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

Specializes in Case mgmt., rehab, (CRRN), LTC & psych.
And to go back to what the OP said. I've never once had a patient ask for a "cute nurse only." I've had them ask for only females but that is generally in good reason.

Some patients and family members prefer physically attractive caregivers and will reject nursing staff members whom they deem too 'ugly.' Also, many hiring managers are biased toward good-looking applicants:

I listened to a testimonial in church whereby a relative of a patient told a nurse, "Sorry, you're too ugly to care for my grandmother." Another relative retorted, "I'm sorry, but you are too ugly to care for my grandmother." The nurse was hired on a private-duty, hospital basis left immediately and did not return. The congregation in the church laughed in response to hearing the story. I did not and do not think it's funny.

. . .We get all sorts of complaints/requests... patients who don't want "male" nurses, or the "ugly" nurse... there are patients who would prefer they not have the "too cute to really be a nurse" nurse or the "old hag." Do you get the picture?

It's a well-known fact that attractive people are going to be preferred to represent a company. The person hiring may/may not be aware that they are choosing the more attractive person, but 9 times out of 10 they'll pick the pretty one. This isn't just nsg...

No question that the obese are often passed over for employment, as are ugly people, people with physical deformities, and people who are poor and don't dress well. Yes managers do "NOT" hire someone simply because they do not like the person, as well as because of qualifications.
Specializes in Pediatrics, Emergency, Trauma.

*** Uh, they dont hate change. They hate change for the worse. They hate changes that will reduce their abiliety to provide high qualiety nursing care. They hate changes reduce their pay or benifits even further and they remember a time (very recently) when nurses pay and benifits got better each year.

^This!!!

Most of what nursing fights for gets cyclical...and this is usually the bottom line. I have exited for change after change; I have stated at places where "young and new" brought a lot of problems with pt care, almost to the point of liability issues. They cleaned house; however, the damage had already been done.

That is NOT "EATING THE YOUNG". It is concern for patient safety.

This point of "old nurses leaving in droves", WHY??? I remember one nurse telling me she stayed at one ace when's he was "fresh and new" while the older ones left; the facility was closed within six months. HER PRIDE on that ridiculous "mantra" made her miss the importance of the WHY the experienced ones were leaving. The "young" was strictly a money move, that is played to save dollars...in this case it was implemented, but didn't save the facility, so this "young" nurse was out of a job.

She always told me: "It is NEVER about YOU. Don't take it personal. Keep you eyes and ears open about how a hospital works, and what they are willing to do to their employees. If anything, make that your lesson; learn what you can, and, above all, keep the patient safe."

That nurses advice has saved me from burnout, being allegedly "eaten" and will allow me to stay for another 30+ years. And, with hindsight, is fa fact.

Specializes in Pediatrics, Emergency, Trauma.

Some patients and family members prefer physically attractive caregivers and will reject nursing staff members whom they deem too 'ugly.' Also, many hiring managers are biased toward good-looking applicants:

^This!!!

Specializes in Intermediate care.

*** Uh, they dont hate change. They hate change for the worse. They hate changes that will reduce their abiliety to provide high qualiety nursing care. They hate changes reduce their pay or benifits even further and they remember a time (very recently) when nurses pay and benifits got better each year.

But you don't make the decisions. New grads will go with any change. That's what hospitals want...its a business! Its the way it goes.

When I said experience doesn't matter I meant LIFE experience. It doesn't matter to me the struggles you've had in life or the other jobs you've had.

New grads are smart, fresh,eager to learn and more accepting of change. We had a huge exit of staff because they hated the change. This opened up doors for us newbies.

And yes when I'm 50 years old the same thing is probably going to happen to me. I'm going to hate it and ill be jealous over the 20 year olds getting hired. But ill remember I was there once too. The hospitals do not care "that it isn't fair to you." Yes it sucks and I'm sorry about that. But nursing is a competative world. We all had to fight for our spots in school and we will fight for our jobs. We stared out with 250 students declared nursing the first year. 97 got accepted and 77 graduated. 250 from 77. Clearly if I can make it through that I have something to offer. Yes I have brains, but I also bring other things with me. My coworkers I think were a little threatened by me at first. But once they stopped judging me on my looks, my age, my size then they saw WHY the hospital hired me (other thn the fact that I get paid half what they so).

You guys are the ones being so judgemental. There is nothing wrong with being young and taking care of yourself. I am slim, but it is because I take care of myself. I take pride in my looks/hygiene. On top of that I take pride in my success, my job. And I am good at what I do. I LOVE hearing stories from my older nurses of how hospitals used to run. But that doesn't make her better than me.

And to go back to what the OP said. I've never once had a patient ask for a "cute nurse only." I've had them ask for only females but that is generally in good reason.

Jenni811, being lectured about life by a 24 year old is a bit tiring (no offence to other 24 year olds who are not presuming to give lectures about life). When I or my family are hospitalized we hope and pray we will get a nurse with a decent amount of life experience (more than just your personal experience of being in an accident), along with competent nursing/strong patient & family member advocate abilities. We don't care about your looks, how smart you are or much of anything about you, except that you can deliver competent, intelligent nursing care. That life experience that you consider unimportant is in fact very important in complex patient/family situations: It is what enables you to understand situations and to have the necessary insight to inform your action. One is not born with life experience, and at 24 one has not accumulated a lot of life experience (yes, I know you were in a car accident and have experienced being a patient in ICU, and know all about being a patient and being a nurse).

I wouldn't worry too much about your co-workers feeling threatened by your good looks and brains. I suspect you are over-estimating your own importance.

But you don't make the decisions. New grads will go with any change. That's what hospitals want...its a business! Its the way it goes.

If new grads will really go for ANY change, then this profession is in more trouble than I thought.

Really? You're going to lecture experienced RNs on "how hospitals work" and the ins and outs of business? You deserve the storm that's coming to you.

Specializes in Pediatrics, Emergency, Trauma.

If new grads will really go for ANY change, then this profession is in more trouble than I thought.

^ THIS new grad and many new grads with life experience behind them DO NOT go for ANY change....

Most people these days abhor BS...including myself. If it smell like it, sounds like it, and they want me to script and speak it and taste like BS, I will move on...and I have in the past.

Specializes in geriatrics.

Everyone DOES deserve respect, regardless of their circumstances, and respect is earned. No one is disputing this here. However, the common theme is this: "you don't know what you don't know." Certainly, one can acquire life experience from a young age. I know I did. Nevertheless....I was not naïve enough to think that I was as experienced at 24 as I would be at 40, 50, or 60. We are all evolving, learning, and changing. If you understand this, you're one step ahead in life. You (and I mean this in the general sense) need to be around long enough to "get" it.

Specializes in Pediatrics, Emergency, Trauma.
Everyone DOES deserve respect regardless of their circumstances, and respect is earned. No one is disputing this here. However, the common theme is this: "you don't know what you don't know." Certainly, one can acquire life experience from a young age. I know I did. Nevertheless....I was not naïve enough to think that I was as experienced at 24 as I would be at 40, 50, or 60. We are all evolving, learning, and changing. If you understand this, you're one step ahead in life. You (and I mean this in the general sense) need to be around long enough to "get" it.[/quote']

^AMEN!!!

I think some people are confusing the word "respect" with the word "courtesy".

Everyone equally deserves to be treated with courtesy. But respect, by definition, is earned.

Does the new grad just off orientation deserve the EXACT SAME level of respect as the nurse who's been working on the unit for decades?

Specializes in ER trauma, ICU - trauma, neuro surgical.

I gotta say...this thread is actually pretty good. No matter what side you are on, you gotta love a hot debate!

Specializes in Intermediate care.
I think some people are confusing the word "respect" with the word "courtesy".

Everyone equally deserves to be treated with courtesy. But respect, by definition, is earned.

Does the new grad just off orientation deserve the EXACT SAME level of respect as the nurse who's been working on the unit for decades?

Um, yes. They get paid more but they earned that. So no argument there.