New Grad trolling for advice...please

mariebailey, MSN, RN · Sep 14, 2012

Do these ads recruiting say "BSN required" or "BSN preferred". I almost did not apply for several jobs b/c "bilingual preferred" deterred me. I was hired for one of those "bilingual preferred" positions, and I'm far from bilingual (although I try). I thought home health agencies "preferred" those with experience in critical care, but I could be wrong.

llg, PhD, RN · Sep 14, 2012

I am going to say some things in this post that will probably offend some people, but I think that you, OP, need to hear the truth -- even though it is not what you are going to want to hear.

Fact #1: In 1965, the American Nurses Association made it's goals for the nursing profession clear -- that the BSN be the required entry-level degree for professional nurses. They supported the continued existence of the ADN programs, but only for the provision of nurses who would function with a lower level of responsibility. And thus the debates and conflicts about the appropriate educational preparation for nurses has continued. (Actually, it has continued since the 1800's as nurses started to become formally educated in the first place.) The current national goal adopted by many major key players is for 80% of all RN's to be at least Bachelor's-prepared by 2020.

Fact #2: Recent economic conditions have led to a glut of nurses in the job market. There are multiple applicants for every open postion -- allowing the most desirable employers to be very picky with who they hire. Many are using that luxury to upgrade the educational level of their staff by hiring only BSN-prepared nurses. While I am not familiar with the Dallas job market, I would expect you to run into that phenomenon there.

Fact #3: As an educational program, Excelsior is controversial to say the least. Their entry-level Associate's Degree does not even make you eligible for licensure in some states -- and the number of states who accept their degree is shrinking, not growing. The fact that you got 100% of your nursing education there puts you at further disadvantage in an already crowded job market.

Fact #4: The fact that you are currently studying to be an NP may not help you in the job market. It signals to potential employers that you are looking for temporary employment only -- and you will be leaving them as soon as you graduate, if not sooner when you need more flexibility with your schedule to do your clinical practicums. Orienting a new graduate nurse is a lengthy and expensive process -- particularly one who has zero or minimal clinical experience with acute bedside NURSING care because you went to a nursing program that didn't require that. Employers may not want to risk having to invest a lot in your clinical orientation... only to lose you when you have progessed in your schooling.

I'm sorry that you apparently made your educational choice without being fully aware of the job market in nursing or of the major trends in nursing education that are now effecting your career options. I wish you the best of luck in deciding how to proceed from here. If you are really committed to a career in nursing, then the best advice I can give you is to get further nursing education from a very reputable school whose credits are universally accepted and respected. That will give you the most nursing opportunities. For income while you attend school, you may have to accept a nursing job that is unappealing to you ... or use your chiropractic training for a little while longer.

chiromed0 · Sep 14, 2012

No offense there. That's damn good advice. :)

I agree on every point you make and reality sometimes interferes with my fantasies which can be annoying.:)

If it weren't for the fact that I routinely see RN-BSN programs that are all online. If Excelsior's program is so deficient then how are they the largest nursing program, with the most graduates practicing in the United States? It's hard for me to fathom why an online school that only accepts people with significant healthcare background are somehow suspect b/c their program offers credit by examination, but yet, you must still pass an on-site hospital based clinical exam graded by graduate level practicing nurses? My test proctor was the Dean of the nursing school that the local hospital used for their extension feeder program for Versant internships. So if I was good enough for the Dean of Nursing to pass me then why wouldn't I be good enough for the hospital that relies on her judgement to hire me? My wife's cousin, who came by way of EMT, is also an Excelsior grad and hired as an entry level nurse which leads me to believe like many in the job market it's who you know and some creative application strategies.

Such is life and I DO appreciate your candidness. It is not offensive to me but does make it apparent that my journey will continue to be a long and winding road. Nevertheless, I only need 1 yes and a thousand no's won't deter me at all.

allnurses Guide · Sep 14, 2012

Questions:

1. Do new ADN nurses get hired? I'm in the DFW Texas area and I see BSN on almost every job ad. Of course, I don't blame them for "wanting" that since there are a lot of schools around but do ADN's get hired...ever?

Yes, we do get hired. I am in DFW too, an ASN nurse and working in a local major hospital since January (graduated in December). However, I had inside connections. Most of my classmates who had connections (worked in the hospital prior to graduation usually) got hired too. Others are still struggling.

2. If I ever see an ad that looks promising most want the usual 1 year + experience. I've even seen 6 months experience which is odd to me. However, w/o getting that first beginner job what do novice nurses do? Volunteer? Find some preceptor somewhere? Does that count? I haven't practiced nursing but how can 10 years + experience with thousands of patient visits, exams, consults, education, therapy, etc. count for "nothing"? I mean...seriously...nothing?

You have experience but not at nursing. It honestly doesn't count. Fair or not, nursing is its own profession. I imagine if I became a chiropractor my nursing experience would not count either.

3. Internships? Like Versant. Who gets those..is that usually just associated with the hospital and if you get hired there then they place you into a program like that? Or is it a separate application and more competitive. I've read accounts of new ADN's as well as recent grads getting hired right into it. Of course, for me, that would be the perfect scenerio but the actual nuts & bolts of it seem fuzzy. Lots of marketing info on it but very little straight forward process information.

I got into an internship, but again, this was because of my inside connections. Everyone in the internship with me also had inside connections. There were more BSN educated in the internship than ASN.

4. Lastly, from what I read, most new nurses get on with long term care, hospice or home health. It would seem to me that would require more autonomy and more experience so that's a little confusing. Is this the case?

Most of my classmates who didnt get hospital positions are working in home health. None of them care for it. I don't know anyone who got on with LTC or hospice. I know one who works for an MD's office.

The DFW market is extremely tight for new grads, as you have discovered. There are still jobs out there but it is as much about who you know as anything else to get these opportunities. Many of them are not even publicly opened. Mine never was.

Your educational path may indeed also make you less desirable. Most of the MSN NP programs have a clinical aspect that make working next to impossible. The employers already know this and know they won't get more than a year or so out of you before you have to move on.

classicdame, MSN, EdD · Sep 14, 2012

Employers prefer BSN for many reasons, like Magnet status. Experience is preferred partly because it cuts down on the orientation time (paying nurse to learn, not do). The national rate for new grads who leave their first employer in

nurseprnRN, BSN, RN · Sep 14, 2012

Since when is a DC the same as an MD? In every work comp system I've seen (and I've seen a lot), for insurance purposes chiros are classified as physical therapists, not physicians.

More hard words: Do not think that being a chiro is going to give you a leg up in nursing. It's not. They are not on the same continuum and there are few transferrable skills. And if you find yourself using your chiro maneuvers as an RN you will find yourself in extremely hot water.

Excelsior? Hey, there's a reason it's what it is. Shoulda checked with the boards of registration in nursing or the colleges you planned to attend for your BSN or MN/NP before you relied on that one. :banghead:

llg, PhD, RN · Sep 14, 2012

Chiromed0: I'm happy that you were not offended by my post. I really was/am just trying to be helpful.

In answer to your question: There are a couple of reasons why there are so many Excelsior grads out there even though the school is not respected by so many people.

1. Historically, Excelsior evolved out of a program designed to help LPN's become RN's. Everyone within nursing knew that those LPN's had plenty of bedside nursing experience -- and therefore accepted them as RN's once they got the additional "book learning."

2. Many people were not aware that they had expanded their admissions to include people with no previous education or clinical experience in nursing until recently. Many people are still not aware of that fact.

3. Few people hiring nurses all over the country were (are?) aware that Excelsior students do not do any sort of clinical practicums as part of their education -- or even that it is a distance education program that offers no actual "classes" -- that it is all self-study. They simply see an applicant come in with a license and they hire them, assuming that they are graduates of the same types of programs that most nurses are familiar with -- with classes and teachers and clinicals, etc. The average hiring manager has no clue of the characteristics of some school in far-away New York they never heard of. When the people at my hospital learned the details about the program, they were shocked and a little angry that the State Board in my state had granted Excelsior grads RN licenses. (My State Board has since put some additional requirements in place that Excelsior grads must meet before they can be licensed.)

4. A few years ago -- there was such a dramatic shortage of nurses that hospitals were hiring anybody with a license and a pulse. There was little consideration of qualifications or credentials back then.

5. A lot of Excelsior grads already have their "foot in the door" for RN jobs as they already work for hospitals as LPN's, RT's, Paramedics, etc. They are already known to the employer as a good employee, oriented to the general hospital routines. That helps them get hired.

6. A lot has changed in the last 8 years:

A. Online education exploded -- and so did the for-profit schools. Suddenly, there were a lot of formally "vocational schools" offering ADN's or ASN's. And some of those schools were/are of very poor quality. People in nursing started to notice that not all nursing schools are alike -- and started seeing some things they didn't approve of.

B. Everyone and their uncle thought that nursing was a "recession-proof" career. They flooded the schools (good ones and bad ones) with students ... who kept growing, pumping out more new grads than the market needed.

C. As the economy tanked, hospitals needed to cut expenses and -- see my previous post.

So ... there are a lot of societal forces coming together to produce the current situation. Yes, a lot of good nurses are graduates of Excelsior. But the nursing profession is in the process of elevating its educational standards and Excelsior grads and other new ADN grads are graduating into a profession different world/different profession than what existed 10 years ago.

mariebailey, MSN, RN · Sep 14, 2012

4. A few years ago -- there was such a dramatic shortage of nurses that hospitals were hiring anybody with a license and a pulse. There was little consideration of qualifications or credentials back then.

Ha. That explains how a monolingual fool was hired for "bilingual preferred" position.

chiromed0 · Sep 15, 2012

Well Green Tea, nobody said being a DC is the same as being an MD so maybe you should read more carefully. As for workers comp, the classification was AD2 Level 2 physician provider same as MD for those years. If you don't like it, tough, take it up with the legislature.

As for education, if you knew anything about a D.C.'s education, it does mirror (as do all pre-professional degree tracks) MD/DO/DDS/DPM/OD schools. If you don't like chiropractors, that's fine, your entitled to your opinion. Not your own facts.

Never said I wanted a leg up. However, using some logic, I do believe that someone with nearly 300+ accredited college hours should have some consideration especially given the coursework which is mirrored in other healthcare professions. As for your comment about spinal manipulation on the job as a nurse, again, I don't believe I ever mentioned it in the first place but thanks for that insight into your intelligence.

And before you go too far in thinking your right, you are not. A great many D.C.'s have already transitioned over and graduated with MSN-NP in the last 3 years, you WILL run into one sooner or later as our profession has become redundant with PT's and Physiatrists. Just so you know the programs they have attended are State Universities and have awarded advanced standing credit (12 hours) to be exact in their programs for prior coursework in chiropractic making it a 30 hour program. I DO want to go that route but many of my colleagues did so, while maintaining their current D.C. practice, and are now dual licensed not having practiced a single day as an RN. I have decided I don't want to do that. I WANT to learn nursing and go through the NP process as a nurse, not a D.C. I certainly welcome advice from people but criticism about my profession or the school I went to? Well...you know where you can put that.

As for Excelsior College, do you have any idea what it even is? It's a school CREATED by Board of Regents of New York! They govern all the schools and programs in New York State. It's not some fly by night post office box in a strip mall. They also award BSN and MSN degrees. Just so you know the purpose of Excelsior is a great one in that medics and ex-military personnel with field experience in war zones were having a hard time transferring that training into traditional nursing programs, Regents College (Excelsior) was created to fill that need. It's grown from that and to dismiss online programs in general is plain foolish. Every major university in the entire country has adopted online programs and almost every nursing program has online RN-BSN or RN-MSN programs. Are you of the opinion they are all inferior? Why?

Honestly, it's this type of ignorance that causes the very issue I'm facing. Nevertheless, it's reality and while I hold this type of ignorance in disdain it is the reality I face.

chiromed0 · Sep 15, 2012

Chiromed0: I'm happy that you were not offended by my post. I really was/am just trying to be helpful.
In answer to your question: There are a couple of reasons why there are so many Excelsior grads out there even though the school is not respected by so many people.
1. Historically, Excelsior evolved out of a program designed to help LPN's become RN's. Everyone within nursing knew that those LPN's had plenty of bedside nursing experience -- and therefore accepted them as RN's once they got the additional "book learning."
2. Many people were not aware that they had expanded their admissions to include people with no previous education or clinical experience in nursing until recently. Many people are still not aware of that fact.
3. Few people hiring nurses all over the country were (are?) aware that Excelsior students do not do any sort of clinical practicums as part of their education -- or even that it is a distance education program that offers no actual "classes" -- that it is all self-study. They simply see an applicant come in with a license and they hire them, assuming that they are graduates of the same types of programs that most nurses are familiar with -- with classes and teachers and clinicals, etc. The average hiring manager has no clue of the characteristics of some school in far-away New York they never heard of. When the people at my hospital learned the details about the program, they were shocked and a little angry that the State Board in my state had granted Excelsior grads RN licenses. (My State Board has since put some additional requirements in place that Excelsior grads must meet before they can be licensed.)
4. A few years ago -- there was such a dramatic shortage of nurses that hospitals were hiring anybody with a license and a pulse. There was little consideration of qualifications or credentials back then.
5. A lot of Excelsior grads already have their "foot in the door" for RN jobs as they already work for hospitals as LPN's, RT's, Paramedics, etc. They are already known to the employer as a good employee, oriented to the general hospital routines. That helps them get hired.
6. A lot has changed in the last 8 years:
A. Online education exploded -- and so did the for-profit schools. Suddenly, there were a lot of formally "vocational schools" offering ADN's or ASN's. And some of those schools were/are of very poor quality. People in nursing started to notice that not all nursing schools are alike -- and started seeing some things they didn't approve of.
B. Everyone and their uncle thought that nursing was a "recession-proof" career. They flooded the schools (good ones and bad ones) with students ... who kept growing, pumping out more new grads than the market needed.
C. As the economy tanked, hospitals needed to cut expenses and -- see my previous post.
So ... there are a lot of societal forces coming together to produce the current situation. Yes, a lot of good nurses are graduates of Excelsior. But the nursing profession is in the process of elevating its educational standards and Excelsior grads and other new ADN grads are graduating into a profession different world/different profession than what existed 10 years ago.

This input I appreciate and I'm still not offended. I know there's some crack pots that came out of Excelsior. Just like I personally know some that came from the University of Texas b/c they are my patients! However, I fully understand your point and the concern. Same thing has happened to my wife with her brick & mortar MBA vs. everybody and their brother has an MBA, too, from work experience credits, etc. I DO understand the dilemma and I DO agree that most that have gotten past this hurdle did so through a side door as I am sure I'm about to do myself. Again, thank you for this advice and commentary. Well said and appreciated.

mariebailey, MSN, RN · Sep 15, 2012

Never said I wanted a leg up. However, using some logic, I do believe that someone with nearly 300+ accredited college hours should have some consideration especially given the coursework which is mirrored in other healthcare professions. As for your comment about spinal manipulation on the job as a nurse, again, I don't believe I ever mentioned it in the first place but thanks for that insight into your intelligence.
Honestly, it's this type of ignorance that causes the very issue I'm facing. Nevertheless, it's reality and while I hold this type of ignorance in disdain it is the reality I face.

I'm an RN-MS who went into nursing as a 2nd career choice. I did attend a traditional university, but I have a non-nursing degree as well (although it's only a BA). I believe having a varied educational background can markedly enhance your ability to perform as a nurse. I also believe that people who lack an interdisciplinary education are often less likely to value it or understand how it directly or indirectly contributes to your ability to perform as a nursing professional.