Community College Selection Process-What A Joke!

Warning - very long answer:

It's not that I think it's an all-fired 'conspiracy'. But, the leaders of healthcare generally are well aware of the concept that, using vocational standards, a 'low paid' nurse is a better nurse. Anthony Heyes, whom I quoted earlier, didn't invent this concept; it's been the modus operendi of setting nursing salaries for decades.

Even through to the early 80's, you really had to be motivated to be a nurse, because you certainly would not make enough money at it to support a family. This is the key reason why men haven't been in nursing in any number until very recently. In many family dynamics, especially in the past, women can be '2nd income' earners, but men have been traditionally conditioned to be 'primary breadwinners'. And nursing - nursing wasn't a job that could accomplish that. Ask those that have been in the field for 30 yrs and many will tell you that their starting salaries way back then were not much more than minimum wage. Even in the mid-90's, my starting RN salary was 13 dollars an hour.

The dynamic, as I discussed, is changing. Because nursing is no longer a job where someone that is 'called' can actually meet that calling on our busy units, pay has had to go up to create the supply of nurses willing to work 'in the trenches'.

THAT is why schools are full now. It's enough to draw candidates in, but still not enough to keep nurses in the profession. The physical demands and moral distress of being a nurse is enough to tax the strongest person. It is a job that exacts a heavy toll. Those on the outside looking in generally think: wow! what a salary for the level of education! Those of us IN the trenches normally think: I'm not being paid nearly enough for what I do.

But don't doubt that those that set salaries are greatly concerned about how to keep them in check. Employee salaries are traditionally the largest expense of any company and when your largest group of employees start to earn in the 50-70k range, that is cause for alarm, especially if YOUR salary and bonuses are dependent upon keeping such expenses in check.

There have been mulitple attempts to keep salaries low over the years.

Look at the ADN/BSN debate. NO, I don't want to get it started, but I just want to make a point. In any rational economic theory, higher education should equal higher pay. In reality in nursing, those degrees get paid almost identical salaries. Why? Management simply doesn't want a concept that would allow a convenient way for nurses to transition to educational degrees that would command a higher salary. Once you stratisfy such salaries, the result is to go down the road of ever increasing salaries as nurses catch on that more education equals more money. So, there is almost a nationwide collusion to refrain from acknowledging the economic value of such degrees. If hospitals had paid for such a difference in education over the years, that whole debate would be moot by now: the economic benefit of such a degree would not only cause movement to transition towards such degrees, it would affect the choice of programs, in the first place.

Look at the concept of magnet hospitals: IN EXCHANGE for decent work environments (something that should have been provided all along), nurses will be 'drawn like a magnet' to environments and job situations not expressed in the bottom line. I'm not opposed to the concept of spending a few hundred thousand dollars on work environments. I am opposed to it when the concept seems to be that, by doing so, hospitals can save a few million in salaries.

Look at turnover rates. Depending on which study you look at, the annual turnover rate for nurses nationwide is 15-21%! If you employ 300 nurses, that means, EVERY YEAR, you are looking to replace 45-60 of them! Why would hospitals allow such attrition? Because most administrators believe that it's simply cheaper than paying a salary that would keep attrition at a normal 5-7%. (Another argument here is that, by allowing such turnover rates, hospitals can keep replacing higher paid, more experienced nurses with new nurses on the lowest salary rungs.) I could argue that this isn't the case, that such strategies aren't cost efficient, but that's another debate. Bottom line, retention is poor because administrators BELIEVE that such is the cost of doing business at the price they are willing to pay.

Now, look at Anthony Heye's theory: low pay equals better nurses. Management is certainly aware of this concept - they've been depending upon it for decades. At it's heart this is a question of vocation vs. profession. This formula works for a vocation, and works well. But for a profession, the usual economics apply: higher pay equals better candidates. But the reverse is true as well: better candidates demand higher pay.

It's not that there is some conspiracy at work so much as employers are seeing their long used economic advantages over hiring nurses slip away. When you are talking about millions of dollars in play, there is ample incentive to attempt to turn the tide. Once that tide fully rolls in, the economic free for all that results in the creation of commensurate salaries will be huge.

Hospitals don't worry about paying doctors commensurate wages: the formula is in place for them to bill themselves. That was a necessary result to ensure that hospitals and doctors both got a decent piece of the pie. What hospitals are very concerned about is that nursing will cost so much that the economics will turn to nurses becoming independent contractors in order to command truly commensurate salaries, salaries that employers will never pay in their own right.

Ask any hospital administrator what they think about paying 'agency' salaries. Most administrators think of such salaries as practical extortion and shun having to deal with them whenever they can.

If a small hospital that hires 300 nurses gave each nurse a dollar an hour raise, that translates to more than half a million a year in extra salaries. Now, mulitiply that by much larger hospitals and much larger pay increases.

No, this is about money. Big money. And when you are talking about motivations in the millions of dollars, hospitals are very keen to control such costs, by any means necessary.

Disarming nursing from becoming a more qualified force to contend with at the bargaining table (increasingly becoming more qualified to demand higher salaries) is but ONE way - out of many stratigies being employed - to control costs. It's simple economics: the best and the brightest also tend to have a much higher valuation of their worth.

Bottom line: higher pay equals better nurses is the exact reverse of the formula that hospitals have used for years to employ nurses on the cheap. Since, under this formula, one equals the other, the solution to control ONE of these variables (salary) is to control the other.

Answer me this: what other economic benefit could be involved with a lottery system? Don't tell me that it's about altruism to students - full programs mean full tuition fees regardless of the actual body in the program. In any case, such a system is inherently unfair and creates MORE hassles than would be the case with a straight competition system. Why create such hassles? The answer to such questions is normally this: follow the money.

~faith,

Timothy.

Excellent post. You bring up many good points. One of the arguments that was used to justify this process at our local college is that they felt that a more pratical nurse was a better nurse, hence this leads toward the need felt by some to classify nursing as a vocation. And yes the consequence of this is lower pay.

Hey Tim, hang in there! I can't imagine what you are dealing with but try to keep at it. Don't give up.

I'm not sure where you are located but I'm in a wonderful ADN program at Mendocino College here in Ukiah that does not use a lottery system, they use a formula that is based on grades.

PM me if you want more information...the program is expanding, too!

Regards,

Ken

Thanks Ken,

One of the things that I must have is coverage for my friend who is an epileptic. As a consequence, I need to be in a place that I can recieve support from family members. But if it was myself, I would love to attend school in such a beautiful area. I have been looking at many options and I have set in motion a plan, but like all plans in life it is not perfect, but it will allow me to eventually obtain my goals. Again, thank you for the support.

Tim

If I can make a suggestion for those who are dealing with lottery systems and waiting lists ...

When it became clear that my school was going to have a waiting list, and my 4.0 GPA probably wasn't going to count for anything, this is what I did while I was taking pre-reqs.

I met with the director of the program every couple of months or so just to see if the criteria was going to change because I knew they were trying to go to a GPA system but, I also knew there was no guarantee that it would happen (and it didn't).

But, real reason I met with her and touched base was so everyone from the director on down to the secretaries knew who I was. I didn't want to bug them too much but, every couple of months or so I'd drop by the office and chat, just so I could make my presence known.

By the time I was ready to apply, I also had all of my pre-req professors write letters of recommendation, even though that wasn't required in the application. I made sure those letters were also delivered personally to the director, not just stuck in some pile of applications.

Now I have no proof that any of this actually helped and maybe I just got lucky but, I did beat the waiting list. There were no guarantees but I figured it couldn't hurt if they knew who I was instead of just being another name in a big pile of applications.

My point is: do whatever it takes to try to stand out. Meet with them as much as you can (although don't bug them too much) and, don't forget that even the secretaries can be important. Go above and beyond what they're asking for in the application with letters of recommendation, awards etc. because ... you never know, it might help.

:typing

Lizz

Does Your school have a lottery? Because in a true lottery, standing out does not matter.

Lizz,

It sounds like you do not trust the integrity of the lottery system. A professional corp. in our area is also concerned about the integrity of the system. They want to see a selection process that is open to the eyes of the public. They petitioned our local school to release the surnames of all the qualified applicants and the surnames of those selected. The school would not release this info. sighting confidentiality requirements. Now I have made my case very clear in that I want the best qualified applicant to get the place in nursing school. But if it is to be a lottery against my preference of merit, then I want to see all qualified applicants put in a room together, have each of us put our name into a hat ourselves, and witness firsthand the drawing of the names. A system without public oversight is a system that can be manipulated and corrupted. I realize that I sound distrustful, but I do live in Calif. afterall.

You have to understand that, for the programs, a body is a body.

While it might be highly personal for those individual candidates, on the main, it's merely demographics.

And, since the programs are full, the schools already get maximum tuition, regardless.

From the school's perspective, it matters little who gets in.

The only real caveat is that schools have to be mindful, due to federal law, of their diversity mixes. I would argue that THIS requirement alone, makes a lottery system not subject to complete chance. And once you allow any behind the scenes tinkering, you allow enough subjectivity to get in those that merit favor with those making the decisions. The only catch is that the actual 'lottery' process must remain secret, or risk legal remediation.

I would think though, that a completely random lottery is NOT at issue with most programs. I would almost bet that a certain percentage of applicants are accepted by 'off the book' standards. So, I think Lizz is on to something.

You can't even argue that the programs are concerned about their passing rates with entry standards. It's not who they let in that effect such scores, but who are allowed to graduate. Since attrition doesn't affect tuition, how many they drop is of no relevance.

I think, if schools were graded on BOTH pass rates AND attrition rates, you'd see a far different selection system. And due to the "shortage", while it might not be of interest to the programs how many they drop, it is of vital interest to society, more then meriting that programs be evaluated by that standard, as well.

And this in fact, is what I argue as a preceptor. I have told my boss on multiple occasions NOT to pair me up with somebody if the exercise is to be about ME determining if they should be allowed to continue. I will not. I have told my bosses that I make an automatic ASSUMPTION that, by being allowed to precept into our program, some determination was already made about the viability of this new nurse, in advance. That being the case, my job as a preceptor is HOW to get a nurse into the mix, not IF they are allowed to do so. IF they shouldn't be allowed to continue, that is my boss's job to determine; not mine. I won't be the mechanism to set somebody up to fail. That means that I put it on my boss to develop some criteria for evaluating the viability of candidates, in advance.

Unfortunately, schools have absolutely no incentive to do this. We've been talking about what criteria could lead to a higher level of success. In reality, for the programs, such criteria matters little, if at all.

~faith,

Timothy.

In a very real sense then, you prove my point that it is not a true lottery at all. You mentioned federal law requiring a certain mix based on ethnic identification and then you mention that Lizz might be on to something.

So let's sum up. We have for the most part put those of merit on an equal basis with those who are just passing. Then we call it a lottery, but we tinker with it to come into compliance with various federal laws regarding diversity. And lastly we allow futher tinkering of the system to allow SOME of merit(not all) to subvert this so-called lottery by the methods that Lizz used.(Note- Lizz should have been there regardless based on her acheivement.) This again proves my point that this is an immoral and corrupt selection process and it needs to be changed.

Can't argue with you there. For me it wasn't a matter of trust or distrust. I'm just a pragmatist. If my grades weren't going to count, I was going to do as much as I could to make them count by bringing it to their attention.

And I won't lie ... I was trying to subtly grease the wheels of the system in my favor. Did it work? I have no idea.

I was kinda hoping that since I did have a 4.0 GPA and they were, at least, trying to go to a grade based system (even though they failed in that endeavor) that they might look upon my application favorably anyway.

But, IMHO, they still needed to know who I was instead of being some name in a stack of papers. And, I did tell the director several times (albeit politely) I thought it was unfair that my grades meant nothing.

Again, I have no idea if it helped me or not. They certainly never said anything, nor did I even get a hint as to whether it was going to make any difference.

Nevertheless, I just couldn't sit around and wait for some lottery to determine my fate. Trying to stand out did make me feel better ... if nothing else ... because I at least felt like I was doing something about it.

:typing

I am proud person Lizz. And in a very real sense I am from the old school. An insructor of mine said to many of us one time "I do not grade on a curve, because in real life your are in competition with your peers". I believe that this is the way it should be. I do see some value to taking the steps you have mentioned, however I feel that at least for myself that I would being sacrificing a measure of my own pride to do so.