Can someone tell me about GN's?

elkpark · Mar 17, 2008

"Graduate nurse" (GN) status dates back to the days when the NCLEX was offered twice a year, and it took easily six weeks to get your results. Depending on exactly when you finished school, it could easily be six to seven months between when you graduated from school and when you finally got licensed. In order to give new grads a chance to start working during that time, and keep them from having to just sit around, forgetting stuff :), the state BONs offered a temporary "permit" to practice, based on the assumption that you were going to pass boards when you took them. New grads could be hired as "graduate nurses" (graduated from school, but not yet licensed) and function as an RN, but had to be supervised by an RN at all times. It basically functioned as an internship. GN status (the temporary permit) was only good until you took boards -- once you took the exam, you either passed and got a "real" license, or you didn't pass, and the temporary permit immediately became invalid. Once you didn't pass boards, you became just an unlicensed person, same as anyone else on the street, and would have to wait until the next time the exam was offered to try again.

Now that the NCLEX is set up so you can take it any time, at your convenience, some states have just eliminated temporary permits entirely. Other states still offer them. However, even in the states that offer them, it's up to individual hospitals to decide whether to employ people as GNs. It was v. easy for hospitals to keep track of "their" GNs' licensure status back when everyone took boards the same day and got their results at the same time, but, now that everybody gets their results on a different day, a lot of hospitals have just chosen to no longer hire people as GNs, because it's too much trouble for them to keep up with everyone's status, and they just won't employ anyone until s/he is licensed.

If a hospital employs new grads as "GNs," they are typically hired at the standard new grad salary. The temporary permit is good for the amount of time specified by the individual state BON (I think 90 days and 180 days are pretty common choices) OR until you take the NCLEX and get your results (whichever comes first). It is still the case that, if you take the NCLEX and do not pass, the temporary permit is immediately void, and you are suddenly (the next day) practicing nursing without a license, which is illegal in all 50 states. Both the new grad and the employer can get into serious legal trouble if one continues practicing after flunking the NCLEX. If, for some reason, you haven't taken the NCLEX by the expiration date of your temporary permit, it expires and you are, again, just another unlicensed person.

If the new grad doesn't pass and loses her/his temporary permit ("GN status"), most employers move you into a CNA position (at the CNA salary) until you re-take the NCLEX. There have been a lot of threads here in the past started by people who feel they are being seriously mistreated and insulted by their employers who do this, but the reality of the situation is that the employer cannot continue to use you in the RN role. By letting you continue working as a CNA/tech, they are doing you a favor by continuing to allow you to work (instead of just firing you), as well as protecting all the money and effort they have already invested in your orientation so far. Then, when you retake the NCLEX and pass, you are moved back "up" into the RN position.

It is not nearly as easy to find a job as a GN as it used to be. Lots of facilities just won't hire you until you have your permanent license. But some places do still hire GNs. Full-time vs. part-time would be between you and the individual facility. There are a lot of us experienced nurses here who think it's really important for new grads to work full-time, but that's a whole 'nother conversation.

MzKGoRN · Mar 18, 2008

The previous poster summed it all up pretty well. I would just add that here in Texas various hospitals are hiring GN in internship position. Some hospital start at GN pay and some hospital give you a year's experience pay for every 3 years you have been a CNA or patient care tech. In Feb. the hospitals in Dallas and surrounding areas started posting position for the GN internship that start in June have start filling those positions also. I got a position in the ICU internship and a lot of my classmates have excepted offers for internships in various hospitals starting in June and we graduate in May. So I guess it does depend on the state.

queenjean · Mar 18, 2008

Kansas no longer has a GN status. I don't know how they work it now--I don't know if you can even get hired and oriented until you pass boards.

I suggest you call your state board of nursing and direct your questions to them.

coopman712 · Mar 18, 2008

Wow-thanks for the tutorial. That is far more than I knew about them. I suppose once I start my program I will learn a bit more about how things work here specifically, but at least now I have a knowledge base to go on. Sounds like it is something slowly being done away with. I think I had it in my mind to be the way it used to be when the boards were only given twice a year.

I really appreciate you taking the time for the thorough answer. THanks again! :wink2:

elkpark · Mar 18, 2008

You're welcome. :)

spider11 · Mar 18, 2008

I'm in Indiana and a lot of hospitals will hire you as a student nurse. Where I work, they have a grading system SNE I, II, or III. It all depends on how far you are in school. SNE III would be considered a graduate nurse. You do work under the license of your preceptor. I am not sure of what the pay difference is though. I started out as a Tech and then graduated as a LPN. I start the transitional RN program in June.

PsychNurseWannaBe, BSN, RN · Mar 20, 2008

I was hired initially as a GN. The organization gave me 90 days to take NCLEX. I was actually paid as an RN, which was cool. Show me the money! :)

Ours worked a little different if you didn't pass. If you failed you moved into a Nurse Technician role. If after 2 attempts you didn't pass... you could possibly move into a CNA role, if you had your CNA cert. If not... see ya! Quite a lot of pressure and stressed me out!

The difference between nurse tech and GN for us was the level of supervision for the most part. GNs only needed "general" supervision. So as long as there was an RN "somewhere in the building" I was good to go. Nurse Techs should really be working along side the RN (direct supervision) plus I do believe they still need counter signatures...at least in my state they do. Additionally, GN are technically and legally allowed to practice professional nursing. However, organizations can limit what you are doing. If the patient is taking a turn for the worse than both the GN and NT should consult with an RN ASAP.

There was always a gray area that I could never find the answer to. Can GN's take verbal orders?

I passed the first time so...phew!

ChristineN, BSN, RN · Mar 24, 2008

There was always a gray area that I could never find the answer to. Can GN's take verbal orders?

In the state of PA, no.

classicdame, MSN, EdD · Mar 28, 2008

Also in Texas the GN permit allows the GN to work as an RN with RN supervision. The permit has a deadline of 90 days. The GN must take and pass the NCLEX within that time period as the permit will expire otherwise. We hire GN's every semester and pay them the same as any other new licensed nurse. This gives them a little incentive to come work with us because they can start earning RN pay right away. Rarely does the GN not pass. When that happens they are allowed to work as CNA if they choose, but not in any capacity that requires a license.