So how's the job market NOW?

PMFB-RN, RN · Apr 13, 2012

Worse than ever in Portland and the surrounding areas.

*** I am really suprised to hear that. 5-6 years ago I spend some time in the Portland area doing various ICU & ER agency work. I could have worked every single day if I wanted there were so many hospitals short of nurses. Given the volume of calls I continue to get BEGGING me to come and work, and the very high wages being offered ($50-$62/hour), I assumed that was still the case.

pnlu007 · Apr 13, 2012

taz,

looks like ur right about linfield upping clinical hours...they are in the process of revising curriculum and it will include more clinical and lab hours.

busymommy · Apr 13, 2012

Thanks, taz! Can you tell me exactly where on the westside that Kaiser hospital will be? Any target date for opening day? That's very encouraging, and I know my DH will be happy to hear about that. Central Oregon has been on our 5-year relocation plan for a while now, so I guess it's time for him to start exploring his prospects up there. :up: He's an electrician and I know nothing about that kind of work, other than he loves it. I'm hopeful that with all those jobs opening up back east that the trend will continue to the west coast really SOON, for everyone!

pnlu007 · Apr 13, 2012

kaiser westside will be in hillsboro...august 2013 is the expected completion.

pnlu007 · Apr 14, 2012

hey taz,

i really appreciate some of your insight about linfield...someone posted this on another thread...were most of your clinical hours really just at nursing homes?

"To put it nicely the program is a hot mess. IF you want to spend all four semesters at a nursing home for your clinical then go for it!"

taz5869, RNC-OB · Apr 14, 2012

There are jobs for experienced nurses who are looking for work, but not for new grads. Many of my cohort members and I are absolutely perplexed because we can't even get interviews in the hospitals, letalone jobs.

taz5869, RNC-OB · Apr 14, 2012

pnlu,

The clinical hours for my classes were listed as:

Fundamentals - 84 hours

Mental Health - 126 hours

Community Health - 84 hours

Clinical Nursing Skills - 84 hours

Maternal-Child Health - 84 hours

Chronic Care - 126 hours

Acute Care - 126 hours

Leadership - 84 hours

Senior Practicum - 144 hours

It looks decent, doesn't it? The problem is that a lot of your "clinical" hours for all of these classes except your senior practicum are used up in the lab, in praxis meetings, and in other seminars. For example, I'm pretty certain we only spent 3 days in a nursing home for our fundamentals class... and I highly doubt they were 12 hour shifts (my memory is a little hazy, but I couldn't believe that's all we got). Certainly far less than the 84 hours that was on paper. We had a two day training seminar in chronic care that counted towards our clinical hours. We typically spent 2-4 hours per week in praxis meetings with our clinical instructor.

Again, I was in the accelerated program, so the class schedule was a little bit different for us than other cohorts and it's been redesigned with the new curriculum. As far as the community focus and clinical assignments are concerned... as I said, we got 3 days in a nursing home during our first semester. Second semester was our Mental Health and Community Health rotation. Some (probably most) of us didn't even set foot in an institution for fall semester and we didn't wear scrubs a single day that fall unless we were lucky enough to be part of an immunization clinic. Our clinical nursing skills class was in January - over 6 months after we started nursing school. At that point in time, we finally were learning skills like Head-Toe Assessments, medication administration, priming IV tubing, inserting NG tubes, sterile technique for trachs and catheters, etc. (Though we only practiced straight caths, not foleys). FINALLY we were able to practice some nursing care, though our clinicals were focused on practicing our assessments, not our other skills. (It's important to cultivate good assessment skills, so I understand the focus.) All of us were in nursing homes for that rotation. In February, some of us were finally assigned to hospitals for the Mother-Baby rotation (half the cohort was taking Mother-Baby for the first half of the semester while the other half was taking Chronic and then we switched). I think some people were placed in nursing homes again for Chronic. I was one of the lucky ones who was in a hospital for Chronic. So, by the time we had finished Spring term and had been in school for almost a year we had been in one or two hospitals at the most. We had written more papers than I care to even think about and had done several community assessments, windshield surveys, etc. I've been told that this is the difference between the ASN and the BSN degrees... BSN's focus on critical thinking and have a LOT of writing.

Summer was our Acute care course and that's where I really felt like I was finally learning and practicing the nursing skills that I thought/assumed I would have practiced a lot earlier (i.e. the clinical skills we learned in January - we hadn't had a lot of opportunity to do them during mother-baby and chronic).

We had a five week break after Acute care and then spent the first half of fall semester doing our Leadership rotation. So, by the time we were able to start our Senior Practicum at the end of October it had been another 3 months since we had been in a hospital practicing clinical skills. Our senior practicum was 144 hours - no more, no less. 12 shifts. Throughout school I was pretty disappointed that we weren't even allowed to volunteer our time and get more hours during our clinical rotations than we were required to get.

I'm not saying that Linfield is bad - but it's far different than what I expected. I had no idea that it would require so much writing and, for lack of better word, busy work. I knew prior to going to Linfield that others were not content with the time allotted for clinicals, so I thought I knew what to expect in that regard. I didn't realize that I would feel so frustrated with the lack of clinical experience. I thoroughly enjoyed my clinical rotations and wish that I could have had more time to practice the skills I was learning. I also feel like my curriculum was weak on pathophysiology and pharmacology because they were elective courses. We had pharmacology incorporated into our classes, but I didn't think it was as thorough as it needed to be. I know they've changed this, somewhat, but still suspect they're not dedicating enough time to it.

I am grateful that I got into Linfield and was able to get my degree, but I'm astounded at how much I still have left to practice and learn. Nursing school provides you with the bare basics to make sure you have the skills and critical thinking ability to prioritize your tasks and keep patients alive.

Most of what nurses know they'll learn on the job.

taz5869, RNC-OB · Apr 14, 2012

Oh, we didn't start giving meds until Spring term (Mother-Baby/Chronic care), either. We'd been in school for almost 8 months when we were finally allowed to start giving some shots and medications (besides immunizations) under the supervision of our clinical instructor or a RN.

I don't know if that is typical of BSN programs - I doubt it. I think our clinical skills were pushed back because Linfield has their mental health rotation earlier than most programs. My understanding is that most programs have their students take mental health during their Senior year.

PMFB-RN, RN · Apr 14, 2012

Most of what nurses know they'll learn on the job.

*** You are absolutly right. I believe part of the reason hospitals are reluctant to hire new grads is the large investment in training they must make to get a competent bedside RN. One hospital I work for has a 7 month new grads nurse residency. We had to implament the residency after so many new grads came totaly unprepared to be entry level bedside nurses.

This program is obviously VERY expensive, running hundreds of thousands per year. I think it's time we demanded more of our nursing schools.

pnlu007 · Apr 14, 2012

Oh, we didn't start giving meds until Spring term (Mother-Baby/Chronic care), either. We'd been in school for almost 8 months when we were finally allowed to start giving some shots and medications (besides immunizations) under the supervision of our clinical instructor or a RN.
I don't know if that is typical of BSN programs - I doubt it. I think our clinical skills were pushed back because Linfield has their mental health rotation earlier than most programs. My understanding is that most programs have their students take mental health during their Senior year.

Thanks for all the info taz...I'm wondering if you and I have the proper expectations for a BS nursing program and an accelerated BS where there is even less time. I think we may all picture being in the hospital, being around patients and rolling up our sleeves most the time...however, how prepared are we really to do that with a few classes under our belt...I really don't know. Although we all hope to be super prepared health care providers at the end of the program, maby the point of a BS isn't that...that we are really only there to get the basic knowledge to provide care...and the rest is to learn on the job...i really don't know.

taz5869, RNC-OB · Apr 14, 2012

*** You are absolutly right. I believe part of the reason hospitals are reluctant to hire new grads is the large investment in training they must make to get a competent bedside RN. One hospital I work for has a 7 month new grads nurse residency. We had to implament the residency after so many new grads came totaly unprepared to be entry level bedside nurses.
This program is obviously VERY expensive, running hundreds of thousands per year. I think it's time we demanded more of our nursing schools.

Agreed. New grads are expensive to train and the hospitals want to make sure that we're not going to jump ship once the going gets tough or a "better offer" comes along.

taz5869, RNC-OB · Apr 14, 2012

Thanks for all the info taz...I'm wondering if you and I have the proper expectations for a BS nursing program and an accelerated BS where there is even less time. I think we may all picture being in the hospital, being around patients and rolling up our sleeves most the time...however, how prepared are we really to do that with a few classes under our belt...I really don't know. Although we all hope to be super prepared health care providers at the end of the program, maby the point of a BS isn't that...that we are really only there to get the basic knowledge to provide care...and the rest is to learn on the job...i really don't know.

Yes, I think we all have the romantic notion that we're going to be proficient nurses when we graduate. But that's not the case... and hospitals know it and don't expect us to be. Every nurse knows that new grads are novice/beginning nurses and have to gain experience on the job to develop proficiency. There's just too much to learn to get it all in nursing school and different jobs will require different skill sets.

I've been told that hospitals know that BSN nurses typically have less experience with the clinical skills because we have to be trained to critically think through things and better understand how/why we are seeing certain signs/symptoms, the implications that they have, and understanding which ones take priority because we are the ones who may be charge nurses. The hospitals can easily provide us with the clinical experience for IV insertion by sending us to the ER for a day, but it's not as easy to teach us the critical thinking aspects regarding fluid volume overload or deficit and provide us with the foundational understanding of which patients require isotonic vs. hypotonic vs. hypertonic and why (based upon their age, diagnoses, lab values, etc... not just what s/sx to look for, but truly understand the processes).

*Shrugs* I dunno... I don't know what the curriculum is like for an ASN, so it's really hard for me to know for sure... that's just what I've been told.