Unemployed New Nurses Would Be Wise To Remember These Equations

Many newly graduated nurses dream of landing their first positions in certain nursing specialties within the acute care hospital. However, what if the recruiters and nurse managers are not calling to set up interviews? Should you accept employment outside the hospital? Nurses Announcements Archive Article

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As a newer nurse (RN or LPN / LVN), you should feel very proud of the milestones that you have worked tirelessly to achieve over the past year. For starters, you have successfully completed a challenging program of study that would perplex the majority of adults in the United States. Moreover, you have passed the NCLEX and attained professional licensure that allows you to lawfully practice as a nurse. After all the hurdles you have jumped, I am assured you are excited to begin your career in the vast field of nursing.

Many new grads dream of landing their first positions in certain nursing specialties. Labor and delivery, postpartum, the intensive care unit, the emergency department, and pediatrics seem to be popular specialties where numerous new nurses would like to work. Also, countless new grads are willing to start on medical / surgical floors to establish the foundation upon which the rest of their careers are built. Anyhow, you are eager to start working, so you begin submitting employment applications to various hospitals in the area where you currently reside.

Six months have elapsed since you first received your nursing license. You have submitted so many applications, resumes and cover letters that you do not have enough fingers and toes to accurately keep count. Not one single callback. You might have thought aloud, "What is going on? I heard there was a critical nursing shortage!"

At this point you might be feeling a little sick to your stomach because the student loans will be due for monthly repayments rather soon. Even though deferment is a possibility, this option will only add more interest and slowly increase your overall balance. Preferably, you need a licensed nursing job. After all, you graduated from nursing school because you wanted to actually work as a nurse. Right?

Meanwhile, a company that hires new grads into private duty nursing cases is constantly advertising on websites such as CraigsList, Monster, CareerBuilder and Indeed. A home health company has placed an ad in the local newspaper for nurses (no experience necessary). An assisted living facility within reasonable commuting distance seeks a full-time RN to complete tasks such as wound care, assessments and taking call every four weeks. A local nursing home has a permanent sign in the front window that reads, "Now hiring LPNs, RNs and CNAs!"

As tempting as these job openings look, you are feeling leery about applying because you are still clutching onto your dream of securing employment at an acute care hospital. You might fear that you will become a less attractive applicant in the eyes of recruiters and hiring managers if you take a nursing job outside the hospital setting. My advice is to remain cognizant of the following equations:

Nursing job outside the hospital = Licensed Nursing Pay + Licensed Nursing Experience

Waiting for the acute care hospital job of your dreams = Zero Pay + Zero Experience

As a newer nurse, the worst thing you can do is become an 'old' new grad who has never held a nursing job more than one year since passing NCLEX. Some experience is better than none at all. I know multiple nurses who were offered the hospital jobs of their dreams after starting at a nursing home, private duty case or home health company. Personally, I was offered a job at a major county hospital and another position on the floor of an outlying suburban hospital after having spent four years in the long term care setting.

Furthermore, the 'losing my license' mantra is grossly overrated. I pay close attention to the disciplinary action pages that my state board of nursing regularly posts. The majority of nurses in my state of residence whose licensing has been censured were working at hospitals, not nursing homes, home health, or other areas outside the hospital.

One more thought. . .hospital employment is on the decline as more patient care is pushed outside the inpatient setting to cut costs.

RESOURCES

Hospital Jobs in U.S. Decline for Second Straight Month - Bloomberg

 

I'm not so sure about this!

"Nursing job outside the hospital = Licensed Nursing Pay + Licensed Nursing Experience"

I have 8 years LPN experience, and 4 months as a RN. While LPN's are also "licensed" it is not the experience people are looking for. It has to be RN experience. Unless I am doing something totally wrong.....and my HHC company pays crappy I'd get better pay in acute care. Significantly more! But I keep the job because of my seniority. And as much as I'd like to specialize, I can't even get hired in med/surg because of the "one year experience required".....and that year means RN.

Amen! It HAS to RN experience, and they either want "one year recent" or some arbitrary number like "8 years RN experience" in something specialized which means you basically had to have entered into that specialization right after graduation or been an RN for more than a decade... pretty much the younger generations can be classified as the Generation Screwed, a highly educated youth, most of which are burred in student debt, population who struggles for jobs and home ownership.

Starting outside the bedside is uncharted territory. Historically, the most successful nurses started at the bedside, not away from it.

Furthermore, working for more than a few months in fields like LTC or public health carried a grave danger of resulting in being "pigeonholed" and not being able to leave, and having poor job prospects later. I know you can learn valuable skills and these places are important, and what I am saying is unfair, but the sad truth is hospitals are very picky, and for "experienced nurse" positions, they want someone who has worked in a hospital before.

Healthcare is moving out of the hospital, and into nursing homes, clinics, etc. but these places even ask for "1 year acute care experience, preferably in the ICU/ med/Surg" when hiring. It is unfair, but it is the sad truth.

starting outside the bedside is a gamble. There is no way of knowing whether or not this will lead to success until the future, when we can see what has happened to all these new grads who are now working in places like SNF's or clinics. Do they succeed and build careers?

Hi @obesity33 Do NOT fool yourself because pigeon-holing happens within the hospital too!!! I'm a nurse who started off working in a hospital (I've also worked in gerontology, palliative, LTC, nursing homes, ccc, med/surge, OR, orthopedics, rehab, respirology, dialysis... for an RPN I have pretty diverse clinical experiences and employers do not care) and I currently work in a large hospital... I'm realistic and I know I'm ultimately less employable than an RN... so I am working on obtaining my degree to improve my career growth potential. But I digress, whatever area or specialization a nurse works in (whether it be cardiology, oncology, gerontology, palliative, etc...) is what employers will not look beyond when considering them for less/similar/ sometimes equivalent or other specialized positions. Most places around here consider your clinical skills in one area to be expired/out of date withing a few months... so unless you are working in the specific specialization area you are applying to... unfortunately, you will often be overlooked because, "that experience or that job was almost 6 months ago". Then if you attempt to go back to school (to specialize, upgrade or whatever) employers start asking, "Hey nurse, where's the beef? I see all your extensive clinical skills but it's not recent licensed nursing experience & that's what we want". I hear the sme complaint from all my RN friends, too! Ridiculous... utter nonsense! All this nonsense students are being fed about nursing careers being so flexible and diverse is a ridiculous sales pitch to keep students applying and enrolling into oversubscribed nursing programs just like that whole fallacy of a "nursing shortage" big freaking joke. Perhaps the only versatile nurses who can cross specializations are ER nurses? ER nurses are extremely versatile in my eyes - who wouldn't want to hire one, they can do just about anything! Most nurses I meet who land their ideal jobs have some form of connections whether is be nepotism or some other connection. Most of my peers from nursing school had mothers or other close/immediate relatives who are nurses and just make a phone call to get them a job. To be realistic, it all boils down to LUCK. Some people are luckier than others and that's the TRUE unfair reality to nursing and life in general!

Hi @obesity33 Do NOT fool yourself because pigeon-holing happens within the hospital too!!! I'm a nurse who started off working in a hospital (I've also worked in gerontology, palliative, LTC, nursing homes, ccc, med/surge, OR, orthopedics, rehab, respirology, dialysis... for an RPN I have pretty diverse clinical experiences and employers do not care) and I currently work in a large hospital... I'm realistic and I know I'm ultimately less employable than an RN... so I am working on obtaining my degree to improve my career growth potential. But I digress, whatever area or specialization a nurse works in (whether it be cardiology, oncology, gerontology, palliative, etc...) is what employers will not look beyond when considering them for less/similar/ sometimes equivalent or other specialized positions. Most places around here consider your clinical skills in one area to be expired/out of date withing a few months... so unless you are working in the specific specialization area you are applying to... unfortunately, you will often be overlooked because, "that experience or that job was almost 6 months ago". Then if you attempt to go back to school (to specialize, upgrade or whatever) employers start asking, "Hey nurse, where's the beef? I see all your extensive clinical skills but it's not recent licensed nursing experience & that's what we want". I hear the sme complaint from all my RN friends, too! Ridiculous... utter nonsense! All this nonsense students are being fed about nursing careers being so flexible and diverse is a ridiculous sales pitch to keep students applying and enrolling into oversubscribed nursing programs just like that whole fallacy of a "nursing shortage" big freaking joke. Perhaps the only versatile nurses who can cross specializations are ER nurses? ER nurses are extremely versatile in my eyes - who wouldn't want to hire one, they can do just about anything! Most nurses I meet who land their ideal jobs have some form of connections whether is be nepotism or some other connection. Most of my peers from nursing school had mothers or other close/immediate relatives who are nurses and just make a phone call to get them a job. To be realistic, it all boils down to LUCK. Some people are luckier than others and that's the TRUE unfair reality to nursing and life in general!

It is super unfair :(

But I would rather be "pigeonholed" into the hospital where the pay is generally better and there is more room for growth than "pigeonholed" into LTC or HH, where the pay is generally lower and there is less room for growth.

AND someone with 2 years of med-surg experience is much more likely to be hired into oncology, peds, etc than someone with 2 years of LTC or Home Health.

I agree that this whole situation is very unfair.

It is super unfair :(

But I would rather be "pigeonholed" into the hospital where the pay is generally better and there is more room for growth than "pigeonholed" into LTC or HH, where the pay is generally lower and there is less room for growth.

AND someone with 2 years of med-surg experience is much more likely to be hired into oncology, peds, etc than someone with 2 years of LTC or Home Health.

I agree that this whole situation is very unfair.

@obesity33 As a nursing student, you are seeing the world of nursing through different coloured lenses. I saw things differently too before I became a Nurse. I'm not saying these things to sound judgmental or appear superior to you (or nursing students in general, because hey... I was one once too). I say these things to hopefully help you understand that the shift in role is DRASTICALLY different from nursing student to licensed nurse. Your perspective will change and your options will not be everything that was promised to you in school. That's the real world for ya! It is VERY rare that a new nurse will get a choice in what area he/she gets "pigeonholed" into. If you're lucky, you will get a job in the area you chose to specialize in during your consolidation. WE all had our preferences or notions of an ideal job when we were nursing students, then we graduated, became licensed nurses and started looking for work. Then we realized that we didn't have the option of choosing and had to take the "undesirable" job options to get the licensed experience to hopefully land us something more desirable or tolerable in the future... only to discover we were now "pigeonholed" or didn't have any other employment options without relocating. So you see @obesity33 what you often get "pigeonholed" into is whatever job you are lucky enough to initially land as a newly licensed nurse. The only way to survive this vicious cycle is continuous education, and even still your job is never secure. The only way to make yourself more marketable and create employment options is to make yourself available for relocation! My hospital just "laid off" two Nurse Practitioners due to budget cuts. This month our hospital started laying off all-over, starting from the top with the most expensive nursing positions and working down accordingly. In this economy no amount of skill, education, loyalty, great personality will make you invaluable to employers. Modern health care is a BUSINE$$ and don't you forget it ;)

Life is unfair (not just nursing).

Aside from being a diploma nurse and working on completing my BScN, I also have a poly-sci degree and used to work in government prior to my nursing career. I have a laundry list of education and credentials and I still have to fight tooth-and-nail AND exploit my connections for jobs. That's life. Unless you're born rich and/or have great connections within your industry it will be some struggle to establish yourself. P.S. I have 3 years med/surg experience and it doesn't provide any protection against being "pigeonholed". Employers all want RECENT experience and that can vary from employer to employer. They may ask for recent experiences of 6 months, 1-2 years, or 8 years... it will all feel arbitrary and it will not make sense as a new grad who has accumulated no licensed nursing hours. The operative word is LUCK. If you are lucky enough to get a job offer in acute care, take it! But that does not necessarily mean you can jump between specializations, nor is it a buffer against being "pigeonholed". In order to work in most nursing specialties requires a post-graduate certification.

After graduation I could not get an RN position in an acute care setting for two months. I took an RN position in a sub acute rehab facility where I learned a lot. I did admissions, wound care, drew blood, passed out meds, assess, administer fluids, antibiotics, and TPNs. I also knew that I had to obtain my BSN to make myself look more competitive if I wanted to work in an acute care setting in NY.

A year later, I landed an interview with a community hospital, because I knew someone in the unit. But, as per the manager, she hired me because she knew that working in an LTC setting meant I had good time management, good assessment, and customer service skills. She said that all the other skills can be taught once I started working. And oh yeah, I was also a semester away from getting my BSN.

Two years later I have a BSN degree (magna cum laude), med-surg and PCCN certifications, a Daisy award, and I just started my first two classes for my MSN. I was also recently recruited by two major NYC hospitals and I was ecstatic to accept an offer.

I still work at the LTC facility that hired me as a new grad. They took a chance on me and they taught me a lot, and still do. I also recommend new grads from the local community college that I graduated from for RN positions in my hospital as long as they started their BSNs.

I am a new graduate RN with no experience. I have tried applying to multiple positions over the last few months with no luck. I think this is a good article, but can someone address how it works to be a new nurse in private care? I wanted to work in a hospital because I know they have orientation programs and as a new nurse you have a preceptor. How well does private care prepare new nurses? I would seriously appreciate any advice.

I didn't apply for a post-grad position in any of the 'popular' areas. In fact, many nurses (old & new) find the area i'm in 'boring'. I find it fascinating and fulfilling. In less than a week of starting my post-grad year I was offered full-time permanent work. Look outside the box and it's amazing how many opportunities are out there.

Specializes in Case mgmt., rehab, (CRRN), LTC & psych.
How well does private care prepare new nurses?
It's called private duty nursing. Some private duty companies provide new grads with an awesomely thorough orientation, whereas other companies provide training that is less than stellar. Therefore, it all depends on which company you end up working for.

Great article, and great advice! I have seen this work over and over again. You absolutely do not have to work in a hospital after getting your license.

My first job was as a RN coordinator for a clinical study. I still did some assessment work, learned their EMR systems and so much more.

The more important aspect of wherever you work is "What are the transferable skills" i.e. assessment, time management, drug safety, communication with health team, labs, wound care, communication with family/friends, admission, discharge, and so on. All these skills are applicable when you present yourself for that hospital position dream job. Good Luck!

Specializes in ICU.

Good words of advice. I started out intending to go straight through to my RN, but as luck would have it I had to sit for my LPN and take a year off to earn enough money to pay for school. I ended up working in a ventilator rehab center and after a year went back to school. I was one of the first of my graduating class to take a job at a small hospital in the ICU, a coveted spot as a new grad. My director told me the reason she agreed to hire me was because I had familiarity in vents. I would also add this piece of advice to new grads, don't forget to look at small community based hospitals. They are a great place to learn and are often understaffed because nurses tend to flock to the big named hospitals. I left after 3 years of great experience and now work in a well respected trauma center.

Private care should come after longterm, SNF or some place where you will get to see lots of conditions.