Working RNs and the CNA are to blame for new graduate RN program shortages .

allnurses Guide · Jun 17, 2012

I just wonder when an antiestablishment attitude becomes "becoming". I suspect there are many instances throughout history where a fear of appearing unbecoming to those who hold all the power has cost people their lives. It's kind of an archaic notion. Thank God for the loudmouths throughout history who dared to challenge the status quo. That sounds a little too much like "sit down and shut up" to me. Just my .002.

DoGoodThenGo · Jun 17, 2012

I just wonder when an antiestablishment attitude becomes "becoming". I suspect there are many instances throughout history where a fear of appearing unbecoming to those who hold all the power has cost people their lives. It's kind of an archaic notion. Thank God for the loudmouths throughout history who dared to challenge the status quo. That sounds a little too much like "sit down and shut up" to me. Just my .002.

Seen on a bumper sticker recently: "Well behaved women rarely make history "

Esme12, ASN, BSN, RN · Jun 17, 2012

Another thing.
Your title mentions "CNA's" as part of this high wage nursing staff problem. Am sure there are many whom would love to know where nursing assistants are pulling down big money. The ones I know are either making minimum wage or barely above. Certainly nothing one could call a living wage; well not for NYC anyway.

Do Good.....CNA here was for shock value I think.......

CNA here is the California Nurses Association. :idea:

I did a double take as well.

:paw:

minnymi · Jun 17, 2012

i worked on a med/surg floor where there were so many new nurses they had nurses who had just been out of orientation for two weeks being the preceptor for another nurse. scary!

i made friends with the oldest nurse on the floor and i used to say that when i graduated i was going to request to be put with her for my preceptor because i did NOT want to be taught by someone who barely even knew what they were doing. i ended up leaving that job, but there were times that i stuck it out just because i wanted to be trained by that nurse. i still miss her!

she really was wise. most of the nurses made it their mission in life to make the nurse manager happy. she made it her mission to stay out of the manager's office! and every time someone was trying to figure out why something was done a certain way or why things were being changed that didn't make much sense....she always knew the answer. money!! she would talk about how she used to work night shift with a couple of other RNs and they got everything finished without any help from assistants, but with the newer nurses you would have thought someone had died if an assistant called into work or there just wasn't one scheduled.

i like having someone around who has seen things change. they have some good stories. plus, it's nice to have a mother hen around which is how they act (from what i've seen) unless you're a jerk. they get paid more because they're valuable - duh. if you were a patient or your child was a patient - would you rather your nurse be an "old nurse" or a new nurse? would you care how much they got paid THEN?

RNsRWe, ASN, RN · Jun 17, 2012

I'm wondering which and how many of the most senior, most experienced nurses should retire this week in order to make room for the most inexperienced new grads waiting for their jobs?

And I wonder at what point the OP would like to find himself/herself being handed a pink slip simply because someone fresh out of school wanted his/her job?

Oh, and the CEO of the last hospital I worked for (a smallish community one) had his salary published in the paper. It was just under $700,000. Plus a whole lot of benefits and perks NOT included in that shiny salary. Wonder what the going rate for a big-name facility is?

Yeah, I'm sure it's the RN who is finally making a decent living after 20+ years on the job that's putting the hospital in cut-back mode.

Dixielee, BSN, RN · Jun 17, 2012

I have read this entire thread and intentionally did not respond to it the first time I read it. I do not hold the same views on this as many of my peers, but here goes. I have been an RN for 38 years. I graduated at age 19 from an AS program at a community hospital. My mentor in school was an "older" LPN (aged 38) who was returning for her RN. She was twice my age so I classified her as older.

When I started working on a med surg floor, I also was mentored by an "older" LPN. She taught me time management skills, coping with difficult people skills and taught me how the system worked. I will forever be in her debt!

I transferred to ED where again, my mentor was an "older" LPN who took me under her wing to teach me how to be an ED nurse. I will never forget her influence!

As I raised my family, worked weekends, holidays, double shifts etc., many "older" nurses continued to teach me the value of what I was doing. I went back to school and obtained my BSN in my mid 30's. I took advantage of all the classes I could at work. I became a BLS instructor, then ACLS and PALS. I became a preceptor, mentor and teacher.

Now I am one of the "older" nurses. I work full time, recently obtained my CEN, still teach ACLS and BLS, serve as preceptor, committee chairman of several committees. I have begun work on my Masters and will complete it just before my 60th birthday.

My husband died 4 years ago, my children are grown and on their own. I make as much money as I want to. I work overtime, fill in anywhere I am needed and am a team player. I own a modest home, a 3 year old car and a dog. I have worked hard to get where I am.

So my comment to anyone who complains about my salary, the hours I work, or how "entitled" they are to what I have would be....so what! This is America. It is a free country and still the land of opportunity. Often opportunity is disguised as hard work and sacrifice, so many don't recognize it! I am entitled to work as long as I want to and do with my money what I will. I tithe 10% to my church, regularly volunteer for service projects and offer my time freely to those who need it. But even if I never gave anything back, it is still MY choice.

If I wanted a doctor's salary, then I would have gone to med school. If I wanted a CEO's salary, I would have gotten an MBA. I don't care how much they make or what they do with their money. It is their money!!

So if anyone wants to whine about their situation, it is up to them to change it. Be your own advocate. You can't expect anyone else to. The ONLY person on earth who is responsible for my health, safety, warmth, well being and happiness is ME! And I am always looking for ways to make that happen!

Fiona59 · Jun 17, 2012

I think I'm seeing a huge cultural divide here.

My country used to have mandatory retirement. You reached 60 (female), 65 (male) and you were retired with the national pension and any work plans you had paid into. Then in the mid-80s the mandatory retirement laws were challenged and our Supreme Court did a way with them. The strange thing is, it wasn't your secretaries or labourers who went to Court, it was the upper management types. I have worked with managers who were well into their 70s when they left. They were not that productive but they were in management and until it became glaringly obvious that they weren't pulling their weight they were permitted to stay incase they went back to Court.

You rarely see this "I want to work forever" atitude in people who do hard physical work. Police retire at 55 or when they have 22 years service. The military are the same. Ultrasound Techs go as fast as they can. Dietary, housekeeping the same.

It seems to be very American to want to hang in forever. Perhaps it is also due to the lack of a social support network that the US is seen to have around the world. Little in the way of national pension plans and universal healthcare.

My hospital has fewer than six RN who are doing the hang in there thing. Their union has to support them because they used to be stewards or very vocal in their "I will go to Court" statements. They are slow, tired, and two are downright dangerous. One is older than the bulk of their patients. Their Union knows, their professional body knows, management knows but not one level wants to deal with it.

One unit that has an RN who is pushing 80 jokes that they need to know her code status. The patients have reported her crankiness and down right brutal attitude towards pain control. She disappears for very long breaks and no-one knows where she is. Yet, she knows "her rights".

Ruby Vee, BSN · Jun 17, 2012

i am a new grad. a chief of staff of a major northern california health system told me, "rns and their high salaries made new graduate programs cost prohibitive." i work in a hospital . and work with a few people who could retire. but they've opted to continue working, buying property, cars, while i work every day, rent a room in a house , wishing i had the same opportunities they were given as a new grad. the high paid bay area rn just isnt sustainable to the future of nursing.

it's not rns and their high salaries that are cost prohibitive -- it's executives with their solid cherry office furniture, sky high salaries and mega-bonuses.

i hope you're not implying -- as your post suggests -- that it's up to people who can retire to do so in order that you can have more opportunities. people who are close to retirement age and continue to work don't do so in order to make things more difficult for you -- they keep working to pay for the educations their children are getting, and to recover the retirement savings they've lost in the market.

danarooo, BSN, RN · Jun 17, 2012

I understand the frustration felt by the op. I am a "new grad" and can't find a job anywhere. I don't blame the odler nurses, I value them because they are here to teach us what we don't know...which is a ton!

I am just angry at the greed of those "haves" who are screwing the "have nots" which has resulted in the mess our country is in and my not being able find a job. I did read the post about IV's and I was astonished that schools were turning RN's loose not having taught IV skills. I am out of practice since I graduated over a year ago and haven't landed my first nursing job, but I know how to do IV's. Our school insisted we know how to manually calculate medications without the awesome and fancy pumps that now do that for you. As a matter of fact, we took a test each quarter and if you didn't pass you were out of the program.

I know we, the new grads are expensive to train and have to be taught so much but dang it I need a job. I want to be a nurse, I spent so much time and soooo much money and my poor family went without for a long time for me to accomplish this goal to provide us a better life and now I can't. I wished new grads all over the country could come together with the help of the experienced nurses and do something to try to figure this out. I don't see nursing associations doing anything about this issue, haven't heard a word about it from them (maybe their talking, I haven't heard it though).

Something has to be done, so many nurses are floundering and can't find jobs. When things begin to get better, will those who are supposed to be there to take the place of the aging nurses going to still be around to do that when it is finally time? I know for me, I've thought so many times about looking to something else as I've hit rock bottom and had so much frustration and hurt at the failure of my goals. I never thought I'd think I made a mistake picking a profession I so dearly wanted to be a part of.

DoGoodThenGo · Jun 17, 2012

Do Good.....CNA here was for shock value I think.......
CNA here is the California Nurses Association.
I did a double take as well.
:paw:

OIC. Never mind then.

Please carry on!

DoGoodThenGo · Jun 17, 2012

I think I'm seeing a huge cultural divide here.
My country used to have mandatory retirement. You reached 60 (female), 65 (male) and you were retired with the national pension and any work plans you had paid into. Then in the mid-80s the mandatory retirement laws were challenged and our Supreme Court did a way with them. The strange thing is, it wasn't your secretaries or labourers who went to Court, it was the upper management types. I have worked with managers who were well into their 70s when they left. They were not that productive but they were in management and until it became glaringly obvious that they weren't pulling their weight they were permitted to stay incase they went back to Court.
You rarely see this "I want to work forever" atitude in people who do hard physical work. Police retire at 55 or when they have 22 years service. The military are the same. Ultrasound Techs go as fast as they can. Dietary, housekeeping the same.
It seems to be very American to want to hang in forever. Perhaps it is also due to the lack of a social support network that the US is seen to have around the world. Little in the way of national pension plans and universal healthcare.
My hospital has fewer than six RN who are doing the hang in there thing. Their union has to support them because they used to be stewards or very vocal in their "I will go to Court" statements. They are slow, tired, and two are downright dangerous. One is older than the bulk of their patients. Their Union knows, their professional body knows, management knows but not one level wants to deal with it.
One unit that has an RN who is pushing 80 jokes that they need to know her code status. The patients have reported her crankiness and down right brutal attitude towards pain control. She disappears for very long breaks and no-one knows where she is. Yet, she knows "her rights".

It really isn't fair to compare the United States with the UK or EU countries when it comes to retirement. As you mentioned we do not have a very generous state pension scheme here, and while there is Social Security at best it will provide one-third to one-half (IIRC) of one's pre-retirement income. The rest must come from savings, investments,assets or such.

Amercians as a group have been famously bad for saving and that includes for their senior years. Private employers are dropping or reducing pension schemes fast as they can in favour of 401K style investment schemes where the employee is in more control of their retirement funds.

Due to the recent economic upheval/credit crisis many of those at,near or in retirement have seen the value of their investments including assets such as homes drop. Thus many have no choice but to continue working or return to work in order to repair the damage.

In order for someone around 65 years of age to retire in the United States, and by "retire" those in the know mean totally unemployed, the average US citizen today requires nearly or over one million dollars in assets/wealth. The average American 50+ years of age barely has 1/3 to 1/4 of that amount, and the numbers get worse for those aged 40 to 50.

DoGoodThenGo · Jun 17, 2012

I understand the frustration felt by the op. I am a "new grad" and can't find a job anywhere. I don't blame the odler nurses, I value them because they are here to teach us what we don't know...which is a ton!
I am just angry at the greed of those "haves" who are screwing the "have nots" which has resulted in the mess our country is in and my not being able find a job. I did read the post about IV's and I was astonished that schools were turning RN's loose not having taught IV skills. I am out of practice since I graduated over a year ago and haven't landed my first nursing job, but I know how to do IV's. Our school insisted we know how to manually calculate medications without the awesome and fancy pumps that now do that for you. As a matter of fact, we took a test each quarter and if you didn't pass you were out of the program.
I know we, the new grads are expensive to train and have to be taught so much but dang it I need a job. I want to be a nurse, I spent so much time and soooo much money and my poor family went without for a long time for me to accomplish this goal to provide us a better life and now I can't. I wished new grads all over the country could come together with the help of the experienced nurses and do something to try to figure this out. I don't see nursing associations doing anything about this issue, haven't heard a word about it from them (maybe their talking, I haven't heard it though).
Something has to be done, so many nurses are floundering and can't find jobs. When things begin to get better, will those who are supposed to be there to take the place of the aging nurses going to still be around to do that when it is finally time? I know for me, I've thought so many times about looking to something else as I've hit rock bottom and had so much frustration and hurt at the failure of my goals. I never thought I'd think I made a mistake picking a profession I so dearly wanted to be a part of.

Thing is it is not just a staffing issue, though that plays a large role in the problem, but a shift in how healthcare is provided in the USA which is growing and likely not going to reverse.

While many nurses are trying to land or keep hospital jobs, facilities are finding ways to do more with less professional nursing staff (RNs and LPNs).

Mandated staffing ratios would help some parts of the problem of nursing not being able to find work, but it can do nothing to address the push towards more community focused healthcare.

Federal, state and local governments along with insurance companies are pushing to keep people *out* of hospitals in favour of home & ambulatory care in the name of cost saving. In response hospitals are dropping the number of inpatient beds often in favour of outpatient services. The latter means you don't always require more than one shift of nursing staff.

Just in time staffing is becoming more and more common where the nursing service is tuned to census counts. In the old "a nurse is a nurse is a nurse" days one could be floated around to different units which may not have been fun but at least you worked/got paid. Now with everyone so specialised that often isn't possible.

Healthcare services are somewhat unevenly distributed in the USA. In many areas there are far too many hospital beds for the population, others too few. As demographics shift and for other reasons there is bound to be a shake down where we see more closures in some areas of the country while others will see expansion/openings. For local nurses that is not always good news as not everyone can pack up and move to say North Dakota.