What are the risks of hiring a new grad RN

TheCommuter, BSN, RN · Jul 7, 2014

For those of you hiring nurses, what is it specifically that deters you from hiring or even considering new grad RN's?

Although I do not do the hiring, I am in a lower management position at a small specialty hospital. I can provide some insight, though.

First and foremost, hospitals and other healthcare facilities are businesses. These places are in existence to generate revenue, not to train new nurses or provide members of the community with jobs. Healthcare facilities do what they feel is in their best interests, and sometimes their strategies are very short term.

So if the local community hospital needs nurses in order to provide patient care and generate revenue, their recruiters and HR managers will do whatever it takes. In the past this included aggressively hiring, recruiting and training new nurses as well as sponsoring foreign nurses.

For the past few years, many employment markets across the US have been glutted with too many nurses. Another problematic issue is the lack of training provided by today's nursing schools. Modern-day nursing school, whether at the associate, BSN or direct entry MSN degree level, does not provide adequate preparation for graduates to function as independent bedside nurses. On the other hand, the diploma nursing grads of yesteryear were ready to practice at the time they graduated, thereby eliminating costly orientation time.

Many of today's nursing programs teach graduates nursing theory along with some clincial skills and some strategies on how to pass NCLEX. Hence, it has become the hospital's very expensive job to accomplish the feat of training the new grad to function as a bedside nurse.

Physicians leave their residencies and fellowships ready to practice, whereas new nurses must contend with local employment markets to obtain the training they need. Prior to the Great Recession of 2008/2009, hospitals were willing to absorb the staggering costs of training new nurses while secretly crossing their fingers that the new hires did not quit before the first couple of years had elapsed. Hospitals provided this training not out of the kindness of their hearts, but because at the time their bean counters felt it was in their best long term interests.

In today's world, things have changed drastically for the new grad nurse. Nurses are viewed with disdain as just another huge expense that cannot be directly billable to patients or their insurance companies. The cost of nursing care is neatly rolled into the daily bed fee along with the toilet paper and complimentary lotion.

Although many nurses have attempted to devise ways to bill for nursing care, the current reality of the situation is that nursing, unlike respiratory therapy or speech language pathology, is not a billable service.

Ruby Vee, BSN · Jul 7, 2014

New grad nurses don't tend to stay in their first jobs. The first year of nursing is rough, and as soon as the going gets tough, new grads start looking for new jobs. One of the risks in hiring a new grad is that you'll spend six months orienting them, teaching them the skills they didn't learn in nursing school, and the moment they're on their own and the unit is about to start seeing some return on their investment, they leave.

Signing a two or three year contract is probably the best solution for both parties. The hospital knows you're serious about staying, and has a hope of getting a return on their investment in you. And you get a job, one that you'll stay in long enough to actually become competent.

TheCommuter, BSN, RN · Jul 7, 2014

2) What can I do absent a nursing job, to mitigate the risks of hiring me, a new grad RN?

First of all, you are in California, which is one of the toughest states to secure new grad RN employment. It is a state where an estimated 43 percent of all new grad RNs are unemployed.

In this day and age, many jobs are found through inside connections. It is important to make friends who work at hospitals so that these people will be willing to put in a good word for you to the recruiter, unit manager or HR staff.

If you have a friend on the inside of an organization who can vouch for you, your application may suddenly be pulled and you might be called for an interview. But if you are doing cold searches for jobs, your application remains at the bottom of the virtual pile along with the 500+ other new grads who applied to the same position.

In addition, be open to non-hospital employment in LTC/SNF, private duty, home health, clinics, hospice, jails, prisons, psychiatric hospitals, group homes, adult day care and assisted living.

Another technique involves pounding the pavement. An estimated 70 percent of jobs are not advertised. In essence, you might be able to secure an on-the-spot interview if you dress nicely and apply in person during business hours. This tactic is less effective for securing hospital employment, but smaller employers out of the hospital are often receptive to the cold visit approach, especially if you present yourself as someone they'd want to hire.

Finally, if you can relocate, a few other states are welcoming new grads from out of the area. North Dakota comes to mind, and multiple unemployed new grads RNs from CA have found work there. Other states include Wyoming, Nebraska, Missouri and Oklahoma. You can return to CA with your marketable skills once you have accrued anywhere from two to five years of experience.

Good luck to you.