Hello All: I live in NY, not Missouri, and the situation is the same here. One of our local hospitals just hired 10 new grads, all internally based, out of a pool of 200 applicants. You have to figure it this way, using NY as an example. In NYS, we have something like 25 nursing schools, statewide (not counting online schools.) Each school graduates students twice a year. Let's say they graduate 50 students each graduation. That is 100 students per year for one school alone. Multiply that by 25 and you have 2,500 new grads for NYS alone. Where are all these people going to go?? One of my colleagues got one of the treasured jobs in a hospital and they started her out with 4-5 patients as a brand new grad. Now, one year later, she is regularly saddled with 7-10 patients and wrote me and said it was "an unsafe environment for patients" (not to mention her license) and that she is going to go to Physician Asst school (like me, she has a BSN, and was top of the class.) A few days ago, I ran into a lady down in NYC on the subway and we got talking. She works, or used to, for Columbia Presbyterian. She was a scientific researcher for over 20 years for that facility and was just laid off. She has done productive research on Alzheimer's and many other diseases. I remember her face was all puffy from crying. (And the layoff had not happened that day, but earlier.) She felt as if she had been kicked in the teeth. The grant funding that paid her salary had been cut off (it had been coming from NY State but they are cutting back, so she was cut off). In any event, in regards to nursing, her daughter works at that same hospital as a nurse and she was telling me that her daughter was looking for a way out as conditions there are similar to what my friend is experiencing here locally, unsafe patient loads (7-10 per nurse) and administration rolling the dice trying to save money, hoping no patient dies as a result of their being short staffed and hoping that they dont get sued. But that rolling of the dice is going to fall on the back of the nurse first. If the nurse is a new grad, and has not yet developed the instincts needed to respond quickly and correctly to any situation, then the chances are increased that administration's roll of the dice will produce a patient death or lawsuit. See what I mean? Yes, they are all looking for nurses, and there are tons of ads in the papers and online. But they all want experience of at least one year which means that you know enough to fly on your own at least a little and are not as likely to commit any major errors as a new grad would be.
As far as the perennial question, "how are we going to get experience if no one will hire us?" The short answer is, no one in the health care industry cares one whit if you EVER get experience, or get to use your nursing degree or get to repay your student loans. Frankly, it is not their problem. This is what we all get for having a capitalist-based health care system. It is a business and if you are not good for their bottom line, then why should they care about you and what do they need you for?
There has been alot of academic discussion about what will happen to the US healthcare system say by 2020. What we are already seeing is the closing of major hospitals, like St. Vincent's in NYC, and countless community hospitals. Those community hospitals are often in poor areas, or at least within reasonable driving distance of such areas, and will one by one be picked off and shut down. There was an article in, I believe, The New Yorker or New York Magazine several years back that roughly hypothesized that what will remain will be a core of well funded (i.e. by wealthy donors) hospitals, like NYU, Mount Sinai and Columbia Presbyterian left standing at the end, with most community hospitals having gone extinct. What this will mean for the poor will be the possibility of a 2-3 hour ride to a hospital as their local hospital has been closed. If that person has been shot, and is bleeding out, they will likely be dead by the time they reach the hospital. Oh well, what is another poor person more or less? Or, as Scrooge said in "A Christmas Carol", "Well, if they are going to die they had better do it and decrease the surplus population."
This is what we have come to as a nation. As nurses, we are trained to do everything we can to help a patient and keep that patient alive (if no DNR exists). But this is not going to be an ongoing reality. It is unrealistic and unsupportable monetarily. With the lost of millions of jobs in this country, and along with those jobs their well-paying health insurance, hospitals and other providers now have to rely a great deal on Medicare, Medicaid payments, which pay much, much less or no payments at all for the totally uninsured who do not fall into a category where they qualify for any kind of insurance. My dentist once told me that Medicaid pays $4 for a shot of novocaine for a patient. His cost is about $69 for the same shot (and this was a few years back). The math just does not add up and hospitals (where expenses are in the hundreds of thousands for patients) cannot sustain such cost disparities indefinitely and out of work patients cannot absorb it either.
It is just a shame that all of us went to nursing school at a time such as this, when the US is on its way out as a superpower. I continue to look for ways to use my nursing skills any way I can, continue to self educate and teach others when the opportunity presents. The most important thing is not to allow your education that you worked and sweated for to become stale. Just because you are no longer in school, it does not mean that you stop learning and educating yourself.