Introduction - along with a few questions

[HusbandOfANurse2B]

Hello,

As you can guess from my username my wife is going to school for her RN license. She started applying 2.5 yrs ago and was passed over because of the lottery system here in the Sacramento, CA area. Her grades are near perfect and she ended up doing really well on the entrance exam - the name of it escapes me right now. She stopped applying after the fourth rejection notice, but something told her to apply one last time and finally got in on the fifth try. We're both extremely happy. She finally has a chance to pursue a career she's interested in and not just dropped into. Anyway, she starts the American River College program in Spring 2010 - just a few weeks away actually and will graduate in December 2011.

I've noticed a few online articles about the nurse shortage. You would think it would be great for those entering the nursing program, but from the posts on this site, as well as hearing from others, it appears nursing may not be the best career choice. They (posts) seem to indicate new nurses are unlikely to get hired. Is this just due to the country's current economic state? Or, is it perhaps that those graduates didn't do as well in terms of grades, interview, etc... as their classmates? I just assumed hospitals would be knocking on the instructor's door asking for the top students to apply. I haven't told my wife of what I've learned as it would only serve to upset her. See, I've spent several weeks now trying to convince her that quiting her well paying job was the right decision. If she knew of what I've read, she would back out of the program. I'm not going to let her stay in a job that she dislikes just because it's safe.

She ultimately wants to go all the way in school and become a nurse practioner. I told her not to limit herself as she will get a chance to rotate and will have a better understanding of what she wants to continue with, but for her, sky is truly the limit. She is very intelligent and does very well in her studies. So, I'm sure she won't have any issues with the classroom work. Time will only tell if she'll do well in the actual clinical portion, but that's something you can't know until you do it.

My questions to you are:

• Do you think employment opportunities for new grads will improve over the next two years? Is the non-hiring of new grads just temporary?
  
• If given the opportunity, would you recommend going straight-through? i.e. RN->BSN->Masters
  
• If you had to do it all over again, would you go through the Physician Assistant program or Nursing program?
  
• I've seen opportunities for student CRNAs, but not sure how much clinical experience the student must have. Would it be an option to go straight-through to become a CRNA?
  

Regardless of the outcome, we count our blessings I'm able to provide for us while she pursues her dreams.

Sorry for the book, but I just wanted to introduce myself and ask a few questions. I'm sure I'll have many more for the community over the next couple of years.

Thanks for reading!

[Virgo_RN, BSN, RN]

Do you think employment opportunities for new grads will improve over the next two years? Is the non-hiring of new grads just temporary?

I don't know about the next two years, but it is my opinion that the current situation is temporary and will improve at some point. When that will occur, I have no way of knowing.

If given the opportunity, would you recommend going straight-through? i.e. RN->BSN->Masters

Not to nitpick, but "RN" is not a degree. A person can be an RN with an ADN or a BSN. To answer your question, no, I would not recommend going straight through for two major reasons. One, it is my opinion that an advanced practice nurse, such as an NP, needs to have significant bedside experience. Two, working as a bedside RN will be the acid test as far as whether this is something your wife wants to pursue further. NPs don't make a whole lot more than bedside RNs, their liability is significant, and the education needed to get there is expensive.

If you had to do it all over again, would you go through the Physician Assistant program or Nursing program?

Nursing. Job opportunites are limited for PAs in the area I live. I make a good living as a bedside RN, without having to relocate.

I've seen opportunities for student CRNAs, but not sure how much clinical experience the student must have. Would it be an option to go straight-through to become a CRNA?

My understanding is that acceptance to most CRNA programs are so competitive that one is not likely to be accepted without at least two years' experience in critical care.

[misplaced1]

I disagree with the poster about about the not going straight to the NPdegree. By 2015 they are trying to phase it in so that all NPs will have to have a doctorate. Some people think this is not going ot happen but I am quite sure IT WILL. I was working at a university with a pharmacy school and this same exact thing happened, people saying oh they wont implement it etc etc and wha-la, no more bachelors in pharmacy now you need a doctorate. It is a way to "upgrade" a profession, although nurses as a whole tend to fight against things that will give their profession more validity to the outside world, like upgrading educational requirements. I dont know if this is due to the high rates of codependency in the profession or just simply not understanding how the business world works. Moreover one must accept that medicine is a BUSINESS and nursing is a JOB and that means when you make decisions you are planning your CAREER. Many nurses see nursing as a calling and you will likely find that this notion is touted in nursing schools. Therefore, from what I have seen, nurses tend not to act in their own best interest. The martyr mentally is very prevalent.

These things are so deeply seated in nursing that I am thinking of throwing in the towel myself, but I dont want to discourage you. Its not the job itself but often nurses get treated poorly by employers who see them as an expensive liablility and nurses themselves will pull each other down at every turn. Nursing enforces the attitude of everyone comes before the nurse, the patient, the company, the other nurses etc etc. I suspect it is the largest collection of codependent people on Earth. And if they are taking crap then you should take it too and shut your mouth about it. And if anyone else around you is not doing their job IT YOUR RESPONSIBILITY and why shouldn't it be, I mean the poor patient is laying in the bed sick and if you dont cover for everyone what will happen and no one else cares or advocates for the patient etc etc on and on ad nauseum.

I have not seen this crazy attitude so much in NPs and thus I am currently in NP school. But I am so wary of the whole thing that I am having second thoughts and wondering what the heck I am doing and what have I gotten myself into and kicking myself for not taking the nice comfortable job in my previous field that I got offered while in nursing school.

Tell your wife to be very careful who she takes advise from, nurses tend to be like crabs in a basket! She should find someone who is doing what she wants to do and ask them how they got there and their recommendations. IF she wants to go direct to NP she should find a person that did that and ask them about it, see how they are functioning. Many studies have shown that the roles of RN and NP in a primary care setting are so differnt that in this setting NPs do fine without 20 years of RN experience. I believe that if one wanted to be an acute care NP that would be a completely different animal and yes I think that in that case one would want as much hosptial experience as possible. BUt, on the flip side, in my area the local hospital hires acute care NPs straight out of grad school and will train acute care nps with no experience. At least in my area this is a very sought after specialty. The primary care NPs have a harder time finding jobs but at least in my area, they are not unemployeed

[misplaced1]

I wanted to come back because I believe my post may have been too negative. I just wanted to tell you some things no nursing instructor is going to. You should know that hospitals dont bill for nursing tasks and therefore nurses are considered an expense. Nurse practioner services on the other hand are billable, albeit at a lesser rate then physicians. If you are a business person should understand what this means and how it might affect the treatment of nurses vs NPs. I think it is still an employers market for most NPs and nurses, there are just slews of them and certainly no shortage of most types of new nurses, loaded down with student loans and needing a job. That is the case in most areas at least and I am especially surprised that you would think people would be beating your wifes door down with her RN in California. I have heard that new grads are having an especially hard time getting jobs there. California nurses have ratios and that is supposed to be like the best place to work in the country so there is mostly a dire shortage of nursing positions there.

I wish you the best.

[roser13, ASN, RN]

Just out of curiosity, why are you posting here rather than your wife?

For some reason, this statement bothers me:

"If she knew of what I've read, she would back out of the program. I'm not going to let her stay in a job that she dislikes just because it's safe. "

I guess I'm thinking that if I were your wife, I would like to be included in all available information and to be emplowered to make my own decisions. Not "letting" me stay in a job for whatever reason wouldn't be a part of my husband's prerogatives.

[roser13, ASN, RN]

Oops! emplowered = empowered

[loriangel14, RN]

Just out of curiosity, why are you posting here rather than your wife?

For some reason, this statement bothers me:

"If she knew of what I've read, she would back out of the program. I'm not going to let her stay in a job that she dislikes just because it's safe. "

I guess I'm thinking that if I were your wife, I would like to be included in all available information and to be emplowered to make my own decisions. Not "letting" me stay in a job for whatever reason wouldn't be a part of my husband's prerogatives.

I was also wondering why he is posting instead of his wife. Is she not allowed to speak for herself ? I would be wary of any man saying he was going to "let" me do something. I woud think her carteer decisions would be her own, not her husband's to make.

[MauriceRC]

Hey Husbandofanurse2b, I thought your post came across as really supportive of your wife and I don't really understand why others are bothered by it. If my husband independently researched things I was interested in pursuing I would feel like we had a strong partnership and I think that your use of the word "let" was more figurative than literal. Clearly you have a great relationship together! Don't "let" :wink2: the economy scare your wife away from her dreams because no one knows what job searching will be like in a couple years.

[HusbandOfANurse2B]

@Virgo RN - Thank you for your comments. I'm glad to hear someone feels this is a temporary hiring freeze. If you don't mind, what area are you referring to?

I agree with your second point - I think it will be beneficial for her to experience it in order to decide if she wants to go further, but I don't necessarily agree that a person needs experience to do their job. Most companies have job shadowing. I think it would be rare for hospitals to turn a new grad loose the first day. If they do, it's poor professional development by management.

BTW - I don't recall writing RN is a degree, but no worries on the nitpick. I think it just depends on who you ask. The counselor refers to it as a "2yr nursing degree" - whether the counselor is correct/incorrect, I don't know. All I know, when all is said and done, she'll have her RN's license and if she decides to continue on to become a Nurse Practitioner, then she'll need to pursue a Bachelors degree before she can be accepted into the local program.

[MedSurgeMess]

Check your local hospitals online employment opps to gauge what the need is in your area.....some areas are in terrible shape, others in decent shape. Good luck to her.

[leslie :-D]

but I don't necessarily agree that a person needs experience to do their job. Most companies have job shadowing. I think it would be rare for hospitals to turn a new grad loose the first day. If they do, it's poor professional development by management.

please remember this:

working as a nurse in a hospital, is unlike any other job you will ever have.

mgmt doesn't give a darn about their nurses, and will turn them loose when they want/need to...

doesn't matter if they're a new grad or not.

since you're doing all this research for your wife, perhaps you should read about the many obstacles we nurses face...

locally and nationally.

and from my personal experience, i've never met an apn or crna who didn't have bedside experience.

one truly needs to have 'that' experience if they are ever to be an effective np.

finally, if you think your wife dislikes her job now, wait til she becomes a nurse.

(half kidding)

it is truly one of the most stressful jobs (with the least support) a person can ever hold.

leslie

[Virgo_RN, BSN, RN]

@Virgo RN - Thank you for your comments. I'm glad to hear someone feels this is a temporary hiring freeze. If you don't mind, what area are you referring to?

It was a general statement, not referring to any particular area.

I agree with your second point - I think it will be beneficial for her to experience it in order to decide if she wants to go further, but I don't necessarily agree that a person needs experience to do their job. Most companies have job shadowing. I think it would be rare for hospitals to turn a new grad loose the first day. If they do, it's poor professional development by management.

I stand by my opinion that an advanced practice nurse with diagnostic and prescriptive authority should have bedside nursing experience under their belt. As far as "new grad" orientation (I'm assuming we're talking RN here), you will find that the quality and quantity of orientation varies widely from institution to institution. As an LPN (one year certificate) on a busy, high acuity cardiac unit, I received ten days, with several preceptors. Ten days of orientation before I had the lives of very sick, fragile people in my hands. While I was able to thrive in this "sink or swim" type of approach, it is not an ideal learning situation for most new RN grads, let alone a brand new LPN. I think you will find this is how most "companies" do business.

BTW - I don't recall writing RN is a degree, but no worries on the nitpick. I think it just depends on who you ask. The counselor refers to it as a "2yr nursing degree" - whether the counselor is correct/incorrect, I don't know. All I know, when all is said and done, she'll have her RN's license and if she decides to continue on to become a Nurse Practitioner, then she'll need to pursue a Bachelors degree before she can be accepted into the local program.

You wrote RN>BSN>Masters, so I interpreted that you considered the RN a degree. Plus, it is a common misconception that there is a distinction between an RN and a BSN, so it wouldn't be out of the realm of reasonable reality that you might have that misconception. A two year nursing degree is going to be an ADN or an ASN, depending on where it is obtained. Both the two year ADN/ASN and the four year BSN graduates sit for the same licensure exam, the NCLEX-RN.