Young, Thin, and Cute New Hires

The management at my place of employment recently hired a group of nurses who are all youngish, slim, and physically attractive as a response to declining patient satisfaction scores. Is the solution working? We can only wait and see. Nurses Relations Article

My workplace, a freestanding specialty hospital owned by a for-profit corporation that operates multiple facilities across the United States, has been having recent troubles with low Press Ganey patient satisfaction scores. This does not bode well in an era where patient satisfaction scores are tied to Medicare reimbursement rates.

Patients typically complain on the survey forms about random issues such as the food, the semiprivate rooms, their loud roommates, and the aloof manner of some of the physicians. Some mention that nursing staff failed to keep them informed. Once in a blue moon a patient comments that the hospital employs too many 'foreign nurses' or has staff who cannot 'speak English.' Whatever.

To combat the chronically low patient satisfaction scores, the managerial staff implemented a mix of interventions which they believed would make patients and families feel more 'cared for.' Hourly rounds, bedside rounding at the change of shift, more scripting, and more smiles have been put into action without much positive effect on the Press Ganey scores.

"What was management's next solution?" you're probably wondering. Administration announced they were hiring good people who were more friendly, skilled, positive, and indicated during their interviews that they actually wanted to care for patients. Well, the latest new hires have initiated more questions than answers.

Where do I start? They are all youngish, ranging from early 20s to early 30s. They are all fairly slim, nicely shaped, and physically attractive. The most experienced new hire has about six years of nursing experience, while the remaining nurses have anywhere from one to three years under their belts. The majority have no acute care experience and are learning certain procedural skills for the very first time: starting peripheral IV access, administering blood, performing wound care, operating feeding tube pumps, and so forth.

Don't get me wrong. I'm not an 'old nurse' who is 'eating the young.' I am 32 years old with seven years of experience, and I had no acute care experience prior to taking a job at this facility several years ago. The new hires all have good personalities and are seemingly pleasant to work with. In addition, we all must start somewhere.

However, they are not necessarily more skilled or more eager to care for patients like management said they would be. Several of these nurses remain seated at the nurses station while staring into a smart phone as call lights are ringing. A few walk into patient rooms without employing basic relational skills such as knocking, introducing themselves, or explaining what they are planning to do. I'm not complaining; I'm merely observing.

Here are my thoughts on this issue. Rather than hire a mix of highly experienced and relatively inexperienced nurses, the managerial staff opted to save on labor costs by hiring younger nurses with a certain attractive look that patients and families might find appealing. They hired no new grads because, I assume, they did not want to spend the staggering amount of money on 3-month orientation periods. They hired no one with 15, 20, 25, or 30+ years of experience because human resources would be forced to offer highly experienced nurses a significantly higher rate of pay per the wage grid. They hired no nurses who were badly overweight, gray-haired, or outwardly appeared to have health problems that would drive up insurance costs. To presumably get the most bang for their buck, most of the new hires have between one and three years of experience.

How is this experiment turning out? We shall wait and see.

young-thin-and-cute-new-hires.pdf

Specializes in burn ICU, SICU, ER, Trauma Rapid Response.
I have to disagree with nursing being a "professional" career. It's more like a wannabee professional career in reality. Many may try to argue this, but most nurses on the clinical frontlines that have been in practice for a while will agree. True professionals aren't so openly and frequently treated as disposable.

*** Neither do they punch time clocks like factory workers and nurses do.

Specializes in Intermediate care.

Nursing is becoming bogus! I'm sorry. All our "senior nurses" are getting out of bedside and doing something like intervenetional radiology, OR, clinic, cath lab. don't get me wrong....I can only dream to be there someday. But the truth is they don't hire new people. The only hospital units that hire newbies are med/surg and SOME critical care. Basically bedside nursing. So it may seem like these young,cute nurses are the only ones getting hired. But they are also the only ones applying. All these nurses away from bedside talk about.it being the "best choice they ever made." Trust me if I could I would be getting far far away from bedside. But right now its the only thing i qualify for. So all old people stop complaining because its what we can get. Some older nurses like bedside and stick around and more power to you. Bit.give all these nurses 2-3 years and they will be gone.

Specializes in Vents, Telemetry, Home Care, Home infusion.

One fact not discussed: Applicant pool.

Over the past 10 years, types of persons applying to my positions has varied from season to season in home health,

One group: only internal applicants with 15+ years experience wanting office position, bright energetic and 50+ with great computer skills.

Next group: Mix new grads; 1-2yrs experience 30ish fleeing unsafe SNF's, and mature 30yr career with bare minimum computer experience who don't follow directions in sending me references.

Third group: all new BSN grads wizing around my computer during interview, professing how they loved community health rotations with visiting nurse agency, who when offered FT position all turn me down for hospitals.

Next search unearths candidates who applied due to word of mouth we are great employer, middle aged who moved up ranks from LPN to BSN, RN working 5+yrs at each job --- snatched em.

Specializes in PCCN.
Do you speak 3.5 languages? I say 3.5 because I'm not that great at one of them but I would be able to manage if absolutley necessary.

As a matter of fact, I do: English, German, Arabic (Iraqi dialect) some Spanish (Im mainly teaching myself Spanish for medical reasons), and enough Pashtun to politely greet and eat. I've forgotten almost all of my Russian so I don't count that anymore. Life experience again, living in other cultures. ;)

As for life experience, we all bring our own, and you certainly have had a full plate for your age. But check the attitude about it at the door. Remember why we are all here - the patient.

The problem, I think, that you are focused on patient satisfaction scores, which is not the same as the health and well being of the patient. I am of the opinion that patient satisfaction scores are probably not the best indicator of health outcomes - they only indicate how much the patient "feels" about the services, not about the actual quality of the outcomes.

I think hiring for looks (as was alleged) is a poor managerial decision designed to prop up satisfaction scores via cosmetic measures, rather than provide for better care. In essence it is addressing a business problem (due to how hospitals are scored these days). But they are being superficial: treating the symptoms (satisfaction scores), but not the cause (patient outcomes, adequate staffing to allow time for compassionate care). A compassionate nurse with a patient load that allows them to spend time with the patients will garner higher satisfaction scores than will a overworked, only seen at rounds and meds, nurse who looks like a supermodel. The bonus is that the former will also address outcomes and so on, which over time will lead to higher satisfaction scores. The problem is that the better solution is not the cheaper solution, nor is it obvious to management that comes from business mindset that still is philosophically based on managing production (think Six Sigma or Deming PDCA), not a medical one. For that issue, there is no pat answer -- all the choices are difficult, and applying business methods to medical care (including the application of the word "customer") can produce undesired outcomes (measuring the wrong thing can result in treating the wrong thing).

Back to us, nurses. As nurses, we need all the tools in the toolbox, including compassion and empathy. That's where "life experience" comes in - it gives you a few more tools in the toolbox. I disagree with you that it being meaningless. Being on the other side of the bedrail in ICU as you were, IMHO it definitely gives you a better viewpoint when dealing with a patient in such circumstances, and can help you better communicate and care for the patient (helping both satisfaction and outcome scores). So its relevant. Don't underestimate the value of "soft factors" (versus hard statistics) -- these are mostly secondary to our technical and academic skills, but experience tempers and influences how we use those primary skills. That's why proper experience matters.

As for low cut tops and batting eyelashes, I would be very concerned if it were an option for anyone. I believe that merit (achievement), experience (temperament) and "fit" to the position are the best considerations. It was true when I interviewed and hired engineers, and is also probably true for nursing as well. I expect that will I make it on my own merits - and that's where I go back to the original post: All I want is a fair chance -- I dont want to be eliminated because I'm a guy, or older. I have a feeling wearing a low cut blouse is not an option for me.

Some hiring decisions I'm sure are made because the candidate is "like" the person hiring them, or the person interviewing them. Example, my manager is skinny, cute, and has a baby voice. She hires a lot of skinny, cute girls with baby voices. At one point the night shift had so many baby voices the hospitalist would say "didn't I JUST talk to you five minutes ago? Why are you waking me up again?!"

LOL "baby voices." Yes I do think people use personal similarities, either consciously or unconsciously, rather than focusing fully on what are truly the strongest candidate/s. It just shows that the persons involved in the selection process need to work hard to step outside of that kind of thing--kind of like bracketing in qualitative research, right?

Whether looks should or shouldn't weigh in the selection process, which may be in part human nature and part an intentional hiring practice, it certainly shouldn't be on the top 10 list for reasons to hire a nurse, a doctor, an engineer, an air traffic controller, or similarly vital roles that can easily affect the life and/or quality of life decisions through mental processing and insight.

But since nursing staff makes up a great percentage of hired staff for hospitals, it's one of the first places hospitals cut or reduce costs. So it's not surprising if a they hedge bets and hire the cheapests ones with their "most ideal" overall packages. The idea of "fit" continues to persplex me, b/c it's so subjective and is often used to masked the more trivial reasons for wanting to hire or not hire someone.

Who knows? Maybe in time, being somehow less than someone else's idea of most attractive will become a disability? Maybe then hospitals will be requried to hire so many "ugly" or somehow "less than most attractive" nurses--whatever that means.

Physical attractiveness essentially is about having characteristics that suggest reproductivity/fertility. On that level, one might wonder if the hospital is trying to move it's OB department forward. After all, if sexuality is what is mostly associated with physical asthetics--at least subconsciusly, maybe the young, hospitalized and outpatient patients and family will be subconsciously influenced to get busy and add to the number of deliveries at said hospital. LOL

Mostly, once more, it's about the financial expenses and being able to manipulate certain resources.

Specializes in Intermediate care.

Physical attractiveness essentially is about having characteristics that suggest reproductivity/fertility. On that level, one might wonder if the hospital is trying to move it's OB department forward. After all, if sexuality is what is mostly associated with physical asthetics--at least subconsciusly, maybe the young, hospitalized and outpatient patients and family will be subconsciously influenced to get busy and add to the number of deliveries at said hospital. LOL

Mostly, once more, it's about the financial expenses and being able to manipulate certain resources.

That is taking this a little too far. I hope that was sarcasm.

Specializes in ob.

I had a former co-worker who was about 60, who had great disdain for the new grads. Most of our NG's were young females and a few older second career folks. My contention is that we all bring something to the table. Ideally, the charge nurse has more than 1 or 2 years experience. At that stage in a career, most people still have a lot to learn, whether they realize it or not.

The best unit functions with a mix of ages and experiences among the staff. I am about 30 lbs overweight. I am in my late 40's with grey hair. I can run circles around most of the under thirty crowd. They type faster than I do and are definitely faster when it comes to using new computer systems. I get help from them for IT issues all of the time. They come to me for patient care dilemmas all of the time. I have certainly picked up great ideas from people from all different age levels and experiences and they have from me.

There is ageism in nursing. There is also a lot of envy and plain female, because most of us are women, B******G. I have not worked with any males for a number of years, BUT they can join and do in the B******G too. I have contemporaries who query me about why I don't dye my hair, wear more make-up, etc. I would not dream of saying to another woman.. Why do you dye your hair blonde? You're 55, everyone knows you're really grey and have a boatload of wrinkles. We do with our appearance what we are comfortable with.

I think as nursing has become more about customer service and less about true compassion, we have management and HR folks who see YOUNG and ATTRACTIVE as synonymous with lots of energy, pleasing and perky to patients, lower medical costs, and cheaper to pay. In other words, they get more bang for the buck. They think. Though they do bring a lot to the table, newbies need us old folks to learn what they did not and could not learn in school. Over twenty five years in nursing has taught me a lot more than 2 years of clinical 1-2 days/week. I may not be the pretty perky, 22 year old I was when I graduated, but I am one hell of a clinician and of great value to the team. I am worth every penny they pay me and a lot more. That is not a statement of arrogance, but one of truth. No way can I work forever. I know that. I was a new nurse once myself and I owe so much to those who came before me. The things they taught me and the time they spent teaching me was invaluable. I love our new nurses, but cringe when I see a shift staffed only by those with 5 or less years of experience.

Nursing touts itself as a profession which respects and cares for those across the continuum of life. We owe our own nothing less.

That is taking this a little too far. I hope that was sarcasm.

Really now? ;)

Specializes in Intermediate care.

Really now? ;)

Yes really...

Specializes in Intermediate care.

As a matter of fact, I do: English, German, Arabic (Iraqi dialect) some Spanish (Im mainly teaching myself Spanish for medical reasons), and enough Pashtun to politely greet and eat. I've forgotten almost all of my Russian so I don't count that anymore. Life experience again, living in other cultures. ;)

As for life experience, we all bring our own, and you certainly have had a full plate for your age. But check the attitude about it at the door. Remember why we are all here - the patient.

The problem, I think, that you are focused on patient satisfaction scores, which is not the same as the health and well being of the patient. I am of the opinion that patient satisfaction scores are probably not the best indicator of health outcomes - they only indicate how much the patient "feels" about the services, not about the actual quality of the outcomes.

I think hiring for looks (as was alleged) is a poor managerial decision designed to prop up satisfaction scores via cosmetic measures, rather than provide for better care. In essence it is addressing a business problem (due to how hospitals are scored these days). But they are being superficial: treating the symptoms (satisfaction scores), but not the cause (patient outcomes, adequate staffing to allow time for compassionate care). A compassionate nurse with a patient load that allows them to spend time with the patients will garner higher satisfaction scores than will a overworked, only seen at rounds and meds, nurse who looks like a supermodel. The bonus is that the former will also address outcomes and so on, which over time will lead to higher satisfaction scores. The problem is that the better solution is not the cheaper solution, nor is it obvious to management that comes from business mindset that still is philosophically based on managing production (think Six Sigma or Deming PDCA), not a medical one. For that issue, there is no pat answer -- all the choices are difficult, and applying business methods to medical care (including the application of the word "customer") can produce undesired outcomes (measuring the wrong thing can result in treating the wrong thing).

Back to us, nurses. As nurses, we need all the tools in the toolbox, including compassion and empathy. That's where "life experience" comes in - it gives you a few more tools in the toolbox. I disagree with you that it being meaningless. Being on the other side of the bedrail in ICU as you were, IMHO it definitely gives you a better viewpoint when dealing with a patient in such circumstances, and can help you better communicate and care for the patient (helping both satisfaction and outcome scores). So its relevant. Don't underestimate the value of "soft factors" (versus hard statistics) -- these are mostly secondary to our technical and academic skills, but experience tempers and influences how we use those primary skills. That's why proper experience matters.

As for low cut tops and batting eyelashes, I would be very concerned if it were an option for anyone. I believe that merit (achievement), experience (temperament) and "fit" to the position are the best considerations. It was true when I interviewed and hired engineers, and is also probably true for nursing as well. I expect that will I make it on my own merits - and that's where I go back to the original post: All I want is a fair chance -- I dont want to be eliminated because I'm a guy, or older. I have a feeling wearing a low cut blouse is not an option for me.

I don't remember but was I even talking to YOU directly?

Specializes in Case mgmt., rehab, (CRRN), LTC & psych.
I don't remember but was I even talking to YOU directly?
It doesn't matter. Even though you might not have addressed this particular member directly, this individual is still allowed to respond to any post that he wants to directly address as long as his response falls within the realm of healthy debate.

Studies have proven that more attractive people are thought to be more competent. Perhaps this is why.

To hire those in shape brings a whole slew of benefits from a business standpoint; lower health insurance, less injury, shows patients health is important to nurse.. etc;