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 Oncology (research).

Am I missing something? I don't think the post was aimed specifically at younger nurses. The writer clearly said its an observation and she is talking about her facility. the writer even states that young nurses have to start somewhere. The post was about what a facility is doing to obtain higher Press Ganey scores and how it's about money. Referencing her observations of these newer nurses sitting at the nurse station and looking at their phones is just that...an observation.

There are all types and ages of good and bad nurses. It would seem to me that a place for people to post their stories should be respected and not turn into a huge us against them mentality. These actions just make nurses seem unprofessional. I truly apologize to any new nurse who has experience bullying, but remember there are new nurses who also sit and gossip about older nurses and they get bullied too. I obtained my ADN when I was 38, so I was a bit older, and I have had great experiences. I think there were a few bad apples (nurses) in my training, but I also new that in a profession that requires nurses to perform many types of duties...you better keep up with your nursing education (doesn't mean further education, although it's a great idea). You gain respect by giving respect, and you can't be afraid to admit that you don't know something and ask for help. On the other hand, when you are asked for help you should understand that someone is looking to you for guidance and provide the help/assistance because they may be taking care of you one day.

Nursing is a professional career, but I wonder why they don't include a professional class or section in nursing schools. Students in a nursing class are no longer just young kids, but a wide range of people that come from a wide range of experiences and cultures. I would think since we are all going to have to work together that professional collaboration education would be started in nursing school.

Brandon, I hate to disagree. High admiration as respect is earned. Sincere courtesy requires respect; that is, respect in the sense of reverence for life, reverence for others. Courtesy may be mechanical, but true respect for life and others is a core philosophy that extends from oneself to other human beings. Respect on the level of high esteen and honor is different.

I am talking about respect for fellow humans as people, persons, individuals--not something on the surface. Again, I am talking about an issue of grace, whereby the respectulness is not superficial, but it is genuine.

What I am talking about has nothing to do with the level of honor and respect toward someone for which you would emulate, or for which you have deep admiration. That is the earned kind of respect and honor.

That is very different.

What I am saying is a core philosophy of how to approach fellow human beings, and ideally it's the best way to deal with others--even when they are a pain in the orifice. And for sure, it's not always easy. ;)

samadams8, I agree with you completely that sincere courtesy requires respect, and that all human beings are worthy of being treated respectfully. I know that when I clicked like for Brandon's post I was including respect as part of sincere courtesy, but I was also acknowledging the kind of respect that one earns through consistently practicing one's profession well over time, and through upholding the values of one's profession.

I became a nurse at age 38 and I'm now 46. I seem to look a lot younger than that to most people. Whenever it has come up for me to reveal my age (for example when people ask how old my children are -- they are currently 3, 21 and 24), people always reply that they are shocked and thought I was in my 20s. Sometimes I have thought my youthful appearance worked against me. Patients and their families seemed to think that because I looked young, I wasn't as skilled or knowledgeable as my fellow nurses of a similar age. As far as I'm concerned, I know of many excellent nurses in their 30s and 40s and beyond, and I believe someone in their 20s can be a very good one as well. However, I am convinced, even after 8 years of doing this job, that there is simply no substitute for experience in nursing. No matter how much book learning you have, it takes experience and skill to be a good nurse. I'm sorry to read in this article that hospitals and patients are apparently becoming so focused on youthful appearance. I frankly don't care about the age or size of the backside on my nurse, only that he/she is kind, responsive, and gets my IV/foley cathether/NG in on the first try with a minimum of stress, suffering and mess!

Specializes in Pediatrics, Emergency, Trauma.

What about when they have $60,000+ debt to pay off for their undergrad? What about when they have mortgages and kids and bills?

You think a lot of nurses aren't leaving nursing because they love the way nurses are treated? LOL

It's the same issue either way--economics--utility. You can look at it this way from the nurse's perspective or the company's (hospital's) perspective, but in the end it's about basic economics.

You have to be able to show added value for dollars spent on you; and that's getting harder to do in the current economic situation. It's about economics urvival.

Also soldier, think about. In a few years the new nurses will become"old" in the sense of dollars and willingness to take a lot of crap.That's why these hospital-based residency programs that many places are "good" for hospitals. They can cycle through new grads or very newbies year after year--picking up newbies and dumping those that don't "fit" anymore. Nurses are furniture. They are disposable, and even though you have to understand the economics, the professional influences in nursing have not done enough to change this when places treat nurses as disposable.

Since that is unlikely to change much, and in my life as a nurse--a time when nursing and healthcare have seen the biggest changes at one generational point as ever in history, it's about continually re-inventing yourself in order to survive. For me it's not about becoming like those that treat nurses as disposable or play games--political or otherwise from within.

I determine my value and worth on my terms--and my terms of quite reasonable. I will compromise only to a point of honest fairness. In order to do that, one has to be able to have more than one position in this field. Again, you have to be like the sharks that must keep swimming in order to survive. I don't mean acting as sharks in the sense of how to treat others. No. I mean to be as a shark in the sense that you are always able to work, and if that means having to work for more than one employer and so forth, so be it.

In this environment, nurses can't put all their eggs in one basket. God knows the healthcare employers aren't doing that. You have to be at least as smart as they are in this regard.

^Well said!!

Specializes in Pediatrics, Emergency, Trauma.

Deserve really has nothing to do with it, b/c it's about grace.

^THIS!!!!

Specializes in LTC, CPR instructor, First aid instructor..

I havn't seen any posts about wisdom. Wisdom comes with age, and many older nurses, and granted, s select few younger ones in their 20s and 30s have gained a lot of wisdom. It helps with dealing with a difficult patient, because they have had more experience with difficult patients. I believe they also have a more mellow attitude. That too comes with experience.

Honestly, any more, it's a guessing game when it comes to predicting when/why someone will leave. What will ruin them faster? Abuse or bankruptcy?

I mean ^this is a good point, but when push comes to shove, people will put their survival first, b/c they have to do this.

Doesn't change the idea that nurses that are younger, inexperienced, less risk health-insurance-wise, with an eagerness to get started and start paying down those student loans, are something hospitals are counting on IMHO--especially taken with the "only hiring BSN" deal. And many places will take an application and have a job post without saying BSN required, but, in general, you can be sure that's what most are using right now. They may not have written in their employment posts, but that's their reality. You have a much lesser chance of getting hired without the BSN at this point. They don't have to say it on their job posting.

Am I missing something? I don't think the post was aimed specifically at younger nurses. The writer clearly said its an observation and she is talking about her facility. the writer even states that young nurses have to start somewhere. The post was about what a facility is doing to obtain higher Press Ganey scores and how it's about money. Referencing her observations of these newer nurses sitting at the nurse station and looking at their phones is just that...an observation.

I have to disagree with nursing being a "professional" career. It's more like a wannabee professional career in reality. Many may try to argue this, but most nurses on the clinical frontlines that have been in practice for a while will agree. True professionals aren't so openly and frequently treated as disposable.

I havn't seen any posts about wisdom. Wisdom comes with age, and many older nurses, and granted, s select few younger ones in their 20s and 30s have gained a lot of wisdom. It helps with dealing with a difficult patient, because they have had more experience with difficult patients. I believe they also have a more mellow attitude. That too comes with experience.

I think wisdom may come with age but not necessarily. There are many things that go into making a person truly wise. Usually a wise person will learn well from experience. An exceptionally wise and insightful individual will learn through the experiences of others, even though they will still have to walk through similar experiences on their own. It's just that they are wise enough to humbly take note of other experiences outside themselves and process them with good reasoning and understanding.

It's true though; time does change you. I mean you do learn not to get so bent out of shape about things thay you can't control or that may really not matter. You learn to see things are done in various ways and not just one way. You learn to see nuances that you may have missed before and put them together carefully with the overall picture. You internalize how easy it is for any one of us to make serious mistakes such that you strive to not take anything for granted.

What goes into making one an expert is not, however, time alone. It's what one has done and gained through experiences over time. And some people learn to apply the thinking and experiences earlier/sooner than others. There are different reasons for this.

But it is true that the process usually requires time; it's just that there are some exceptions. Everyone wants to be the exception or outlier; but in my experience it's like a human growth and development thing, and we need time to grow from strong applicational learning--the kind that builds up expertise and judgment. I mean it's also easy for nurses to get stagnate working in certain places. I am fortunate that I moved to keep growing. I wasn't afraid of the crazy inner city university centers that at times can eat you alive and may not even pay as well as other places. I always tried to work in teaching hospitals rather than just learn from a few community hospital nurses and docs. I also, again, learned that there are more ways to things than the one huge university hospital may dictate. They may adopt a particular approach, but it is not necessarily the only or best approach for every situation.

In reality though, you can't rush it or fake the learning process, and any person that would deem themselves an expert but resists a humble approach to continued learned is not really the expert they think they are. No one knows it all, and that's the reality in this world among humans. In general, like the plants grow in the garden, well, you usually can't force them to produce fruit before their time.

Specializes in ED, Informatics, Clinical Analyst.

Ever read The Jungle by Upton Sinclair? Young and hopeful guy applying for a job at the meat packing plant looking down on the older industry veterans who couldn't get work thinking they just had a poor attitude, were lazy, or whatever... and that he was better than them. This thread totally reminds me of that.

i see nothing wrong with how the employer hired a group of nurses in attempts to raise pt satisfaction scores.

without knowing what these women looked like, i could understand where pts might respond more favorably to a 'friendly, approachable' demeanor, vs those who may not have 'the look'.

again, i don't know what was going through their minds when hiring these people...

but would be hard pressed to believe that it was solely because of looks.

and, having 1-3 yrs experience does not = new grad status...

but they wouldn't command top $$ salary either.

all in all, and with the ltd and subjective info we have gotten...

i'm not seeing anything offensive at all.

leslie

Specializes in ER.

We have satisfaction surveys that get emailed to our floor when one of our nurses receives an outstanding compliment and is mentioned by name. The pretty nurses on our unit get far more of these than the others on the unit no matter how skilled or friendly the other nurses may be. It's gross and unfair but this is the reality of life no matter the situation or occupation. There have been plenty of studies done on this and it is just a fact of life that beautiful people are more well liked.