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 Med-Surg, Ortho, Camp.

I am amazed at how many nurses are willing to stay with a hostile environment. I know there are many reasons for this, but the wrong job will kill you. Nursing is 1000 different jobs. Start looking, and take your time.

Specializes in Case mgmt., rehab, (CRRN), LTC & psych.
Its rather immature to write a long post obviously biased against new nurses and then state afterward you weren't meaning to be offensive.
And it's rather immature to take offense when no offense was intended.

I do not feel that my post/article was completely biased against newer nurses, but feel free to disagree. The beauty of living in America is the right to express our opinions, regardless of the fact that certain people will always interpret them to meet their own argumentative needs. Some individuals will always look for a bone to pick.

This is so interesting ! Not long ago ,there was a post that was asking for advice to HR questions for where I am presently employed ,and my response was - "As long as you are young and cute , you will be hired.". My Super Monster of a teaching hospital has always done this sort of hiring ,once the nursing shortage was over.

I was a flight attendant for seven years prior to pursuing my BSN. I can assure you that 90% of them do not look like this. Hahaha.

... Not today, but if you were a frequent (or even infrequent) flyer in the 60's and 70's you'd recall nearly 100% of flight attendants looked like that at many (every?) airlines, back when airlines had weight standards strictly enforced. Reminded me of an industry fashion show back then.

Decades ago when I worked at UPS (United Parcel Service) one driver described the clinic he went to and how all the workers looked. Where do you thin EVERY male driver (all but one of our drivers) went that year (and many subsequently) for that annual checkup/physical? The benefit to that clinic was obvious from a financial standpoint, not just that year, but subsequent years just on word-of-mouth from one UPS driver. Multiply that by other people spreading the word x pricey procedures and, well, you understand the financial impact.

I get it looking through the eyes as a person who runs a business. However I find it an unfortunate reality in healthcare. The practice of not hiring the new grad, and not hiring the highly experienced and or educated is proverb in the field of healthcare and education... There's a lot of highly experienced healthcare workers and PhD educators who can't find work. The number of people today not disclosing that they have a PhD is a sad testament.

Old guy with super long nose hair and hair growing out of his ears, or the frumpy old nurse with bad back and shrewd face, skilled hands and that partial non-fake, honest smile that lets you know she's got your back... But don't get on her nerves!

I couldn't care less, as long as I get the best care possible. ;)

Specializes in ED, Telemetry,Hospice, ICU, Supervisor.

Well there are plenty of new grads that are young, slim and willing to please management.

Its not like you can prove that they are hiring based on looks. If you look at their qualifications as long as they are legal RNs, they are authorized to work in the hospital as such.

From an learning stand point, it would most likely benefit me to hit the gym and lose some weight and perhaps some spray on abs. Marketability isn't just who or what you know, but also the public appearance you express.

Specializes in burn ICU, SICU, ER, Trauma Rapid Response.

To me the saddest part of this whole thing is that it is strong evidence of how far nurses position has eroded. Not long ago, pre-2008, hospitals used to fight for nurses. It was the hospital telling US why we should consider working for them. I remember in the little rural community college where I went to nursing school a nurse recruiter from a big, fancy out of state hospital came around. His hospital was offering to fly us down to their city and put us up in a nice hotel for a whole weekend if we would agree to sit through a 3 hour presentation about why we should consider applying to that hospital. This was for still-in-school ADN students. I aplied for 5 jobs in about March of my last year (only year in my case) of nursing school and interviewed at 4 of them over spring break. All of them, including Mayo Clinic offered me a job (what a stroke of luck for me I didn't accept the Mayo position). The 5th hospital didn't even wait to intervew me but offed me a job over the phone about 2 hours after they recieved my application. 4 of the 5 offered jobs were in ICU (what I wanted) and the 5th was for a combined ICU/ER postion in a small hospital. Several offered sign on bonuses. I ended up choosing one that didn't pay well but offered a 9 month critical care nurse residency program AND $5K in sign on bonus AND $5K in relocation assistance.

Back then hospitals had to treat their nurses at least reasonably well or risk RNs voting with their feet. Sure there were some dysfunctional units/hospitals but they were easy to spot and few RNs tolerated them for long, they didn't need to. Pay raises came around at least yearly, benifits were pretty good and not too expensive.

I remeber very well in 2008 when for the first time the hospital where I worked suddenly found itself with more RN applicants than it had openings. Most of our open positions were snapped up by part time RNs going full time and there was suddenly a line of RNs waiting for each open position. The change in managment's attitude was like walking into an industrial cooler on a hot summer day. Suddenly it was all "this is the way it is and if you don't like it leave" and "no pay raises this year".

This is a direct result of the planned glut of nurses brought about by the false and self serving "nursing shortage" propaganda. Even worse we nurses, though our tax dollars, subsidized the seeds of our own destruction when nurse employers lobbied state and federal governements to greatly expand nursing programs with tax payer money. My school went from one class of 30-40 students graduating a year to 2 classes of 70-80 graduates.

The awful truth is that most women are SO catty. Does it REALLY matter how a new nurse LOOKS as long as they're a great nurse and willing to help/learn?

Are you as threatened by the new nurses who are in their 40's-50's that went into nursing as a second career? The ones that aren't "young, thin, and cute". They're new too! Didn't you have to start somewhere too? I'm glad most of the more experienced nurses I've worked with (as a CNA) don't have that attitude towards the younger, new grads. It must be a nightmare for new grads working with people who think like this. Mutual respect goes a long way.

In Vietnam and China, ALL "female" jobs require you to have a certain look. It does not matter if you came up with the theory of relativity and revolutionized the world of science; if you are considered unattractive, you will lose the position to the ditzy teenager who slept with the HR manager. If by 'their' standards, you are slim and leggy with a cute face and a girly voice, you're hired. This is true whether you are a cashier at KFC or if you're a new nurse. Never mind logic.

There is definitely a shift from Nursing by Merit & Experience to Nursing by Customer Service. It's kind of sad that healthcare is shifting to a customer service model.

Specializes in CCU, SICU, CVSICU, Precepting & Teaching.
I don't think it is about looks. We too have hired alot of young, female, smaller build nurses. The turn over rate in hospital is huge, what nurse in their right mind would actually WANT to go back to bedside nursing?? A nurse in their 40-50's has probably figured it out and has been at the bedside and wants to be done at the bedside. So they leave it up to the young ones who need to figure that out, and need to gain experience before going anywhere else.

Oh trust me, i've heard our experiened staff joke around with things and let me tell you, it actually hurts. They all crack jokes about how it should now be a requirement that "You are under 30 years old, slim with brown hair and a bubbly personality." I fall under that category of "Slim, young, brown hair"...im not an idiot. but the question i have for them is, do you ever think to look beyond that?? How about the fact i graduated with a 3.7GPA and made the deans list 4 years running. how about the fact i worked nights as a CNA while attending nursing school? How about the fact i have worked my butt off getting certifications in things you probably never heard of. How about the fact that my computer skills are far more superior than the 50 year old they just interviewed that can hardly even type? Look BEYOND the surface of these people.

Yes, i think hospitals are hiring young, new grads because the are cheaper. It's a smart business move. if i were running a business and had to pick between a 55 year old with a great personality, 25+ years of experience and wanting $30.00 an hour and a 24 year old with 2 years experinece with a great personality and wanting $24.00 an hour...i would choose the 24 year old. The hosptial wants great satisfaction scores. A Patient really isn't going to care how much experience their nurse has (to a certain degree). Their satisfaction scores come from a smily face, a good personality, friendly nurses, good customer service etc. I've never heard a patient give a hospital a low satisfaction score because "My nurse only had 2 years of experience." So the way hospitals are shifting now days...experience really doesn't matter. I can do the same exact tasks as any nurse on my floor.

Im 24 years old, and i am already training to be charge nurse...i have an orientee with me that has a daughter 1 year old than me. Sure, she has admitted to feeling a little uncomfortable with me being her superior. She has stated once she got to know me that has changed. She has taken me seriously.

yea i do feel a little offended beause people judge all these newbies coming in. Look beyond that, get to know them. No i do NOT have my smart phone out all the time. I am professional when i am at work. yes ill pull it out on my break...because that is my BREAK, that is my time for me to be me and do want i want to do for 30 minutes. So yea...all in all, i have to say hospitals are making a smart BUSINESS move by hiring young, new and eager nurses to work the floors. They are cheaper and can do the same exact thing as any other nurse on the floor. I'm probably repeating myself a lot but think about it...

I'm in my fifties, and been a nurse much longer than you've been alive. I still enjoy bedside nursing and so do many of my peers. You claim to be offended "because people judge all these newbies coming in" and because the experienced staff joke around about needing to be young, thin and brown haired to be hired. You implore those experienced nurses to look at you a little deeper. I might ask you to look a little deeper at your experienced colleagues. And please don't make judgements about whether or not we're interested in bedside nursing.

The patients may not understand that more than two years of experience makes a more capable nurse, but you should. Two years is just about long enough to become comfortable in your job, and to think that you know everything, but not long enough to realize how very little you do know. It's a very dangerous time in a nurse's career. They're being asked to precept and to run charge, so they think they're all that. And they aren't yet. They've been identified as nurses who have potential to become great nurses, but not enough experience to be there yet.

Agism is alive and well in nursing, and especially, it seems, on allnurses.

Specializes in CCU, SICU, CVSICU, Precepting & Teaching.
it sucks, never said it didn't but its a smart business move because they are cheaper. Its kind of the same deal with ADN vs. BSN...a ADN can do the same, but more people want a BSN. Its the way it goes, tough deal.

I will probably hate it in 25 years but its reality.

It is never a smart business move to hire the cheaper, inexperienced employees exclusively without a mix of more experienced staff to train them.

Specializes in CCU, SICU, CVSICU, Precepting & Teaching.
I have a couple thoughts:

I've never liked the equating of being thin or muscular or physically fit with being shallow or vapid. If anything, I think it should be associated with positive character traits. It requires self discipline, motivation and hard work.

And, yes, of course any facility is in trouble if it doesn't have nurses with a wealth of experience. I don't care how bright and energetic or "up to date" new grads are. Experience trumps all. You don't know what you don't know 'cause you don't know it yet.

At 50, being thin, muscular and/or physcially fit requires self-discipline, motivation and hard work. At 25 all it requires is good genes and a modicum of exercise.

Specializes in OR.
At 50, being thin, muscular and/or physcially fit requires self-discipline, motivation and hard work. At 25 all it requires is good genes and a modicum of exercise.

Yet another example of stereotyping based on age.