Young, Thin, and Cute New Hires

The management at my place of employment recently hired a group of nurses who are all youngish, slim, and physically attractive as a response to declining patient satisfaction scores. Is the solution working? We can only wait and see. Nurses Relations Article

My workplace, a freestanding specialty hospital owned by a for-profit corporation that operates multiple facilities across the United States, has been having recent troubles with low Press Ganey patient satisfaction scores. This does not bode well in an era where patient satisfaction scores are tied to Medicare reimbursement rates.

Patients typically complain on the survey forms about random issues such as the food, the semiprivate rooms, their loud roommates, and the aloof manner of some of the physicians. Some mention that nursing staff failed to keep them informed. Once in a blue moon a patient comments that the hospital employs too many 'foreign nurses' or has staff who cannot 'speak English.' Whatever.

To combat the chronically low patient satisfaction scores, the managerial staff implemented a mix of interventions which they believed would make patients and families feel more 'cared for.' Hourly rounds, bedside rounding at the change of shift, more scripting, and more smiles have been put into action without much positive effect on the Press Ganey scores.

"What was management's next solution?" you're probably wondering. Administration announced they were hiring good people who were more friendly, skilled, positive, and indicated during their interviews that they actually wanted to care for patients. Well, the latest new hires have initiated more questions than answers.

Where do I start? They are all youngish, ranging from early 20s to early 30s. They are all fairly slim, nicely shaped, and physically attractive. The most experienced new hire has about six years of nursing experience, while the remaining nurses have anywhere from one to three years under their belts. The majority have no acute care experience and are learning certain procedural skills for the very first time: starting peripheral IV access, administering blood, performing wound care, operating feeding tube pumps, and so forth.

Don't get me wrong. I'm not an 'old nurse' who is 'eating the young.' I am 32 years old with seven years of experience, and I had no acute care experience prior to taking a job at this facility several years ago. The new hires all have good personalities and are seemingly pleasant to work with. In addition, we all must start somewhere.

However, they are not necessarily more skilled or more eager to care for patients like management said they would be. Several of these nurses remain seated at the nurses station while staring into a smart phone as call lights are ringing. A few walk into patient rooms without employing basic relational skills such as knocking, introducing themselves, or explaining what they are planning to do. I'm not complaining; I'm merely observing.

Here are my thoughts on this issue. Rather than hire a mix of highly experienced and relatively inexperienced nurses, the managerial staff opted to save on labor costs by hiring younger nurses with a certain attractive look that patients and families might find appealing. They hired no new grads because, I assume, they did not want to spend the staggering amount of money on 3-month orientation periods. They hired no one with 15, 20, 25, or 30+ years of experience because human resources would be forced to offer highly experienced nurses a significantly higher rate of pay per the wage grid. They hired no nurses who were badly overweight, gray-haired, or outwardly appeared to have health problems that would drive up insurance costs. To presumably get the most bang for their buck, most of the new hires have between one and three years of experience.

How is this experiment turning out? We shall wait and see.

young-thin-and-cute-new-hires.pdf

Jenni811, you seem smart, driven and raring to take up the challenge of being the best nurse in the facility. But don't let your ego and IQ fool you into thinking that you know so much -- experience has a way of catching up to you and informing you as to just how much you do not yet know.

Here is a handy Latin saying I learned many years ago in Catholic school, from which you may benefit: "Acta, non verba". It was a hard lesson for me when I enlisted in the Army (at your age) having already earned my first bachelor's degree (giving me the false arrogance that I was "superior" due to certifications and a high GPA). Anyone with life experience will not be overly impressed by academic achievement like GPA and paper awards. This is especially so if they are backed up by only 2 years of real experience, and very little life experience. I learned early as a non-commissioned officer that rank (or office) will be rendered its formal/legal due by others, but the person bearing that rank or filling that office still has to earn the actual respect. When I got promoted, I was told by my experienced 1SG that in the real world, where things can go wrong and people can die, my college and my brand new sergeant's stripes meant 2 things : jack and squat. It was up to me to show (not just pass exams) that I was a capable soldier and a capable leader by my actions.

As an RN (and a student at the moment), I guarantee you this: I do not and will not demand respect from anyone when I'm on the unit. I realize that I am just a student, and even after I graduate, I will be just a newbie. But I expect to eventually have the respect of my peers and supervisors, but only after I have done things to earn it -- and not a moment sooner (and certainly not after only 2 or 3 years on the job!).

We tend to learn best from our mistakes. But life is short, so we don't have enough time to make all the mistakes we need to make in order to learn all we need to know. So take advantage and learn from the mistakes of others. Feel free to benefit from my prior error of ego, and ask yourself "what if I am wrong?" Hubris can bring some hard lessons.

Couldn't have said it better myself. My clinical instructor praised me at the end of our first clinical. I don't get compliments like that every day, so it meant a lot coming from an instructor I admire. That did not make me think I was destined to be the greatest nurse out of my whole cohort, though. Say what you will about CNA experience being "pointless" prior to entering nursing, but being a CNA taught me so much. The most important lesson was: It'S NOT ABOUT ME.

So let's make nice. Age and appearance do not determine nursing ability; however, they influence how patients view us and how much trust they are willing to give us. Actual ability and patients' perception of ability go way back (think Psychology 101!) to the halo/horns effect. Your management is probably attempting to tap into the halo effect by overestimating the influence appearance and personality have on Press Ganey.

It is experience and open-mindedness that make a great nurse. We are all taught that nursing is a science...and an art. You might be good at technical skills, but have atrocious bedside manner. You might be the sweetest nurse in the world, but can't start an IV to save your life. The caring, the knowledge, and the wisdom to make judgments are traits that every nurse needs and hopefully acquires as he/she moves through life and through their nursing career. Even when (if!) I pass my NCLEX, I recognize that I'm still not done. Just because I'll graduate with a BSN doesn't mean I know more than anyone. There is much to be learned from the LPN and the ADN who have spent decades on the floor.

Specializes in Med/surg, Quality & Risk.
How do you think one develops depth, strength, and character? Try life experience, which you don't have a lot of when you're young.

Unfortunately life experience can't be taught. They just have to learn through their mistakes. Til then they will continue to speak as if they know everything, and we will continue to be entertained by it. I am sure 50 year olds think the same of me.

could not have said it any better myself.

I am just wondering if this will turn into an epic thread? :lurking:

Specializes in inerested in school nursing, peds, OR.
Aging is not an accomplishment of some sort susie, nor does it impress anyone. It's something everybody goes through, even the morons. You don't get points just for being old, sorry.[/quote']

I have not read every post, but oh my this irked me. You don't get points for being old? What happened to respecting our elders? IMO, being old is definitely an accomplishment, especially for those who made the most out of life and gained as much knowledge as possible.

I pray to god I have an "old" knowledgable nurse to be my mentor when I get my first nursing job. I guess I have a place in my heart for the seasoned and wise or something, but this "aging is not an accomplishment not does it impress anyone" comment almost made me tear up.

Maybe since I did not read every post I'm missing something. (Hope so)

Specializes in Leadership, Psych, HomeCare, Amb. Care.

No, I did not read all 136 previous posts...

The original post does not appear to be a slam against young nurses, or new grads, but appears to point out that the organization may be hiring only younger attractive people. If they are hiring them over equally qualified nurses over 40 who have applied, that's illegal. If it is found that certain racial or ethnic groups are consciously, or unconsciously, considered more friendly and attractive, and being disproportionately hired; likely also discriminatory and illegal.

Specializes in Rehab, Med-surg, Neuroscience.

You are grouping all us new hires together. Not all of us have bad bedside manner. I always make a point of knocking on doors, pulling curtains, saying please and thank you, and addressing the patients with Mr. or Ms. and most of the other new hires I have worked with are the same way. If anything, I have seen some of (NOT ALL OF) the more experiences nurses disregard these simple manners, as if over time they have forgotten, or stopped caring.

So are you saying that because some of the new hires behave this way, you shouldn't hire them? Thats like saying that since experienced nurses are a certain way, none of them should be hired.

Being slim and healthy is a GOOD thing. You make it sound like its an unattractive quality. Are all nurses supposed to be older and overweight? No. Taking care of your body is a sign of responsibility and maturity.

Don't eat your young. And don't discourage your bosses from hiring honest, good, and respectful nurses just because they have less than 5 years experience. These "new hires" will be taking over for you someday when you retire, which you will. You may be SuperNurse, but you won't live forever.

Specializes in Peds/outpatient FP,derm,allergy/private duty.

I just read the OP's article for the third time. I just can't help but wonder if some of the replies indicate they either haven't read, or haven't comprehended what she was saying.

chrisrn24, does your mother have more life experience than you? Does a nurse with many years experience have more experience than a nurse with a few years experience?

Does my mother? Yes. But I've met 40 and 50 year olds who are naive and glib. So age is not an indicator of anything in my opinion.

Geez just because someone is old does not mean they automatically get my respect. Sorry.

I have not read every post, but oh my this irked me. You don't get points for being old? What happened to respecting our elders? IMO, being old is definitely an accomplishment, especially for those who made the most out of life and gained as much knowledge as possible.

I pray to god I have an "old" knowledgable nurse to be my mentor when I get my first nursing job. I guess I have a place in my heart for the seasoned and wise or something, but this "aging is not an accomplishment not does it impress anyone" comment almost made me tear up.

Maybe since I did not read every post I'm missing something. (Hope so)

I respect my elders who deserve respect. If you're 80 and naive and rude and disrespectful you do not deserve my respect because you're old.

Work as a server for a few months then you'll reconsider what I'm saying. I've met young respectful customers and old nasty men and women.

I don't respect people for their age but for their attitude, compassion, dedication and experiences. Not their age.

Specializes in Pediatrics, Emergency, Trauma.
I just read the OP's article for the third time. I just can't help but wonder if some of the replies indicate they either haven't read or haven't comprehended what she was saying.[/quote']

^Or internalizing...sometimes we have to take a step back and read the article...marinate-think about it. It's not about YOU...And I am using the term "you" relatively.

Another thing is how people read posts, and they hear a different tone while they are reading it and get in total offense and defensive mode, and it creates a total cyclical "pseudo-attack" when they can respectfully agree to disagree. If you are secure enough in your self, WHY the argument; heck even the "correcting" of how people should respond or post? That can be conveyed as rude or disrespectful as the rudeness or feelings of disrespect that you see in the words across the screen.

We can agree there is ageism and the illusion of what is "pleasing" does not always convert safe or competent practice. We all can understand that aspect. We agree, disagree, share, bond in a solution, or keep scrolling onto the next post. But we can just read the words, check what place and feelings are they coming from and respond...are you internalizing it for some reason??? Is there a reason to do so??? Or engaging in lively debate, no feelings hurt?

I hope for the latter for the sake of positive debate. :)

But I digress...my humble opinion expressed in words, not negative attitude or tone. :)

Not all new grads are young. Rising numbers are second-career students.

I'm a new grad and 42 years old. Career changer. Agree with your post and I myself am bringing a lot of energy into my new career!