andywolfe

"Cost of Hiring New Nurses on ADVANCE for Nurses (This article includes the chart referenced earlier in the thread, breaking down the specific costs involved in getting a new graduate RN from the hiring process to "competency" and showing those costs add up to nearly $100k at one NY hospital)" From the same article you failed to mention that "The approximate starting salary for a graduate nurse in the New York City and Long Island is between $65,000 and $75,000 annually." In the middle part of the country, you won't find these kinds of salaries for graduate nurses!!!! Just 2 weeks ago, my friend had offers from a hospital in both Arkansas and Alabama that started her at $19.00/hour + shift differential. At $19.00/hour, it is mathematically impossible for someone to earn between $65,000 and $75,000 for working full time only!!!!!!! 　 "The hospital did a study 3 or 4 years ago and came up with $35K-$38K to orient a new grad nurse. That figure has probably changed or gone up since then. She has seen figures of $50K-$90K for all bed size hospitals in orienting these nurses." (Please note this data is from 2008) In the beginning of article it clearly states that "A plethora of orientation programs has been developed to meet the needs of novice nurses. These multifaceted residency, internship, or preceptorship programs last from 4 to 12 months and are designed to provide new graduates with supervised hands-on clinical experience." Again it's like I keep beating a dead horse. 4 MONTHS=Approx 16 weeks and 12 months=52 weeks. Training now a days for med-surge doesn't last 4-12 months. Mine lasted only 6 WEEKS. All the research you quoted is misleading due to the fact that you are comparing training that last from 16-52 weeks, to my training that has lasted only 6 WEEKS

In this country, for every 1 hospital like parkland, there are at least 10 other hospitals that are training med surge nurses in a time period of 6-8 weeks. THIS IS A FACT!!!!

[TABLE=width: 500] [TR] [TD=class: formOffsetColor, bgcolor: #C0C0C0]Department:[/TD] [TD=class: form, bgcolor: #F5F5F5]4 West Medical Surgical Renal[/TD] [/TR] [TR] [TD=class: formOffsetColor, bgcolor: #C0C0C0]Schedule:[/TD] [TD=class: form, bgcolor: #F5F5F5]Full time[/TD] [/TR] [TR] [TD=class: formOffsetColor, bgcolor: #C0C0C0]Shift:[/TD] [TD=class: form, bgcolor: #F5F5F5]Nights[/TD] [/TR] [TR] [TD=class: formOffsetColor, bgcolor: #C0C0C0]Hours:[/TD] [TD=class: form, bgcolor: #F5F5F5]7p-7a[/TD] [/TR] [TR] [TD=class: formOffsetColor, bgcolor: #C0C0C0]Job Details:[/TD] [TD=class: form, bgcolor: #F5F5F5] 4 West is a 39 bed Medical Surgical unit practicing individualized care of the adult patient. 4 West nurses are experienced in the care of a wide variety of chronic and acute medical conditions and receive special training for the care of renal patients. Nurses collaborate with interdisciplinary teams and a variety of specialists including: palliative care, cardiology, neurology, urology, oncology, and orthopedics. 4 West is team- oriented and has been successful in providing our patients with superior quality and outstanding customer service. Our unit is an ideal place for nurses looking to optimize their clinical expertise, time management, and critical thinking skills.ORIENTATION •UMC General Hospital Orientation •UMC General Nursing Orientation •Electronic Documentation training. Individualized Unit Specific Orientation •Unit specific orientation is in addition to UMC’s General Hospital Orientation and General Nursing Orientation •Orientation consists of observation, classroom, and clinical hours over a 6-8 week period. •Medical Surgical classroom orientation takes place over 2 days. •During clinical orientation you will be paired with an experienced nurse preceptor. The preceptor is chosen to best fit your personality and learning style. •Unique training includes Peritoneal Dialysis and care of the Renal Transplant patient. •Clinical orientation may be conducted on days or nights, depending on the shift the nurse is hired for. •Professional growth and development opportunities are available and encouraged including: committee participation, educational, and leadership advancement. Committees are available at unit level as well as hospital wide. •Other opportunities include: mentoring and a mix of core and flexible scheduling to optimize staffing and balance for our employees. Qualifications •Graduation from an accredited School of Nursing •Valid Texas Graduate Nurse Permit required. •Current CPR certification from American Heart Association. •Customer service abilities including effective listening skills. •Critical thinking skills, decisive judgment and the ability to work in a fast paced environment. •Ability to perform work that requires walking, sitting and standing most of the time while on duty. Occasional lifting or patients with assistance is required. Benefits •Full-time benefit package inclusive of health and dental coverage •Competitive compensation based on education and experience •Relocation assistance package if relocating > 75 miles / To reside in Lubbock, Texas •Educational Reimbursement for BSN / MSN •Eligible for overtime pay after 40 hours per week •Eligible for yearly annual increase •Eligible for Career Ladder after 12 months •Uniform Payroll deduction •Certification Exam reimbursement •Long Term Disability/Group Life Insurance/Group Dependent Life Insurance •Vision Insurance •Tax Sheltered Annuity Program •Supplemental Insurance Programs •Healthcare and Dependent care spending accounts •PTO and Extended Illness UMC Health System is the leader in comprehensive healthcare delivery in West Texas and Eastern New Mexico. More than 300,000 patients a year have come to expect [/TD] [/TR] [/TABLE]

I would encourage you to look at the training for community hospitals. My original post did exclude hospitals that have Versant training programs and other programs that are similar to it. Here is an example of one of them "Looking for a company that will train you upon graduation from college? If so, IASIS Healthcare could be the one for you! We hire new graduates into many different areas of our hospitals; if you are a recent graduate from a nursing, physical/occupational therapy, laboratory sciences, respiratory tech, surgical tech, anesthesia tech or pharmacy program, give us a call today. IASIS places great emphasis on training and transitioning new graduates from the academic to the clinical/hospital setting. For example, our orientation program for newly graduated registered nurses is structured to last between four to 12 weeks. The length of the training varies from facility to facility and may take place in the classroom and/or clinical setting. Each hospital structures training based on unit needs, structure and the individual progression of the employees in the program. Rest assured if you were hired into one of our programs as a new graduate, you would receive the training you need to start your career. In addition to training, IASIS Healthcare offers competitive salaries and benefits, opportunities for career advancement, education programs and a variety of locations spread throughout the country. We have a total of 19 hospitals (18 acute care facilities and one behavioral health facility) located in Arizona, Colorado, Florida, Louisiana, Nevada, Texas and Utah. To learn more about our new graduate opportunities, contact the Human Resource department at the hospital you are interested in, or go to that hospital website and apply for a position today. Congratulations on graduating and welcome to the exciting and rewarding field of healthcare!"

I am sorry but i am only writing the facts. If you like I can copy and paste the links to job description and names and numbers of the hospitals that are providing 6-8 weeks of med surge training and a max of 3 months of internship for ICU position (even though again I had excluded ICU position from my original comment)

2011 California Tax Rate Schedules Schedule X — Single or married/RDP filing separately [TABLE=width: 417] [TR] [TD=colspan: 6]If the taxable income is [/TD] [/TR] [TR] [TD]Over [/TD] [TD]But not over [/TD] [TD=colspan: 3]Tax is [/TD] [TD]Of amount over [/TD] [/TR] [TR] [TD]$0 [/TD] [TD]$7,316 [/TD] [TD]$0.00 [/TD] [TD]Plus [/TD] [TD]1.00% [/TD] [TD]$0 [/TD] [/TR] [TR] [TD]$7,316 [/TD] [TD]$17,346 [/TD] [TD]$73.16 [/TD] [TD]Plus [/TD] [TD]2.00% [/TD] [TD]$7,316 [/TD] [/TR] [TR] [TD]$17,346 [/TD] [TD]$27,377 [/TD] [TD]$273.76 [/TD] [TD]Plus [/TD] [TD]4.00% [/TD] [TD]$17,346 [/TD] [/TR] [TR] [TD]$27,377 [/TD] [TD]$38,004 [/TD] [TD]$675.00 [/TD] [TD]Plus [/TD] [TD]6.00% [/TD] [TD]$27,377 [/TD] [/TR] [TR] [TD]$38,004 [/TD] [TD]$48,029 [/TD] [TD]$1,312.62 [/TD] [TD]Plus [/TD] [TD]8.00% [/TD] [TD]$38,004 [/TD] [/TR] [TR] [TD]$48,029 [/TD] [TD]And over [/TD] [TD]$2,114.62 [/TD] [TD]Plus [/TD] [TD]9.30% [/TD] [TD]$48,029 [/TD] [/TR] [/TABLE] This is the CA Tax Rate Schedules for 2011. This is direct from the state website. https://www.ftb.ca.gov/forms/2011_California_Tax_Rates_and_Exemptions.shtml#ifr In order for a person to pay about 10K in state income tax only, they must be earning at least $132,000. Here is a crude calculation below So out of that $132,000 on the first $48,029 you pay a tax of 2,114.62 and the remaining $84,000, you pay a tax of 84,000 X 9.3% = $7812. $7812.00+ $2114.62=$9,926 which is close to 10 thousand dollar. I wonder who in their right mind will leave a job that pays them $132,000 for one that pays about 60k-70k (high RN wages in Texas) just so that they can save some money on state taxes and gas:roflmao::roflmao:

Again my original post does exclude higher acuity unit like ICU, NICU, etc etc. You can call community hospitals throughout USA and they will tell you that the training for med/surge unit is about 6 weeks and 2 extra weeks if you need it. Now in terms of Cobra, I have already compared the self insurance and insurance through the employer. Finally calling me ignorant won't really do anything for the fact that you were wrong about the topic below and your feelings got hurt in the process. https://allnurses.com/micu-sicu-nursing/weird-but-missing-792124.html

Again these values don't relate to me or the majority of the hospitals that hire med/surge nurses. We don't get 6 months and 1 week of training as you have indicated in the post above. My training lasted only 6 WEEKS. Only class time I had was for computer training and in house orientation. I already paid out of my own pocket for ACLS, BLS, and PALS!!!! Please try again.

I will say it again the last line of the 1st paragraph in my original post does state that my figures are excluding specialty nursing unit like ICU, NICU etc etc.

Before writing something you may want to do some research about the subject at hand. Homeowners in Texas do have to pay property Taxes. Here is the link to it. Property taxes in Texas And here is a direct quote from the web site “Property taxes are a significant part of the overall cost of owning a home in Texas. The state has no income tax, so property taxes carry a heavy load when it comes to funding public-school, city, and county budgets.” Only a handful of cities in California have a 9.75% sales tax. 90%-95% is between 7.75%-8.75% which is comparable to what we have in Texas. Here is the link to the taxes for each city in CA. California City and County Sales and Use Tax Rates - Cities, Counties and Tax Rates - California State Board of Equalization Houses are expensive on the coast but inland cities like Sacramento, Fairfield, Riverside, Fresno areas have houses that are decently priced. They aren’t as cheap as houses in Texas; but, they aren’t as expensive either.

I highly doubt that this will happen in my lifetime. At this moment in time and for foreseeable future, public seems to be really against Unions. I admit there are certain things that are wrong with some unions; however, overall the unions are good for workers, communities and country. The general public is irrationally blaming the unions for the problems that have occurred with our economy rather than placing the blame on the corporations and CEO's. They are shooting themselves on their own feet by not reforming the pay structure of CEO's while simultaneously decreasing the power of unions!!!!!

Here is a quote from National Bureau of Economic research about the tax breaks that corporations get for providing so called a valuable health insurance benefit. "]Currently, employers' spending on health insurance premiums is exempt from taxation for both employers and employees. Premiums paid by employees are exempt as well if the firm has established a Section 125 cafeteria plan; roughly 80 percent of employees with insurance have such a plan. This tax exclusion is extremely costly - it reduces federal and state tax revenues by $260 Billion per year and is the government's third largest expenditure on health care, after Medicare ($400 Billion) and Medicaid ($300 Billion)." These are straight up Facts not my opinion.

It may be the state that you are in. The insurance that I am looking at has similar if not the same schedule of benefits as one provided to me by employer and it doesn't cost a $1,000 per month in premium. Now let me give you some details about the plan. Out-of Pocket Maximum for individuals for both insurance is $6000.00. PCP deductile is $25 for both insurance. Specialist is $50.00 for both insurance. For the insurance provided by the hospital prescription drugs are $15.00 per prescription for 1st Tier Formulary and $30 for 2nd Tier non-formulary. The self insured prescription drugs are $20.00 per prescription for 1st Tier Formulary and $35 for 2nd Tier non-formulary.

Dealing with the insurance companies for the purpose of selling it to consumers doesn’t tell you the true cost of providing the service. There is an inherent bias that comes into play since your income is completely dependent upon selling the insurance. Each person that you sell the insurance to, the Big insurance company will pay you a commission. Since your income is directly coming from the insurance companies itself, you tend not to question the status quo. It’s similar to what happened in the mortgage business and banks. The banks sold shoddy mortgages to consumers. The auditors were sleeping or missing in action so to speak. While the sales people paddle those shoddy mortgages to consumers. Yet, some of these same sales person had 10 or 20 years in banking experience. Therefore, I would believe in my own research rather than believing someone else and as I had stated earlier I can get the same or similar type of health insurance for less than $500.00.

“5:26 am by Multicollinearity You are way off base regarding COBRA. The COBRA payment amount is the amount the employer is paying for your health insurance to the insurance company plus a 2% administrative fee to cover the cost of administering the plan.” You may want to call a local insurance rep that deals with multiple health insurance company and ask for a quote for a 28 y.o male for a similar or same type of insurance. In CA it will run you less than $500.00. You also may want to research about the tax breaks that the corporations receive for providing insurance to you. They inflate this number so that they can get a bigger deduction on their taxes.

I on the other hand like to question everything and don't like to believe anything on it's face value. I use my own critical thinking skills that was ingrained in the nursing school; however, I have found that the more critical thinking I use, the more trouble I get into

I can pull out a number from anywhere myself and tell you that it cost this or that amount to train a new grad RN. My original post has specific numbers for my case and if someone else has other numbers than please share. It would be kind of pointless for me to believe that it cost $60,000.00 without any specific costs or breakdown of where this number is being generated from “4:33 am by ColleenRN2B There are costs associated with running a business, lots of behind the scenes costs that you can't even begin to imagine. Why don't you straight up ask someone in HR about this "myth" and see what they can tell you? Present your figures and see if they agree with you or can pull out the numbers that will add up to what you've heard it costs to train a new hire.” I did exactly that about a week ago and the HR lady didn’t have an answer for me. She was surprised that someone would even ask this type of question. I didn’t press the issue further, since I didn’t want to rock the boat and get on a bad side of anyone in the organization. There are certainly cost associated with running a business. I have ran and sold 2 small business myself. I have also worked for Blue****insurance company and I can and do imagine these costs.

“4:49 am by kylee_adns I think maybe the additional costs can be from the additional certifications and training besides the preceptorship. I am a newer grad (dec 2011) on a similar step-down unit, and our orientation is almost double yours (10-12 weeks). This of course increases the price. Also there is a lot of additional education besides the orientation. I know I have 100s of hours of computer based training and many, many classes. These include Care of cardiovascular surgery patient, care of thoracotomy patient, ICDs, Pacemakers, ACLS, cardiac drips, etc. I cannot even remember all the classes I have done, and I have 4 in the next month. This is a big investment by the hospital, especially if the nurses do not end up sticking around.” I don’t think the additional courses that you have taken or will take end up costing hospital 10K. Just google for critical care courses in Southern California and you will come up with companies teaching that course for less than $1,000.00. I already had paid out of my own pocket for ACLS ($240.00) and PALS ($240.00) and arrhythmia certificate course($120.00) before I was hired to the unit. Furthermore, the hospital is not paying the full advertised price for those courses that I had paid. Finally, shockingly the two code blues that did happen during my orientation that I was involved with first hand, the docs failed to follow the ACLS guidelines precisely.

To me COBRA statement is like a hospital bill if you don’t have insurance “HIGHLY INFLATED” Not real at all. About a year ago when I was attending nursing school and I received a quote of about $380.00/month for the similar plan that I currently have. Mind you that in the individual insurance marketplace, the consumer has no power what so ever, while the corporations can negotiate and do negotiate discounts all the time. It’s the same as hospital charging $5.00 for 1 81mg aspirin, that I can get 30 at the grocery store for a buck or two!!!!!!

This is the response to the posting by the thecommuter "1. Some new grads receive the $10,000 worth of training, only to be terminated at the end of their 90 day probationary periods due to an inability to grasp critical concepts. Although you seem like a fast learner and good thinker, some new nurses never seem to get the big picture and are unable to practice safely on their own after having been trained and fully oriented to the unit. Hospitals lose money on these new grads who do not last because there's no return on the initial investment." My take on this is that this probably happens to about 2-3 new grads out of 10 new grads. So from at least 7 new grads, the hospitals are making about $20,000.00 X 7 = $140,000/year. They loose about $30,000 from the 3 new grads that are terminated at the end of their 90 day probationary period; thus, the hospitals still make a profit of at least $110,000 from the new Grad RN position. "2. Some new grads knowingly accept job offers in specialties that do not interest them with the ulterior motive of hopping to another job as soon as possible. Some new nurses receive the $10,000 worth of training, stick around for a few months, and quit as soon as they receive a job offer elsewhere for their favorite unit or specialty. This represents a loss for the hospital due to the lack of return on initial investment." Well let see for my case I am unable to even apply to another position in the same hospital until at least one year after I am done with orientation. So this doesn’t really apply to me. Furthermore, job requirements for all other specialty areas in a different hospital do require a minimum of 6 months to 1 year of acute care experience. I won’t be able to find a job in another hospital for at least 6 months past my orientation. For those 6 months, I am saving the hospital anywhere from $7,000-$12,000. So even If I leave right at the 6 months mark, it will cost the hospital a maximum of only $3,000.00. Again I don’t know where the hospitals are coming up with this number of spending thousands and thousands of dollars to train new nurses!!!!!!! Furthermore, for every new grad that leaves the unit after 6-months, there is at least 1-2 new grad that is still working in the same unit past the 1 year point. So in the end hospitals aren’t loosing any money in this situation either since they are making at least 10k-20K per new grad that stays on the unit beyond the year, while, it’s only costing the hospital only 3K if a new grad leaves after 6 months. “3. It takes time to become a good nurse because the new nurse is minimally competent and still learning. With that having been said, it can be argued that hospitals incur increased legal costs resulting from units staffed primarily with nurses who possess less than one year of experience. The newer nurse sometimes does not detect subtle changes in condition that the experienced nurse could spot a mile away. The lack of experience can lead to sentinel events, which results in lost money (read = lawsuits).” Again this doesn’t happen as often as you are hinting. That’s the exact reason why I have malpractice insurance and the hospital is carrying malpractice insurance for the same exact reason. Furthermore, after re reading my post I didn’t find any place where I advocate for staffing a unit primarily with nurses who possess less than one year of experience. My post was mainly about this myth that it cost thousands and thousands of dollars to train a new nurse.

First of all I had excluded all the specialty nursing positions ie ICU, NICU etc etc. See the end of the first paragraph. I have been interviewed for an ICU position 3 times and all of those 3 places had the ICU training lasting for only 6-8 weeks!!!!. However, they were community hospitals and not a level I or level II trauma centers. Furthermore, I also excluded Versant residency program (which can last up to 6 months). I am baffled by the reasoning behind such a long training for med surge floors!!!!! I can understand the extended length of training for an ICU type position; but, not for a med surge position. Anyway, almost 80%-90% of the hospitals in US provide only 6-8 weeks of training for med surge unit!!!!! Now lets talk about the so called benefits. I receive standard medical insurance. It will cost me around $60.00/month. I can get the same type of insurance in the market place for about $200.00/month. So they are paying about $140.00 more per month for insurance for me. So it comes out to be $1680 more that they are spending on the health insurance for me. For this spending on health insurance, the hospitals do get a substantial tax break also. So in the end they probably pay out of their own income about $1,000-$1,200 for insurance. The dental and vision coverage is nothing to get excited about either. My out of pocket cost of vision plan is $98.00/year. I can go to wal-mart and get an eye examination and get glasses or contact lenses for about $300.00-$400.00 total. So the benefit I am receiving is worth only $200-$300.00. For the dental, the 1st $150.00 of bill is covered completely, The next $151-$500 of the bill, I get reimbursed at a rate of 80%, the next $501-$1,500, I only get reimbursed 50%. Finally there is a maximum of $1,500 reimbursement per individual covered. Therefore, both the dental and vision benefits aren't great either. Again the numbers that the hospitals claim that they spent on training new grads aren't adding up!!!!!!! Also these benefits are also provided to X-Ray techs, monitor techs, secretary's, dietary, maintenance personnell etc etc. It's not like new grads are receiving some kind of gold or platinum benefits that the other employees of the hospital aren't receiving!!!!!

I am new to posting on forums and actually I wasn't trying to respond to your post per se. I was actually soliciting a response from someone who doesn't agree with my point of view.

I keep coming across this big myth and when I examine it closely, it seems to me that this myth has absolutely no basis in facts. I would really like someone to refute my point with only facts and not opinion.

To 8mpg I am an RN from CA and I am currently working in the state of Texas. Last time I checked my paycheck stub from a hospital in Texas does have federal income tax, social security tax, medicare tax. I also pay around 8.75% sales tax on items I buy at stores. A gallon of milk cost about $4.00 here in TX; while, it only cost about $3.00 in CA and sometime even $2.00. Fruits and vegetables are more expensive here than what I am used to paying in Riverside, CA. Gas is cheaper here in Texas by about $1.00/per gallon and also in Texas they don't have any state income tax. However, as a nurse in the state of Texas, I am earning at least $16,000-$24,000.00 less each year. When I calculate how much I save with gas and income tax, I am still worst off as an RN in TX, so this myth of Insane CA taxes doesn't hold when you examine the facts more carefully.

Let me begin by giving some background about my situation. I graduated from a nursing school with an ADN in May 2012 from a school in California. Academically I was # 2 in a class of about 60 students. I looked for a new grad RN position in CA; but, no one would hire me. I would like get some feedback on this myth that hospitals spend thousands of dollars in order to train a new Grad RN (here I am not talking about Versant residency or any training into special units like ICU, NICU etc). I was hired by and I am currently working in a medical school affiliated hospital with a level 1 trauma center in the state of Texas. The unit that I am currently working in is the Cardiac Step down unit. It's one level below Cardiac ICU and one level above regular Med-Surge floor. My current wage level is in the mid 20s with differential for nights, weekend, and afternoon. I have received a total of 6 weeks of training. I was signed off on almost all my skills during the first week of hire (Vent, Trach care, Med pass, Blood draws, IV start, Foley, NG etc, etc). During the last 5 weeks of my training my preceptor has been mostly reviewing my charting and helping other Nurses. Here are the hard numbers. I have received total wages of less than $6,000.00 for the 6 weeks of training (this also includes house orientation and computer training (lasted only 6 hours). I don't know how much my preceptor has earned in those 6 weeks; but, I can assume it wasn't more than 9k (70,000/52weeks X 6weeks). I have handled the same pt load as an experienced nurse after my first week on the unit. While most of the time my preceptor has been helping out other nurses on the unit. I am not including the wages for the instructors for house orientation because there were more than 30 individuals including nurses, techs, dietary, HUC (secretary of the units), maintenance etc, etc. Moreover, since the hospital is in the process of going to computer charting, there were about 35 nurses including new hires and veteran nurses that were present during the computer training. So the way I look at it, this hospital has spent about a maximum of 10K (wages that my preceptor received during the training) training me. If I wasn't there, the same number of pts would still be cared by an RN. The only difference is those pt were cared by a rookie RN rather than a veteran RN. Also again my preceptor was usually helping out other nurses during this training. It wasn't like she was hovering over me while I was providing care to the patients. Since very few hospitals will hire a new grad, for providing me 10K worth of training for 6 weeks, I will be working for this hospital for at least a year and the hospital will be saving about 20-30K in wages paying me instead of a veteran RN. So for this scenario in the end, the hospital comes out making a profit of at least 10k-20K. Furthermore, I will be replacing an expensive nurse from resource department along with decreasing the overtime wages for the whole unit. So that just goes to increase the profit margin for the hospital. Finally, I have purchased malpractice insurance independently and the hospital also provides for malpractice insurance for nurses. So again I would like to know where is this myth of hospitals spending thousands of dollars to train a new grad coming from. What am I missing here????