Nurses not immune to sick economy

um. no offense nurserivera, but if she does this I GUARANTEE she will find herself looking for another job within the week.

Again to me this seems to be is a catch 22. Hospitals don't want to risk hiring on a new grad because it costs so much to train them and then the retention rate past the first year is miserably low. But in doing so they just end up leaving more positions unfilled which shifts the staffing strain on the existing nurses.... which in turn could help explain the low retention in new nurses.

If they were smart enough they would do what some hospitals do now, if you are hired in their New Grad program then you must sign on for a 2 - 3 year contract.

But what is the penalty for not fulfilling the contract? Loosing a sign on bonus? The last I heard indentured servatute was outlawed so if you really want to leave you can.

To me I think the only way out is up. If nurses want to stay in the running they need to up the educational requirements. It is the only way they are ever really going to be considered true professionals. I myself am an ADN nurse but I still know the truth. It has been said before that you don't need a BSN to do the nurse's job. Well guess what, for a lot of nursing jobs you don't need an ADN either and hence their replacement with medical assistants. In the same way you don't need an MD to do primary care, so that some of those functions are now being taken over by nurse practitioners. It is just dollars and cents.

I come from a science background but I worked in business settings so I can think that way. If I was running any company, including a hospital or nursing home, I would always want to replace the high paid workers with lower paid workers wherever it was feasible. Hospitals need nurses to manage patient care, a medical assistant is not going to have the knowledge to make that safe. But, I would use as many care technicians as possible and encourage the nurses to delegate a lot and I see that happening around here now.

They are also upping the employment of nurse practitioners, no doubt because they can prescribe and bill for services and, therefore, are income generators as opposed to floor RN's which are expenses. The perk with nurse practitioners is that they can practice independently in a lot of places and they also know the nurse's job which means they can fill in there too. In some hospitals use of more nurse practitioners may cause problems with some physicians but in the end whatever structure generates the most revenue wins and this is cost effective. Especially if they can keep paying an NP a lower salary then a physician and not much more then a staff RN.

Now a position that was once an expense, floor RN, has the potential of being a position that is at least partially income generating. I think in the end this will turn out to be a nice way for hospitals to backdoor increasing reimbursement for nursing services which is currently a huge expense with relatively little direct reimbursement.