Many threads on this forum have dealt with the idea that hospitals lose a lot of money when a new graduate RN takes a position, goes through orientation, and then quits after six months to a year. There have even been reports of hospitals who require new graduate RNs to sign contracts that state they will pay up to $11,000 in "training fees" back to the hospital if the new graduate RN quits or is fired during orientation or even all the way up until 18 months after accepting the job.
This thread is designed to talk about whether you believe that hospitals incur a net gain or a net loss from the training of a new graduate RN during the orientation period. Although the new graduate RN is being paid during this orientation period, are they also not doing work? Isn't their presence on the floor as an "extra hand" a benefit to the staff? Or, do you believe that the trainee is a burden to the floor? Do you think the trainee RN slows down their preceptor because of time taken to explain and to teach, or do you believe they make a preceptor's job easier by assisting in tasks?
Use this thread to talk about your thoughts on new graduate RNs and the idea of whether they are a net gain or loss to the hospital, even during the orientation period.
Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.
Esme12, my original post was not meant to be taken as "EVERY facility that trains a new grad gets a check written to them by the government...I was simply adding a post to this discussion that talked about sources of funding for SOME facilities. I never said that my post applied to all rural, small, and community hopsitals as well as large teaching facilties...just was chiming in on the discussion and mentioning how some facilites off set their training costs. Sorry if you thought I was being harsh, but your response to my first post was harsh.
The cost of business associated with training a new grad will differ from facility to facility, and month to month as well! And while some grants that may be given to facilities may not be "specifically" delineated for new nurses, just having T and D programs in general opens up funding sources. All the money ends up in the same bank, but the more training available, the more money a facility can expect to get. The more money a facility has in general, the bigger and better they get to be!
Agreed, money begets money. Unfortunately community hospitals get left behind somewhat in the money department related to requirements to qualify and overall I believe the cost of training someone while worth every penny ends up being a net loss financially but a net gain ethically so maybe is a wash when added and subtracted all together......No biggie......it was just an initial thought of Ouch:lol2:that's all......If my first response seemed harsh is COMPLETELY unintentional and I apologize.....I type and get pulled away to the pool......I type and someone else is hungry...and someone needs somethnig else and with MS it takes me twice as long to do ANYTHING.....Oh well....... sometimes I really dislike this medium of communication because you can't read the body language and intention of the poster. But for the most part I'm opinionated but nice..... peace
Another thought, hospitals stopped the Graduate Nurse Programs because there are so many experienced nurses working, AND hospitals have cut budgets and decreased staffing. They will have to start them again when nurses retire and the aging baby boomers hit the health care system. They are not going to spend money when they don't have have to, even if its better for patients and nurses to have good training. If nurses who leave before the two years of service have to pay back the hospital for the training, then that should help the cost issue. Personally I would think long and hard about working with that hanging over my head. When did safe adequate training become a two year contract? In an ideal world your job is good and things work out, in the real world things don't go as smoothly. If hospitals want nurses to come better trained they should work with nursing schools to increase clinical time, so they get graduates that can function without a 16 week training period. If they want to train you for ER/OR/ ICU They should pay for training, not you with a two year contract!!! DR's get paid for residency why should nurses pay for their own( hospital specialty) training??
DR's get paid for residency why should nurses pay for their own( hospital specialty) training??
Residents do get paid a stipend during their residency, but it's a small fraction of what they make once their residencies are completed. If new grad nurses worked for an initial orientation/training period at 1/4 or so of what the experienced nurses earn, hospitals might well be more willing to hire and train them.
I assume hospitals count the $80,000 both ways? They lose it if the trained person leaves, but they gain it when they hire a person already trained.
I would wager hospitals are hiring way more trained RNs than providing training to green ones.
So they are WAY ahead of the game, right?
Your correct. Hospital that don't hire and train new grads and rely on getting their employees after being trained in other hospitals are ahead of the money game. It is why with this economic down turn so many hospitals have stopped hiring any new grads and new grads are having such a difficult time finding jobs.
I am not saying that hospitals are not reaping what they have sown with their lack of loyalty to employees being returned. Not that I am not sympathetic to new grads. I was one not that many years ago, and have precepted a few. My hospital is one of the few in this area that is still hiring new grads, although not to any ICU area anymore, that turned out to be too expensive even for this system.
The OP was asking for factual information about the cost of hiring new grads. Not if hospitals are being short sighted by focusing on this money in their current trend of cost cutting.
I would love a 6 month orientation. I got 8 weeks, 4 on one floor, 4 on another (I am a per diem floor between two units).
I've been off orientation for 2 weeks and have worked 4 shifts. I have 5 pts at a time. One floor (acute rehab) I am a lil more put together and organized and more self sufficient. Med/Surg? Worked a 12 there yesterday and we were understaffed one RN and one aide. I came onto the shift with one of my patients having a hypoglycemic episode, later followed by poor PO intake and obviously poor output, another pt who had a trach (which I have 0 experience with-even during orientation. The opportunity never really presented itself) who had a critical potassium. Luckily for me, he self suctions and is otherwise fine. Then I am pushing lasix on my lil old lady across the unit for a suspected PE, who btw takes off the 02 constantly and desatts. My discharge is a 1:1 for impulsiveness, and he is the hardest discharge in the world because I cannot get a hold of his guardian to go over the discharge instructions. Luckily my 5th pt was otherwise stable and just hanging out with her family most of the day.
Oh and did I mention that my charge RN has a pt who bleeding out from their AV fistula sites? And the other RN on has a pt who is choking on his breakfast (we really should have also had a 1:1 for that pt too for meal times but as I said, we were already short 1 RN and 1 aide from the get-go).
Needless to say, I was behind before I even started my shift. Though I was proud of myself for only staying an extra 45 mins after my 12er to get caught up with charting. But only to come home to a disgruntled husband and a cranky baby. It was THEN that I burst into tears-the first and only time ever since I started this job.
Did I also mention I had 3 preceptors on the med/surge floor and 2 on the rehab. There was no real consistency. And it wasn't due to work relations-it was due to scheduling. And none of these 5 were prepared for me. I just showed up and was told I was working with them. Fabulous for all of us. Luckily I loved each and every one of them and they have been great to me, but lets get real, a lil preparation for them in anticipation of having me would have been a nice heads up.
I am sure that my hospital loses money on orienting us new grads. But honestly, I can see why. Our precepting time is severely truncated IMO and we're not adequately prepared/trained. Its overwhelming and you have to really love what you do and be thick skinned and self motivated and extremely flexible to survive. All of which I'd like to think that I am.
But days like yesterday are going to burn us out before we really even get started.
I assume hospitals count the $80,000 both ways? They lose it if the trained person leaves, but they gain it when they hire a person already trained.
I would wager hospitals are hiring way more trained RNs than providing training to green ones.
So they are WAY ahead of the game, right?
I was wondering about that.
Seems that it would ideally be a two way street between hospitals who are "competitors": hospital A loses a newly trained RN to hospital C, but gains one from hospital B. If it becomes apparent to hospital B that movement of newly trained RNs is primarily one way, "away", will hospital B add to the imbalance in the system by decreasing its own new RN positions to stop its losses, relying on hosp. A and C to continue training the workforce, or will hosp. B investigate why hosp. A or C is the preferred employer and how hosp. B can make itself more attractive? Does hosp. B even have any incentive to continue training its own RNs, or is it to hosp. B's benefit to only hire experienced RN's? So many threads have been started by job hunting new GN/RNs about this very scenario that it appears there are many hosp. Bs out there.
Haven't people always left due to life changes and greener grass?
For any profession that has a rather exclusive skillset, a new hire without experience will be trained. This is how the entire outside world works. FYI there is an entire huge world out there that exists. Why healthcare whines like it is the only one that needs to train newbies, IDK. It tires me to no end, especially tonight (thanks canesdukegirl :heartbeat). If you run a crappy company that provides inadequate training, and also neglects to weed out those who will so take it down with their psychosis, that's tough, you know what, for that hospital. The good folks will leave and take their friends with them. That is the way of every darn other profession out there. I wish nursing would just put some bang behind well, anything.
If they want to train you for ER/OR/ ICU They should pay for training, not you with a two year contract!!! DR's get paid for residency why should nurses pay for their own( hospital specialty) training??
MDs in residency get paid a small fraction of what an MD in practice gets, and often less than experienced nurses. Most are required to work 80 hrs a week, not including extra time for prep, etc. They have to do 24 -30 HR shifts, rotate shifts with night call and rarely have a full weekend off.
They also cannot "jump ship" during residency, and take on this task for three years or more, with those that want specialty training, taking 6 or more years of this treatment and lower pay.
Obviously the two professions are not the same! However its the idea behind residency. Specialized skills deserve specialized training, if the facility wants skills beyond the med/surg level they should train not expect the nurse to shoulder all the responsibility! There are nurse residency programs out there now, they are not common and hard to win.
WAY OFF TOPIC.........Casey Anthony.......... INNOCENT!
Wow.....
yes, way off topic but OMGGG!!! what were they thinking?? no justice for that kid ? only guilty for lying to a police officer? what about not reporting that kid missing for 31 days while she was seen dancing and celebrating during those days ? that is not justice, but she will get her Judgement Day, and she better be prepared for real justice
:yeah::yeah:Best post around...way to go!!! Kudos, Kudos, Kudos:up::up:
So, NicuGal, were you never a new graduate nurse? lol
I believe, in the long run, if a new graduate is trained and is treated like a NURSE by the other nurses and not like a lower life form on the floor, that nurse would be more inclined to feel included in the TEAM on the floor and, therefore, the new nurse would be more inclined to stay on after orientation and beyond. It's the nurses who forget that they were once new graduates that create the problem of losing money on hiring new graduates. I think if lateral violence and bullying among nurses is addressed in a hospital and protocol was in place to prevent it, many new grads would stay on, making it worthwhile for hospitals to precept new grads.
:yeah::yeah:Best post around...way to go!!! Kudos, Kudos, Kudos:up:
:up:
Esme12, ASN, BSN, RN
20,908 Posts
Agreed, money begets money. Unfortunately community hospitals get left behind somewhat in the money department related to requirements to qualify and overall I believe the cost of training someone while worth every penny ends up being a net loss financially but a net gain ethically so maybe is a wash when added and subtracted all together......No biggie......it was just an initial thought of Ouch:lol2:that's all......If my first response seemed harsh is COMPLETELY unintentional and I apologize.....I type and get pulled away to the pool......I type and someone else is hungry...and someone needs somethnig else and with MS it takes me twice as long to do ANYTHING.....Oh well.......
sometimes I really dislike this medium of communication because you can't read the body language and intention of the poster. But for the most part I'm opinionated but nice.....
peace