Petition for new nurses

Nurses Job Hunt

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Specializes in Geriatrics, Home Health.
I live in a saturated urban job market, and I have noticed that most of the recent grads from my class are sitting around complaining that they can't find jobs, yet they scoff at the idea of working at SNF's. Those that don't feel entitled got great jobs at SNF's and the like that actually paid a few dollars higher per hour than the local hospitals do for new grads. Additionally they are learning that the acuity level at many SNF's these days is akin to the more "stable" med-surg patients. Included are several IV Abx and the occasional IV start. Hypotension and bleeds are common assessment data, and q shift VS and assessment are absolutely necessary on these patients. The most resourceful students will be able to "do their time" working 1-3 years at a SNF/Rehab facility and then market themselves at a job interview for higher acuity hospital are by explaining the complex cases that are now encountered in SNF and the limited resources these nurses use relative to the more controlled environment of the hospital.

When I graduated in 2008, even SNFs wanted experience. A one-star SNF turned me down.

Have you checked out the Geriatrics/LTC Nurses forum? That might give you some insight about why new grad RNs don't want to work in SNFs.

In my area, and the major city where I graduated, new grad RNs don't want to work in SNFs because SNFs are horror shows. In a hospital, you may have 4-8 Med-Surg patients; in a SNF, you have 20-30, with no on-site physician, pharmacy, RT, social workers, or other support staff outside of M-F 9-5. After a week or 2 of orientation, you're on your own. If things go really wrong, the BON doesn't care if you're overwhelmed, inexperienced, or inadequately trained.

Any good hiring manager at a hospital should be able to look at a student with 1-3 years work experience and see them as more valuable than a student who sat at home, waiting 15 months for a coveted 'hospital job' to find its way to them. Unfortunately some hiring mangers in hospitals are completely jaded in their thinking, but soon that SNF and LTC = RN career death will have to change; it already is in my area.

Going from a SNF to a hospital job just doesn't happen in my area. Hospitals want hospital experience. SNF nurses end up in home health or other SNFs. In a hiring manager's eyes, a nurse who worked for 3 years in a SNF is the same as a nurse who sat at home unemployed, or worked in a non-nursing job for 3 years.

If SNFs are the wave of the future, then SNFs need ironclad nurse-patient ratios (maybe 1-10) and new grad orientation programs that last longer than 2 weeks. When SNFs are no longer hazardous to a new grad's license, new grads will want to work there.

hope4673

17 Posts

I disagree with some of you about all new grads only wanting the "glamour specialties" and not taking others. I'm a new grad. Those from the school I graduated and other new grads I have met at my new job have aspirations to work in some sort of specialty nursing, I hope to work my way to the ED one day. Some even actually want to work geriatrics. But most who I've talked to are willing to get a job in whatever is open. I don't enjoy the med/surg as much but I am still loving my experience. Like some people have said on here, I didn't want to work at a SNF for the exact reason that the patient-nurse ratios are horrendous. I would not feel safe at all as a new grad. I just started orienting on the floor and the idea of taking 6 patients at once seems so difficult. Of course I'll be used to itI think those with experience would give so much better care to those in SNFs.

Good luck to those of you still looking. There is a job out there for you somewhere! It took me a couple months of applying to many hospitals. A tip I suggest which I did is look for the "hot job" at the hospitals in your area and ask the manager if they hire new grads. Usually they will ask you to send your resume. The only interview I got was through that. Another factor to consider is the City or State you are currently trying to find a job in. Maybe getting out of a highly desired area will help.

troop949

175 Posts

Specializes in Public Health.

I am in my final few months of nursing school (2nd degree/career changer/"oldie but goodie" here). While there are a few of my classmates who are dead-set on one of the common new grad "glamour" specialties, most of us will take whatever we can get. Making a broad statement that new grads are only seeking work in the acute care setting is painting us with quite a broad brush. And, I don't know how it works at other schools, but all of my instructors have been practically ordering us to get "one or two years of acute care/med-surg experience" right after graduation, before seeking out specialties or other work in non-acute settings. So, even those students (like myself) who would rather start their careers in a non-acute setting are being strongly discouraged from applying to positions outside of the hospital. Also, as I'm sure many of you have encountered, the pickings are slim for new grads anyway....many non-hospital jobs here in Atlanta won't even sniff at a new grad without some hospital experience under their belt.

I swear, the question of how a new nurse can get a job is even more of a riddle than whether the chicken or the egg came first, LOL.

Nabberdo

7 Posts

I have to say I take exception to the "snarky" comments posted intimating: "you made your bed, now lie in it". REALLY??? I don't know of anyone that would put in the incredible amount of hours and grueling work required to become a nurse "just for the money". And as far as "doing the research", everywhere you look there are ads for RN's needed. What they don't say is "new grads need not apply". And the nursing colleges are certainly not going to tell you there are no new grad jobs, well at least not until two weeks prior to graduation when local recruiters come in and say "take a nurse aid position, or a tech position to at least get your foot in the door". Talk about deflating all your hopes and dreams at 5 mins to 12! The colleges have known for years that there are little or no jobs available for new grads, but they continue to pound them out because they make money. Who knew or dreamed you had to ask "what's your placement rate", after all there are all those ads stating RNs are desperately needed.

"Grads only want the coveted jobs"... all nursing instructors will encourage you to dream big on where you want to be, ie: ICU, ER, etc., and tell you specifically that you need 3 to 5 years in a MS hospital setting. These are your advisors and mentors, why would a student not trust or listen to them?

Move to a different area to find a RN job? Well that may have been a do-able option years ago, but many of you seasoned employed nurses have been out of the Job Search market for long enough to not realize that the landscape has changed dramatically. The new grad problem is nationwide so a hospital in Timbucktoo, if they are even going to hire new grads, are going to hire those from their local area not someone from out-of-state.

"Work in SNF" you say and then infer that new grads don't want to because they are afraid to get their hands dirty. I know plenty of grads willing to work in SNF - but they don't hire all RNs OR LPNs, usually there are very few of either hired in a facility. Most hires are nurse aides. And many new grads are afraid, not of getting dirty hands, but of the overwhelming staff to patient ratio. Maybe you have forgotten what that's like.

It is disappointing to see how many experienced nurses view new nurses literally as a pain in the butt and tough nuggies - just throw new nurses under-the-bus and roll over them a few times to "toughen them up". Such a shame! Must be how they were treated when they became new nurses. No one said seasoned nurses should be thrown out or step aside to make way for new nurses - hell, new grads want to know what you know!! Many would give their eye-teeth if you would be so kind as to impart even a small bit of your experience (in a somewhat pleasant manner) so please lighten up!

The problems for new grads being hired in this market are, at least as I see it:

1. The economy affected hospitals who are also experiencing financial woes as reimbursements decline but expenses remain the same or increase. Because of this they find it difficult to justify the expense of training new grads. They will, however, hire you into a clerk, nurse-aide, or tech position because it is financially worth it to them. Besides the reduced pay, they get an RN who is held to the highest standard of his/her license doing double duty, ie: if something happens with a patient and you don't respond as an RN would reasonably respond (even though you are not working as an RN) you can be held liable.

2. The economy affected many long-term seasoned nurses who find they must continue to work since their 401ks were decimated so there are fewer positions opening up for new grads.

3. Colleges have flooded the market with RNs, it's a money maker.

4. Hospitals feel it makes better economic sense to hire traveler RNs since they do not have to pay benefits to them or guarantee a salary if the RN is not needed. I don't personally get how this saves a hospital money. Travelers are booked through agencies who guarantee the traveler RN housing, transportation, salary, 401k, health, vision, and dental benefits, bonuses, etc, etc to the tune of $6000 to $8000 per month plus the agency fee!! So no openings for new grads who would earn substantially less.

5. Facilities are afraid of Obamacare in terms of reimbursements, especially in light of the new medicare rules on patient satisfaction and re-admissions.

That's my take on it.

thenursemandy

276 Posts

Specializes in Med-Surg, LTC, Psych, Addictions..

Too many new nurses say the same things over and over, " I can't find a job. I thought there was a nursing shortage ?" It's the sad truth that most of these shocked new nurses didn't do their research before applying to school. They heard the nursing shortage propaganda and thought they'd easily find a great job.I wonder how many wonderful nurses will give up on their dreams and throw in the towel once they realize they can't find a job. :(

Tatinha

25 Posts

Many new grads want to work in home care, public health, SNF and nursing homes, but guess what???? these job postings require at least one year of experience, preferably in a hospital. I am tired of hearing people telling new grads to look for work in places other than hospitals. You have to apply everywhere, yes. But please, don't say that new grads are only interested in hospital positions.

Leonardo Del Toro, RN

1 Article; 730 Posts

Specializes in "Wound care - geriatric care.
Too many new nurses say the same things over and over, " I can't find a job. I thought there was a nursing shortage ?" It's the sad truth that most of these shocked new nurses didn't do their research before applying to school. They heard the nursing shortage propaganda and thought they'd easily find a great job.I wonder how many wonderful nurses will give up on their dreams and throw in the towel once they realize they can't find a job. :(

Quite a few, specially if they're young which most are.

KatieMI, BSN, MSN, RN

1 Article; 2,675 Posts

Specializes in ICU, LTACH, Internal Medicine.

In my area, 90% of the out-of-hospital places mentioned (SNF, rehab, home care, hospices, dialysis clinics, offices) specify "at least one year of acute care nursing experience" as an employment requirement. There are exclusions but they are few and far between.

In the meantime, more APN/clinical range programs seem to start taking "bedside experience" in specified area(s) as mandatory for admission. I'm researching possibilities for my next step (Acute care/Adults NP) and find that almost all reputable programs want applicants to have at least one year of med/surg and some experience in ICU to be competitive for admission. All other "specialty" APN programs such as CRNA, CNM, neonatal NP and others require relevant experience as well.

Getting the first nursing job in SNF thus limits career choices, and not everyone can afford years to "advance" from SNF to hospital to bedside specialty nursing in order to get into desirable APN school, with a lot of risk not to make it at the end. This may be another reason why new grads don't want non-hospital jobs, although I just can't get why two years on ortho floor in hospital might prepare anyone better for acute NP practice than the same time in acute rehab which accepts patients from the same floor 48 hours post-surgical.

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