New Grad Orientation Contracts

JKL33 · Jul 3, 2018

I will never in a million years believe that hospitals have decided to recruit new grads out of the goodness of their hearts. They have chosen this model of "talent acquisition" because they have assessed it to be more advantageous than trying to hire/retain experienced nurses or newer nurses that they themselves have trained. But they failed to foresee that new grads/newer nurses would find their corporate MOs just as unpalatable as experienced nurses and then not stay around. Oops.

Cry me a river.

Are the details of these contracts enumerated so that the new grad can evaluate whether the contract is being honored? I doubt it. Whether the contract is honored or not is only for the corporation to decide. The orientee is guaranteed nothing other than a job with the opportunity to be oriented in whatever manner the corporation sees fit. They take no accountability for toxic cultures, shortened orientations due to poor staffing, or patient loads that leave no time for teaching and learning - all things that may occur in increased likelihood in settings were contracts are the only retention tool anyone is willing to consider.

I'm thankful to have been a novice when this was not a common way of doing business with nurses. From my vantage point there is entitlement involved alright, but not on the part of tens of thousands of individual new nurses. Kind of like the adage about how if you think everyone else is a ________, maybe you're actually the _______?

allnurses Guide · Jul 3, 2018

I will never in a million years believe that hospitals have decided to recruit new grads out of the goodness of their hearts. They have chosen this model of "talent acquisition" because they have assessed it to be more advantageous than trying to hire/retain experienced nurses or newer nurses that they themselves have trained. But they failed to foresee that new grads/newer nurses would find their corporate MOs just as unpalatable as experienced nurses and then not stay around. Oops.
Cry me a river.
Are the details of these contracts enumerated so that the new grad can evaluate whether the contract is being honored? I doubt it. Whether the contract is honored or not is only for the corporation to decide. The orientee is guaranteed nothing other than a job with the opportunity to be oriented in whatever manner the corporation sees fit. They take no accountability for toxic cultures, shortened orientations due to poor staffing, or patient loads that leave no time for teaching and learning - all things that may occur in increased likelihood in settings were contracts are the only retention tool anyone is willing to consider.
I'm thankful to have been a novice when this was not a common way of doing business with nurses. From my vantage point there is entitlement involved alright, but not on the part of tens of thousands of individual new nurses. Kind of like the adage about how if you think everyone else is a ________, maybe you're actually the _______?

This would hold weight except for the fact that even with these contracts, new grad positions remain difficult to obtain in many areas of the country. It isn't like they are swinging the doors wide open for every opening and inviting a new grad into the slot. Most only take a few.

JKL33 · Jul 3, 2018

My point is that they are doing what they feel is beneficial for them, according to their preferences and calculations. If they didn't want this particular business risk, they could just as well retain or hire nurses who don't require lengthy orientations. Especially if, as you say, they only need a couple here and there (which is not true; they have a major churn going and they know it and it serves their objectives very well). If inexperienced individuals are hard to come by, they can ask themselves why and haughtily come to wrong conclusions (all those experienced nurses have bad attitudes, they're "burned out," they don't want to work hard, they don't like change, they can't keep up with technology, they don't know anything about "evidence based practice"....blah, blah, blah). But if they've been disingenuous and misrepresented that situation then they will fail to realize that they can't just tap into another demographic and expect things to be different. Which is precisely what they did. Which is precisely why all of the labeling and vilifying is required. Now it's not just that experienced nurses are undesirable, inexperienced nurses are "entitled" and have no loyalty and no work ethic and are job hoppers whose morals threaten large corporations.

As I said.

If your only corporate MO is that everyone else is a problem, maybe, just maybe the problem has something to do with you.

ETA: I will concede this: if it is a situation where new hires are needed very infrequently (i.e. nurses are also being successfully retained) and there is a significantly organized and exceptional orientation process in place that is focused on helping a new nurse to become excellent rather than just meeting short-term organizational goals, this would be a little more understandable.

Ruby Vee, BSN · Jul 3, 2018

I've seen older posts on this site about New Grad Orientation Contracts that require new nurses to stay on their unit for a set amount of time (up to 2 years) or else be forced to pay back orientation costs to the facility. Most of those posts told new grads to run as fast as they could away from the facility.
However, a lot of the places I've applied to all have those contracts. Is this becoming more common?
What happened to sign on bonuses in order to retain nurses?
To clarify, they require you to sign a "new grad residency" contract, which is 8-12 weeks of orientation. If you pass their orientation period you are required to work on that unit for 2 years (and in some cases required to stay at the facility for an additional year). Failure to do so, as stated in the contract, requires the nurse to pay back orientation costs of 10,000 dollars, which is pro-rated down slightly the longer you stay.
I understand that nurse retention is important, but this seems threatening and morale crushing. I completely understand having to sign a contract to pay back a sign-on bonus if you leave early, but having to "pay" for my orientation seems a little ridiculous. It makes me wonder what's wrong with the facility that would make nurses want to leave so badly that HR thought this contract was the only way to keep nurses working there.
Should I follow the older posts advice of running from these facilities or do I bite the bullet and just accept that this is what I have to do in order to get experience?

Hiring bonuses aren't needed unless there is an actual shortage or because there is something about the employer that makes sane and reasonable nurses run the other way. I was offered a $15,000 sign-on bonus from a 22 bed ICU that had only four permanent employees. The rest -- including the manager -- were travelers. The nursing staff had reported the physicians to the Board of Medicine and the physicians had reported the nurses to the Board of Nursing. Most of the physicians were from middle Eastern countries where women are viewed as chattel, and the attitude was blatant. The four permanent employees were the Charge nurses and hadn't actually taken care of patients in years. One of them came in every day with slurred speech and alcohol on her breath and another left that way. I completed my travel contract, praying every day that I could get through my shift without harming anyone or witnessing anything I couldn't, in good conscience, ignore. And then I took a job in another institution that did NOT offer a hiring bonus.

A new grad residency contract is something else. They came about because so many new grads were/are taking a job without any intention of staying in that job a moment longer than they have to. It's not their "dream job" and often they don't even stop looking for another job when they start. New grads used to stay 1-2 years in their jobs because that's what professionals and adults do -- unless the place is completely toxic (see above). Now we see frequent posts from new grads who want to quit their first jobs after a few months because they're bored (always a frightening sign in a new grad), because their coworkers are "mean" to them, are "bullying" them or are "evil people". (Usually what that boils down to is a new grad who doesn't understand and cannot negotiate workplace relationships.) Some want to quit because their afraid they'll "loose my license." (Read your state Board of Nursing newsletter sometime. You'll find that the people who lose their licenses lose them for reasons like diverting drugs, getting high at work and having sex with patients who are unable to consent or to resist.) Losing new grads after a few months of orientation is costly for the facility and demoralizing to the preceptors who pour their energy into an orientee only to see them skip happily off to "greener grass" while the preceptor starts over with yet another new grad.

New grad contracts have become necessary because new grads tend not to honor their commitments.

Ruby Vee, BSN · Jul 3, 2018

Personally, I can see both sides of this issues. It does cost a hospital a lot to orient a new nurse, and then for the hospital to be left with nothing when that new grad hits the road after less than a year? I can certainly defend it for smaller hospitals, where a few new grads leaving after orientation really can hurt the bottom line. OTOH, I work for a large health system. To my knowledge, we do not force new nurses to sign these contracts, and I would have a tough time defending the system if we did.
Even for the small hospitals, the contracts leave a bad taste in my mouth. It seems quite unfair to me that there is no out for nurses whose spouses/significant others might get moved as part of their jobs. Especially if this hospital is the only game in town. I can see why the hospital wants to protect itself from a nurse who just flakes on the job after 6 months, but I would be more comfortable with the idea if they had reasons, with documentation of course, to get out of the contract.
To the OP, only you know what is best with you. If you feel comfortable with the job are fairly certain that there will not be a compelling reason for you to move in the next 2 years, then you should probably go for it, especially if no other viable options exist. As I said, though, you are the only one who knows how comfortable you are with the terms of the contract.

Actually, even hospitals whose contracts don't have an official out for nurses whose partners are required to move for their jobs will forgive that reason for leaving. Often.

JKL33 · Jul 3, 2018

So in the last decade or two, lots of experienced nurses have run for the hills and new grads have generally become fickle, causing hospital corporations a big problem.

Maybe these people shouldn't be in the healthcare biz with luck like that.

NuGuyNurse2b · Jul 4, 2018

Maybe these people shouldn't be in the healthcare biz with luck like that.

Unfortunately there are a lot of people who shouldn't be in the healthcare profession, but yet they are. We just had a new hire who mysteriously stopped being put on the schedule. It also just happened to coincide with the uptick in narcotic counts being off. Management is staying mum but we can all put 2 and 2 together.

AxelNewRN86 · Jul 4, 2018

I am a new grad and took a job that is med surg that is an awesome learning experience, but it is not my dream job and the pay is not enough to cut it in the long haul. I plan on paying my dues and wanting to stay on call down the road. But I figured as a new grad I should aim to stay for 1 to 2 years (as a full time position) and then move into my dream of job of labor and delivery. In your opinion is that too short of time? I do want to leave the best impression as a new grad. I want to learn and grow as a new nurse. But I have also just done 7 years of lower healthcare field jobs to even get to this point. And like I said this first job just barely pays the bills. I would like to actually go on a vacation eventually. Thanks.

Night__Owl, BSN, RN · Jul 4, 2018

I'm in a contract (sort of) right now.

My hospital is decent, but definitely has some Wrongway affiliations. I signed a contract for a residency in ICU/ED for 3 years, with a prorated buyout for leaving early somewhere around $3000. I honestly don't know the exact figure, because at least five people who did the ED residency have left and paying out their contract was never discussed.

My residency was about a month of "classwork" (which was, tbh, useless) and an extended orientation, which I needed every minute of. My hospital is one of two facilities in a small city, and there is a shortage of ICU nurses in the area. It's a nice area, but doesn't really have any marketing points to draw people to relocate there either. So they had pretty much no other option than to try and figure out how to build their own. My group of residents was only the second or third they'd ever done, so they were still working out some details.

I agree, sign-on bonuses are for either jobs that few people want (like med surg at a rural access hospital), or jobs that few people have experience for (like surgical nursing). Residencies are for getting new grads into positions that have shortages (surgical and critical care, usually) in specialties that usually require experience. The two aren't really comparable.

JadedCPN, BSN, RN · Jul 4, 2018

Hiring bonuses aren't needed unless there is an actual shortage or because there is something about the employer that makes sane and reasonable nurses run the other way. I was offered a $15,000 sign-on bonus from a 22 bed ICU that had only four permanent employees. The rest -- including the manager -- were travelers. The nursing staff had reported the physicians to the Board of Medicine and the physicians had reported the nurses to the Board of Nursing. Most of the physicians were from middle Eastern countries where women are viewed as chattel, and the attitude was blatant. The four permanent employees were the Charge nurses and hadn't actually taken care of patients in years. One of them came in every day with slurred speech and alcohol on her breath and another left that way. I completed my travel contract, praying every day that I could get through my shift without harming anyone or witnessing anything I couldn't, in good conscience, ignore. And then I took a job in another institution that did NOT offer a hiring bonus.
A new grad residency contract is something else. They came about because so many new grads were/are taking a job without any intention of staying in that job a moment longer than they have to. It's not their "dream job" and often they don't even stop looking for another job when they start. New grads used to stay 1-2 years in their jobs because that's what professionals and adults do -- unless the place is completely toxic (see above). Now we see frequent posts from new grads who want to quit their first jobs after a few months because they're bored (always a frightening sign in a new grad), because their coworkers are "mean" to them, are "bullying" them or are "evil people". (Usually what that boils down to is a new grad who doesn't understand and cannot negotiate workplace relationships.) Some want to quit because their afraid they'll "loose my license." (Read your state Board of Nursing newsletter sometime. You'll find that the people who lose their licenses lose them for reasons like diverting drugs, getting high at work and having sex with patients who are unable to consent or to resist.) Losing new grads after a few months of orientation is costly for the facility and demoralizing to the preceptors who pour their energy into an orientee only to see them skip happily off to "greener grass" while the preceptor starts over with yet another new grad.
New grad contracts have become necessary because new grads tend not to honor their commitments.

This!! Perfectly said.

AnnieOaklyRN, BSN, RN, EMT-P · Jul 4, 2018

Bottom line... Hospitals are sick of getting burned by new grads that take any job they can get, and then after the hospital has paid thousands of dollars to train them they just leave for what they perceive is their "dream job" now that they have six months to a year of experience!

Hospitals can't afford to keep getting burned, and new grads leaving after 6 months to a year is a known fact. This is just something you will have to deal with, look at the bright side you will only have to deal with it once!

I worked in an ER and this happened with almost every new grad! (of course the ER was VERY poorly run, but still...)

Annie

caffeinatednurse, BSN, RN · Jul 4, 2018

Sounds like a rather bleak interpretation of my contract. I signed a 2 year contract in exchange for a $10,000 sign on bonus. If I leave before the 2 years are up, I am responsible for paying back the bonus. (Seems fair, IMO.)

I'm one year into my contract, and my experience has been good so far. To clarify, I do work at a *good* hospital with an excellent reputation. The contract benefits me by giving me 2 years of acute care experience to put on a resume. (A big deal for me considering I previously transitioned from LTC.) And my facility doesn't have to worry about me walking out the door.

As long as you are ready and willing to make the commitment, I would seriously consider it. If you are concerned about the 2 year commitment, ask about modifying your contract to just 1 year. I had several coworkers who did this (but were paid less in sign on bonus).