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

[andywolfe]

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 malpractice insurance 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????

[themurseman]

Why does it even matter?

[CrunchRN, ADN, RN]

Why does it even matter?

Thank you. That was my question pages ago.

[BrandonLPN, LPN]

I'm going to echo the "so what?" sentiment. Yes, orienting a new nurse is an expensive investment. Not something everyone doesn't already know. I remain flabbergasted any employee thinks they have to "pay back" their employer for the cost of orientation.

If I find a better job offer that works better for my life, I'm giving two weeks weather I've been off orientation for two days or two years. We have to do what's best for our pocketbooks. Employers lay off employees at the drop of a hat if money's tight. Remember, theyd fire us all and replace us with minimum wage techs in a heartbeat if they thought they could get away with it. To THESE people

we are obliged to pay anything back??? I think not.

[dudette10, MSN, RN]

Because 20% of the 42 new graduates in the Lindy and Reiter study were not retained, the estimated cost to orient each of these 42 new graduates was between $39,000 and $65,000." (The article breaks down specifically how these figures were calculated)

The full reference annotation was this:

reported that the cost to orient 42 new graduates to a hospital was $611,455, or $14,558 each. However, this cost did not include expenses related to turnover. Beecroft et al14 reported that the cost of replacing an RN is between 75% and 125% of the RN's annual salary because of costs related to recruitment, overtime compensation to ensure coverage, orientation of replacement employees, lost productivity, and customer satisfaction. Because 20% of the 42 new graduates in the Lindy and Reiter study were not retained, the estimated cost to orient each of these 42 new graduates was between $39,000 and $65,000.

Now, the huge figures for orienting a new grad actually make sense. It's not the cost of orientation. It's the cost of turnover of new grads that is costing money.

[andywolfe]

It's great that the OP is so enthusiastic about using his "critical thinking" skills, but a big piece of critical thinking is at least glancing casually at the literature and info that is already available, and not just looking around your own little plot of earth and seeing what seems to make sense to you based on your personal observations. A formal "orientation" of 2 weeks, 4 weeks, 8 weeks, whatever, is not the total of a new employee orientation. Typically, one isn't formally off orientation until the 6-month mark, and there are costs involved in that ongoing process. Also, however much new grads would like to think differently, they are not as productive as an experienced RN, and remain a financial cost rather than benefit to the emloyer, for quite some time. Are all the figures quoted in the literature just made up? For what purpose?

"Because 20% of the 42 new graduates in the Lindy and Reiter study were not retained, the estimated cost to orient each of these 42 new graduates was between $39,000 and $65,000." (The article breaks down specifically how these figures were calculated)

Nursing Center - Journal Article

　

　

"Recent studies of the costs of nurse turnover have reported results ranging from about $22,000 to over $64,000 (U.S.) per nurse turnover (Advisory Board, 1999; Jones, 2005; OBrien-Pallas et al., 2006; Stone et al., 2003; Waldman et al., 2004)." (This refers to general nursing staff turnover, not new graduates specifically.)The Costs and Benefits of Nurse Turnover: A Business Case for Nurse Retention

　

Cost of Hiring New Nurses on ADVANCE for Nurses (This article includes the chart referenced earlier in the thread, breaking down the specific costs involved in getting a new graduate RN from the hiring process to "competency" and showing those costs add up to nearly $100k at one NY hospital)

　

"The hospital did a study 3 or 4 years ago and came up with $35K-$38K to orient a new grad nurse. That figure has probably changed or gone up since then. She has seen figures of $50K-$90K for all bed size hospitals in orienting these nurses." (Please note this data is from 2008)

LISTSERV 15.5 - MEDLIB-L Archives

"Cost of Hiring New Nurses on ADVANCE for Nurses (This article includes the chart referenced earlier in the thread, breaking down the specific costs involved in getting a new graduate RN from the hiring process to "competency" and showing those costs add up to nearly $100k at one NY hospital)"

From the same article you failed to mention that "The approximate starting salary for a graduate nurse in the New York City and Long Island is between $65,000 and $75,000 annually."

In the middle part of the country, you won't find these kinds of salaries for graduate nurses!!!! Just 2 weeks ago, my friend had offers from a hospital in both Arkansas and Alabama that started her at $19.00/hour + shift differential. At $19.00/hour, it is mathematically impossible for someone to earn between $65,000 and $75,000 for working full time only!!!!!!!

　

"The hospital did a study 3 or 4 years ago and came up with $35K-$38K to orient a new grad nurse. That figure has probably changed or gone up since then. She has seen figures of $50K-$90K for all bed size hospitals in orienting these nurses." (Please note this data is from 2008)

In the beginning of article it clearly states that "A plethora of orientation programs has been developed to meet the needs of novice nurses. These multifaceted residency, internship, or preceptorship programs last from 4 to 12 months and are designed to provide new graduates with supervised hands-on clinical experience."

Again it's like I keep beating a dead horse. 4 MONTHS=Approx 16 weeks and 12 months=52 weeks. Training now a days for med-surge doesn't last 4-12 months. Mine lasted only 6 WEEKS.

All the research you quoted is misleading due to the fact that you are comparing training that last from 16-52 weeks, to my training that has lasted only 6 WEEKS

[NickiLaughs, ADN, BSN, RN]

From what I can tell, you want us to base all concrete evidence only on your particular situation?

I don't think anyone cares that much....especially with how you have portrayed yourself and responded to others. There's a difference between being classy and knowledgeable and being argumentative and condescending.

[sirI, MSN, APRN, NP]

Thread closed and will not be reopened.