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

But experience does command greater respect. And not just in nursing. Who do you think gets more respect in a university. The brand new professor or the one who's seen generations of students pass through? The rookie cop or the seasoned vet who's seen it all?

Think about it.

Specializes in Intermediate care.
But experience does command greater respect. And not just in nursing. Who do you think gets more respect in a university. The brand new professor or the one who's seen generations of students pass through? The rookie cop or the seasoned vet who's seen it all?

Think about it.

This is nursing...not college professors. Did I ever say I agree with it? Just speaking the truth.

But experience does command greater respect. And not just in nursing. Who do you think gets more respect in a university. The brand new professor or the one who's seen generations of students pass through? The rookie cop or the seasoned vet who's seen it all?

Think about it.

This is quite true.

Specializes in Critical Care, Float Pool Nursing.
As a relatively young new graduate, I am ashamed to be classified in the same group as you. I always wondered what preceptors meant when they have said on this site that they hate when new grads act like they know everything and they know it better. I thought surely these have to be cases of misinterpretation. I thought that the new grads of which they are speaking are actually insecure, therefore overcompensate by trying to act confident, not realizing it's actually coming across as acting as if they know everything and are superior. And then I read your posts, and sure enough, those types of new grads really do exist, no misperception about it.

Experienced nurses: please, please know there are many many new grads who respect you and feel grateful for the chance to work next to you. Every change for the better has been implemented by you and the nurses before you by your assessments, continuous learning, research and therefore evidence - based practice. Thank you for impact you make.

Hi. I am actually not a new grad. Thank you for your misguided insight.

Specializes in OR, Nursing Professional Development.

Wow, I'm surprised by those who are taking this so personally. The OP wrote about what is happening at her own workplace; not a generalization about all young new grads. I bet if some of you print this thread out and read it in a few years, first you'll be embarrassed and then you'll laugh at yourself. I know I said/did some pretty stupid things when I first started working as a nurse that make me blush now.

Specializes in burn ICU, SICU, ER, Trauma Rapid Response.
But you don't make the decisions. New grads will go with any change. That's what hospitals want...its a business! Its the way it goes.

*** Yes, that is pointing out the obvious. I was pointing out that experienced nurses, as a rule, do NOT hate change. They usually hate change that makes it more difficult or impossible for them to deliver the qualiety of care they want to provide. I have seen this a number of time with the multitude of really terrable computer based charting programs out there. Something that has the POTENTIAL to reduce the bedside RNs data imput time, thus allowing him to spend more time actually provicing nursing care. The potential is seldome realized and the usualy effect is to greatly increase the amout of time the RN must spend away from the bedside. This is the type of change experienced nurses hate. A very few computer based charting systems are very good and help the bedside nurse access information and greatly decrease the amount of time the bedside nurse must spend away from her patients. This types of change is usually welcomed by experienced RNs. My point being that it's not change that they hate, it's change for the worse. Often the less experienced nurses are not in a position to even know when something has been changed for the worse.

Specializes in Med/Surg., Geriatrics, Pediatrics..

So, when ever a hospitals satisfactions scores are low, whether it be because of the food, docs or their screaming neighbors the next room over, it's the nurses that have to change and no one else. Why is that?

Specializes in burn ICU, SICU, ER, Trauma Rapid Response.
When I said experience doesn't matter I meant LIFE experience. It doesn't matter to me the struggles you've had in life or the other jobs you've had.

*** Of course it matters. We (the instructors in my hospital's critical care nurse residency program) have noticed that new grads who bring a wealth of non nursing life experience are more sucessful in the very demanding residency program. Having previous experience dealing with stress, interacting with a variety of people from very different backgrounds, and decision making, (often with limited information) really shows up. We have not been able to predict sucess in the program based on nursing degree. We have been able to predict sucsess in the program based on previous life experience. Veterans of the recent wars in Iraq and Afghanistan for example have done very well in our program and they tend to be pretty young (early 20's). Those least likely to graduate from the program and be offered ICU positions are those whose life experience consists of living with their parents through high school and then going directly to college and applying to the residency as new college grads. Of course there are exceptions and some of these limited life experience new grads have been wonderful residents and critical care RNs.

Jenni811, you said your mother is also a nurse. Are you honestly trying to tell us that in all the years your mother has been a nurse, she has learned NOTHING, gained no experience whatsoever, that makes her a better nurse than you? Nothing that makes her earn that higher paycheck?

Specializes in Peds/outpatient FP,derm,allergy/private duty.
So, when ever a hospitals satisfactions scores are low, whether it be because of the food, docs or their screaming neighbors the next room over, it's the nurses that have to change and no one else. Why is that?

And on a related note, the article posits these changes, as she said, as an experiment. The theme would be that x, y and z, specific strategies they've already tried did not result in an improvement in their Press-Ganey scores, but since she noticed the trend in appearance and experience (excluding new grads) in nurses already hired, the hospital created a somewhat isolated variable that may serve to fine tune what it is that patients really want. I don't think she's announced to everyone the pattern she observed so nobody needs to get their feelings hurt (over that anyway).

If another 24 year old knows how to make the pizza, why not?

So much of nursing has been learn by experience, trial by fire, sink or swim anyway.

Frequently I've seen new nurses oriented by someone with 6 months or a year experience even when an "older" nurse has been available.

Hmm, wonder if that was the reason the new nurse gave a whole bottle of nitroglycerin for the chest painer, instead of one sublingual tab.

Specializes in Case mgmt., rehab, (CRRN), LTC & psych.
So, when ever a hospitals satisfactions scores are low, whether it be because of the food, docs or their screaming neighbors the next room over, it's the nurses that have to change and no one else. Why is that?
The nurse is one of the easier scapegoats in the healthcare organization.

Upper management wouldn't dare tell any of the standoffish doctors to "smile, use scripting and be nice to patients" because, upon hearing this directive, I'm sure some of the physicians would pull out of the facility and start admitting their patients elsewhere. Doctors are considered the revenue generators of the hospital because they refer paying patients, so management does not want to tell them what to do.

Buying higher quality food would incur more costs than continuing to use the cheap food-service style food, so I doubt management is going to change it to address the food complaints.

The managers wouldn't dare tell a screaming patient that he/she needs to (gasp) behave, respect others in the building, and keep one's voice down. After all, they might lose money. And money is king!

Since the other 'trouble-makers' are proverbial untouchables, it is the nursing staff who becomes the convenient 'fall guys' who must shape up or ship out. We are employed by the facility and they view us as a major financial drain to their revenue flow due to labor costs.