Rural Nursing - How long do most nurses stay?

That Guy, BSN, RN, EMT-B · Jul 20, 2017

I worked at a regional hospital for a pretty rural and barren area. I had originally signed up for 2 years, but the hospital screwed me over hard and I left after a little over a year. I would have loved to stay but they made it hard to do.

mariahlily · Jul 21, 2017

I'm currently a new grad who got her first job at a regional hospital. I got two months of preceptorship and then I worked on the floor on my own. How was I consuming a year's worth of educational resources?

frances81 · Jul 21, 2017

I'm currently a new grad who got her first job at a regional hospital. I got two months of preceptorship and then I worked on the floor on my own. How was I consuming a year's worth of educational resources?

Agreed. I've only ever gotten 5 shifts of orientation for LTC. My understanding is the place I'm looking at gives 2-3 weeks of orientation and then you're on your own. Obviously there will be a learning curve but not sure how that's all that costly for them?

I understand that new grad acute training positions get 12 weeks of buddy shifts & preceptor though, so I can see how that cost the big bucks. I've never been in acute though and am no longer a new grad.

Emergent, RN · Jul 21, 2017

What I don't understand, is why people view rural nursing as a negative? A lot of people in rural areas would be thrilled to have a well-paying job. Rural areas are more livable. The pace of living is slower and more peaceful. I love living in a rural area!

applewhitern, BSN, RN · Jul 21, 2017

I have worked in a rural setting twice, now, and have no problem with it. You still see a lot of the same things, you might just ship them somewhere else, but you still take care of them until you find a doctor and hospital to transfer them to. The rural ICU's don't always have cardio, pulmonary, neurology, etc. there every day, so the internists and hospitalists have to take care of everything. I worked at one hospital where a cardiologist only rounded there once per week, but we still used the same cardiac drips, etc., as in larger hospitals. We manage vents without a pulmonologist. Keep in mind, I am talking about very small rural hospitals, roughly 100 beds or less. The opportunities to cross-train to other units are there, too. I cannot imagine have 6-12 weeks for orientation, the most I ever got was 5 days!

llg, PhD, RN · Jul 21, 2017

I guess I never looked at it that way, and for a straight number of years did nothing but full-time mentor nurses new to the unit, mostly new grads. This involved didactics and my favorite part - bedside nursing. It was almost like an extension of nursing school and clinical. Not that long ago at all. Anyway, a good number of them stayed in their positions, but that's also the age/time of life that people like to start families or get married (possibly reducing hours or moving away), or take travel jobs and see the country etc., I guess I just never felt anything but privileged to have helped them get started in their nursing journey. But my perspective is different because I wasn't carrying my own full assignment while doing this other role, and I saw it as investing in another nurse's future.
I have strong feelings about recent corporate healthcare trends, so I'll let this go. Thanks for your reply.:)

Thanks for not starting a war about this. I agree with you that nurses should be treated better -- and that some of the recent trends are appalling. But I work with nursing students a lot and with new grads a lot -- and I try to help them see all sides to such issues. One of the lessons I try to teach them is that it is very wrong for an employer to treat its staff badly ... but it is also wrong for employees to treat their employers badly. Two wrongs don't make a right.

I guess all of us need to try to treat each other better.

Ruby Vee, BSN · Jul 21, 2017

I don't disagree with some of things you said in the above post ... but that isn't very relevant to the OP's question. I was trying to answer the question asked to start this thread about whether it was fair to employers for a new grad to take a job knowing that she had no plans to stay more than a year. How some hospitals have treated experienced nurses isn't really relevant to that issue.
Regardless of how some hospitals have treated their experienced nurses (or how badly some orientation programs are) ... a good hospital that tries to treat its new employees well will spend approximately a year's salary to orient a new grad. To take all that education with no intention of working for that employer for more than a year is not very fair to the employer who has invested that much into developing your skills is not very fair to that employer.
Also, being a good preceptor/mentor can be hard work. People who do it regularly only to have the new grad leave soon after a short time often end up feeling used and abused. The new grad who doesn't stay long enough to be a useful employee not only hurts the employer financially, she personally hurts the preceptors and mentors (real people) who gave of themselves in order to help him/her become a successful professional.
When many orientees leave soon after hire, employers become hesitant to give people a chance ... hesitant to invest in good orientations ... hesitant to invest in residencies and mentorships ... hesitant to hire new grad and anyone else who looks like a flight risk. It also becomes to find nurses to precept such people and mentor them after those staff nurses have given so much of themselves to orientees in the past only to watch them leave.
Yes ... hospitals should treat their employees well -- better than they often have in the past. But new grads also need to be aware of how their choices reflect upon other new grads. The choices they make will influence the decisions that employers and potential preceptors/mentors will make in the future about whether or not new grads are worth the investment. And the decisions that previous new grads have made have influenced the decisions that employers and staff are making today.
So ... yes ... to take a job and consume all the education and support available in a new grad orientation when you have no intention of staying more than a year ... is not a nice thing to do.

I could not have expressed this better. Thank you!

If you take a job, any job, you should be planning to stay for at LEAST two years. (I'm not sure where this one year and go idea came from.) If you move to a rural area to take a job, you will get lots of varied experience. You may also find that the people are so friendly, the area so beautiful and that you enjoy the lifestyle so much you will want to stay. Don't look at it as exile from the big city; look at it as the wonderful opportunity that it is.

Ruby Vee, BSN · Jul 21, 2017

I'm currently a new grad who got her first job at a regional hospital. I got two months of preceptorship and then I worked on the floor on my own. How was I consuming a year's worth of educational resources?

Are you telling us that you're the only nurse on the unit? Or are there more senior nurses there to whom you can go with questions?

During your two months of preceptorship, your employer was paying two salaries for one patient assignment. You were getting paid, your preceptor was getting paid. That's four months. It also costs money for the educator, the class rooms and equipment, the videos you no doubt had to watch, the guest speakers, the pre-employment physical, etc. Perhaps in your particular case, your preceptorship only consumed 8 months worth of your salary. As new as you are, you aren't operating at the full potential of an experienced nurse. You're gaining experience. The employer is paying you as you're learning and gaining that experience.

allnurses Guide · Jul 23, 2017

If you take a job, any job, you should be planning to stay for at LEAST two years. (I'm not sure where this one year and go idea came from.) .

I think it came from the job listings where employers ask for "at least a year's experience". I've seen that one quite a few times.

frances81 · Jul 23, 2017

To clarify, I don't see rural nursing as worse or less-than. I'd be honored to be offering the position and have that opportunity. And I'm also not necessarily planing on staying just the one year - just trying to gauge what is appropriate and if rural nursing has a higher turn-over than city nursing. Personally the only reason I can't see doing more than 2-3 years is I'd be quite far away from family. Thanks for all the diverse input :)

llg, PhD, RN · Jul 24, 2017

I'm currently a new grad who got her first job at a regional hospital. I got two months of preceptorship and then I worked on the floor on my own. How was I consuming a year's worth of educational resources?

Ok, with your orientation, it probably is less than a year's salary worth of costs. But it was probably much more expensive than you think.

Each "staff turnover" costs more than just the salary of the new nurse hired while that new nurse is officially being preceptered. There is the cost of paying replacement staff while the new nurse is being recruited and trained -- which is likely to be higher than the cost had the original staff member stayed due to overtime costs, cost of a traveler if necessary, etc. "Filling that hole in the schedule" usually costs more than just having it filled by the staff member who left working his/her regular hours. Then there is the cost of recruiting (advertising, interviewing, etc.) ... on-boarding (health screening, immunizations, license-check, criminal background check, credit checks, etc.) ... orienting (classes, preceptorship, salary during orientation, benefits during orientation, etc.) ... the cost of maintaining a recruitment dept, education dept, etc. It adds up to a lot more than just the salary paid during the preceptorship.

Each facility's cost to replace a departing staff member is different. But national studies estimate that most facilities (who have decent orientation programs) pay anywhere from $25,000 to $75,000 per turnover.

chris21sn, BSN, RN · Jul 25, 2017

I was reading some of the prior posts. I don't see issues about leaving after a year or even a little before that in a med surg/telemetry setting. My hospital really uses their new graduates. To the point, many times I'm the one stuck with 6 patients versus their 3 patients. I'm always the first for admission, multiple ones. And if there is a patient they know is going to be discharged or transfered -- im the first to receive. So I say, it's a give and take. They use you, you use them - it's mutually acceptable. And from stories and pictures on my floor -- I've seen many new grads come and go with their new experience. In the end it isn't about loyalty. It's about your goals and your happiness as well! Don't forget how important that is!