Exam reimbursement •Long Term Disability/Group Life Insurance/Group Dependent Life Insurance •Vision Insurance •Tax Sheltered Annuity Program •Supplemental Insurance Programs •Healthcare and Dependent care spending accounts •PTO and Extended Illness
    UMC Health System is the leader in comprehensive healthcare delivery in West Texas and Eastern New Mexico. More than 300,000 patients a year have come to expect

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lol... Ignorant seems correct. Again, your single instance at your hospital with your single age and health status is simply bogus. Please look into many hospitals such as Parkland which has an amazing education system in which some departments get 6 months of straight classroom education then orientation to the unit.

You are simply arguing to be correct. You do not want to take any information given to you by people who have been a nurse longer than you (18 months?) with a little more experience in these areas. Again with your first job, you need to realize every situation is not yours. Until you let your guard down and listen to some others insight, you will simply bang your head against the wall arguing a mute point.

In this country, for every 1 hospital like parkland, there are at least 10 other hospitals that are training med surge nurses in a time period of 6-8 weeks. THIS IS A FACT!!!!

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.

They seem to make it work to their advantage, financially speaking. I don't think people are looking at all the fiscal data compared with the PR benefits related to the choices they make. There's more to this than meets the eye.

I am willing to bet that in most cases, the upfront investment is minimal, and the years of using, say, nurses with less experience at cheaper rates, or using the "churn-cycle" works out for their bottom line right now. It may well not be so in the future, but that depends.

Also, getting into a hospital's books isn't going to happen. Even a good number of those in upper mgt don't know what the controllers know about how funds are used and moved around. You'd have to get some hard and accurate (manipulation-free) data from the controllers. Yep. Like that is going to happen.

You can't just look at what some tell you or what hospitals say. Hospitals are businesses, and business have internal as well as external PR mechanisms running all the time. So, you have to look at WHAT they DO. Follow the patterns. Sometimes you have to force your eyes open, even if it is in the midst of a sandstorm.

With the churn-cycle of nurses, for example, I mean, what some hospitals were doing did NOT make sense--that is, until we observed the pattern many times over and figured out what the benefits were/are to the hospitals. The uppermost administration know and so do the financial controllers. I mean they are the ones doing the financial accounting.

In this country, for every 1 hospital like parkland, there are at least 10 other hospitals that are training med surge nurses in a time period of 6-8 weeks. THIS IS A FACT!!!!

I must be thankful for attentive nurses like you with your long tenure of experience. You have figured out the inner fiscal workings of hospital networks nationwide. With your keen fiscal sense, you have single handedly uncovered one of the biggest healthcare frauds among us. In your extensive 5 months of medsurg nursing you have been able to adequately research and conclude (through 3 blind samples of hospitals nationwide) the general consensus and accurate representation of all the hospitals in the US that the average training is 6 weeks. Through your excellent deductive reasoning you have found that a hospital cannot spend "thousands" of dollars on training employees and that you are a prime example of how $6000+ does not equate to "thousands" of dollars in training.

Through your extensive knowledge of healthcare insurance and premiums you have concluded that the average healthcare policy is based on that of yourself (28ish year old) and that every person out there can have a healthcare policy for $500 or less a month. You have also concluded that it makes more sense for healthcare (may as well broaden it to all industries) that it makes more sense to pay hyper-inflated prices for healthcare premiums for their employees to third party insurance companies to have a greater deduction. Im sure your reasoning is it is much better to pay $100 rather than $50 for a product so you can eliminate the $14 in tax savings. I guess Romney should have given another $5M to charity to save $450,000.

We should not think about other stipulations that corporations must pay for their employees such as income tax contributions, employment tax, 401k contributions, PTO, life insurance, etc. These are not raw costs of having a new hire employee and they should not be considered. We should also exclude liability of untrained nurses.

Thank you for your excellent research study and definitive conclusion that hospitals cannot spend much money on training new graduates. You have greatly excelled in your 5 month tenure and should be CNO by next week.

Specializes in Gerontological, cardiac, med-surg, peds.

One of the top financial executives at a very large integrated health system in our vicinity told our nursing faculty (during a seminar on new graduate nurses) that it costs his organization between $40,000 and $60,000 to adequately train one new graduate RN. I think this executive would know. He had no reason to lie or skew the figures to us.

Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.

At one time......hospitals did "foot the bill" for orientation for new grads. There was classroom training that would be give to new grads and go over policies/procedures, teach IV starts, IV therapy/TPN, blood/blood products, equipment function/policy/usage, restraints, drsg changes, OR permits, computers, orders, meds, etc. Copies of policies were given out.....new employees were given information in binders with copies of all necessary policies/procedures.

Classroom time alone for new grads used to average approximately 6-8 weeks.....it was during that time that new grads were BLS/ACLS/PALS/TELE etc trained and certified. New grads were on a specific orientation that encompassed other departments....PT/OT, radiology and would spend time with those departments. ALL new grads spent time with the ward secretaries/unit coordinators and received training on scheduling ordering exams/tests. There was actually a time when you couldn't take ACLS/PALS without being an RN/Medic associated with a facility.

This is where new grads/new employees are brought up to speed in the classroom. During this time the grads would be paid their salary/benefits. When the new grads went to the floor they received an additional 12 weeks of "precepting"......during these orientations the floors would have extra staff for the grads were NEVER counted in the "staff" numbers. These new grads were confident and competent. The educators have to be paid, the paper cost money. We had to process all the BLS certifications and pay for them with the AHA. Records were made on all new grads, background checks, etc that have to be kept for accreditation purposes. All that costs money.

Then, sadly, things changed. OP...you are correct, your 6 week orientation doesn't cost $60,000. Hospitals have contributed to the perpetuation of the myth of a nursing shortage with, I believe, the sole purpose to glut the market so they may behave however they wish. Most facilities NO longer are the vested in hiring, training, and keeping competent nurses and have decided with the plethora of nurses in the market......we are a disposable expense.

Sad really........the patients are being cheated and they don't even know it. Experienced staff members that are capable of training the new comers are being laid off in large numbers because we speak our minds, we speak up about the present abhorrent conditions, and the lack of bedside training for these nurses because we cost too much to keep and administrations don't like "malcontents". The squeaky wheel in this case gets put out in the trash........I would tread lightly OP.

There are some of the good facilities that continue in this practice and I have noticed that they are the ones now utilizing these "residencies" and are actually saving money by low paying/no paying these poor new grads that owe thousands in student loans. Pretty smart on the hospitals part (sarcasm here) as they are making new grads of these programs sign contracts for re-payment of the education if the grads fail to stay for the allotted time. I have even seen one that charges new grads for this........ with no guarantee for a position when you are through with the program so the new grads may have had a "residency" but still have no job 6 months later. Disgusting......IMHO

OP..your orientation probably did not cost "thousand of dollars" although for the average NRSKaren is right all being told it is about $40,000 to $60,000 when it is all said and done. This is inclusive of the educators, HR personnel, fees for background checks, paper, materials, the extra staff above the FTE allotted for the patient acuity/load etc.

What we also need to remember is to be respectful of each other even when we disagree. As per the TOS....."We"

promote the idea of lively debate. This means you are free to disagree with anyone on any type of subject matter as long as your criticism is constructive and polite. Additionally, please refrain from name-calling. This is divisive, rude, and derails the thread. Our first priority is to the members that have come here because of the flame-free atmosphere we provide. There is a zero-tolerance policy here against personal attacks. We will not tolerate anyone insulting other's opinion nor name calling.

Our call is to be supportive, not divisive.

Specializes in Clinical Research, Outpt Women's Health.

Why does it even matter?

True or not it does not change the current situation.

Am I missing the point? I mean there is so much about this current situation of over supply that is bogus..........

Specializes in Cath Lab & Interventional Radiology.
At one time......hospitals did "foot the bill" for orientation for new grads. There was classroom training that would be give to new grads and go over policies/procedures, teach IV starts, IV therapy/TPN, blood/blood products, equipment function/policy/usage, restraints, drsg changes, OR permits, computers, orders, meds, etc. Copies of policies were given out.....new employees were given information in binders with copies of all necessary policies/procedures.

Classroom time alone for new grads used to average approximately 6-8 weeks.....it was during that time that new grads were BLS/ACLS/PALS/TELE etc trained and certified. New grads were on a specific orientation that encompassed other departments....PT/OT, radiology and would spend time with those departments. ALL new grads spent time with the ward secretaries/unit coordinators and received training on scheduling ordering exams/tests. There was actually a time when you couldn't take ACLS/PALS without being an RN/Medic associated with a facility.

This is where new grads/new employees are brought up to speed in the classroom. During this time the grads would be paid their salary/benefits. When the new grads went to the floor they received an additional 12 weeks of "precepting"......during these orientations the floors would have extra staff for the grads were NEVER counted in the "staff" numbers. These new grads were confident and competent. The educators have to be paid, the paper cost money. We had to process all the BLS certifications and pay for them with the AHA. Records were made on all new grads, background checks, etc that have to be kept for accreditation purposes. All that costs money.

This sounds a lot like my recent orientation; although, the hours of classroom time were spread out throughout the orientation and continue with periodic classes. I had a day of learning in each of these different areas such as with the HuC, tele tech, cath lab, short stay and observing an open heart surgery. The staff being oriented are never counted in the staffing. They just put all the new nurses through ACLS. I did receive a paper copy of our protocols and policy procedures too. :) After reading your post, I understand this is not the norm, and definitely feel very fortunate!

OP: I though you stated that you work in a cardiac step-down unit? Isn't that a specialty area? What makes you so passionate about the cost of orienting a new grad to med-surg?

Specializes in PDN; Burn; Phone triage.

Just something that I didn't realize until I chatted with my nurse manager that wasn't brought up --

a lot of new grad training (and training in general) comes from departmental budgets. It's not as if the hospital itself sits on this big pile of money and all expenses come from that single source, y'know? So, while $10,000 may not seem a lot for a huge corporation, a percentage of that money may be a lot for funds allocated to, say, a 20-bed unit. (My 17 bed burn unit ate the costs for my ABLS, ACLS, PALS, TNCC, cardiac certs; as well as for my online and in-person ECCO classes. Take that x 4 with the other new grads that I was hired on with, and, yeah.

Incidentally, this is where the big money losses come from r/t new grads moving around. I don't know if the 2-3 out of 10 new grads who quickly change jobs is accurate or not (for someone who seems to pride himself on researching statistics, I'm pretty sure the OP pulled that one out of his butt)...but departmental transfers are a HUGE problem at my hospital, which on the surface has an extremely high new grad retention rate because retention is calculated hospital-wide. It takes longer for a department to recoup its losses on hiring a new grad than it does the hospital; even then, the recouping of department losses is less monetary and more about having experienced nurses to train other nurses, reduce rates of CAUTI etc. etc.

Also, and I think esme already said this, even if we agree that it costs substantially less to train a new grad med-surg nurse, it still costs more to train the ICU and "specialty" nurses that the OP wants to leave out of the equation. I don't think it's disingenuous for a hospital to say "it takes an AVERAGE of $$ to train a new grad" and for that number to be higher than what it takes to train the average med-surg nurse.

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