Finding a Good Nursing Job Used to be Easy. Now is Like any Other Profession – Hard
Before 2008 was a different time for nurses and nursing. Back then young nurslings were already being recruited after graduation – not anymore. There was usually two new-grad program openings for every nurse. One could be sure that nursing was worth the hard work and the money spent. That was a almost guaranteed place.
Nurses were needed and valued and the proof was in your pocket. Oh boy, times have changed. I wish I didn’t have to write this post, but I’m just sharing my experience since I graduated in 2010. So before you decide to plunge into nursing and spend money and energy, please find out if nursing still and reliable and employable profession. I still think nursing is a noble profession, but be prepared to find a reality that is different than the adds you read sponsored by nursing schools.
Before 2008 Med Surg. positions were frowned. New Grads were looking for ICU’s, ER, or L&D jobs. Today you’ll be lucky to get a Med Surg. job. Competition is fierce and employers are fussy, positions have been eliminated. Large hospital conglomerate buy small hospitals and consolidate care eliminating staff. Insurance companies limit coverage, employers offer no insurance and less people get treated. With less people treated less nurses are needed.
However there will always be a need for nurses and nurses with experience are still being hired. Less then before but still some are hired. The problem is that training have came to a halt. Not training new nurses became a money saving technique widely used by hospitals looking for ways to increase profits. And with so many experienced nurses out there; why train new nurses?
- You can have a nursing license but without training you are not a nurse
According to various articles, costs for training a new grad vary between 15,000-50,000. With so many experienced nurses looking for work, its a no brainer, there’s no need to train new nurses. Stop new training programs and watch the savings. And so hospitals did. New-grad programs today are a far cry from what they used to be. Few hospitals take a few. The lack of training makes it almost impossible for a new nurse with a license to get a job in acute care. No matter what you do, no matter how many applications you fill online, your lack of experience freezes you on the spot. In nursing you can’t train yourself. You can’t go out and build your skills. You are either let in or you’re not, and that’s a pretty darn powerless position to find yourself in. The other big problem is that as time goes by it doesn’t get necessarily better.
- Welcome to the nursing catch 22
This is a well known conundrum in nursing as well as in other professions. You can only work if you have experience and how are you going to get it if no one hires you. This well known catch 22 is worst in nursing due to the highly controlled and regulated nature of health care. There are very few shades of gray between those who are ready to be on their own and those who are not. You simply have to be trained by a hospital or no one will hire you. Hospitals and clinics are under tremendous scrutiny by the state who monitor their every single move. There are rules, rules and more rules. Fines are huge and hospitals are very conservative places.
- The “old new grad” limbo: a tough place to be
Fortunately some people get jobs. About half of the new graduates get jobs, but if you don’t get a job within a year, you are in a pretty strange place which I call the “old new grad limbo”. You no longer qualify as a new grad and at the same time you don’t have any experience. You are stuck in a uncharted territory with no one to lend you a hand. Your friend who have gotten jobs don’t want to hear about the “no job crap” anymore. They are happy gaining experience and making good money. Your school can’t help you either and your are basically on your own. But wait there is hope; help is on the way.
- Enter Versant, RN residency and volunteering programs
These programs are designed to fill the void and give you the experience you so need. That’s great, but only if it were true. Unfortunately these programs don’t guarantee you job placement or the one year experience you desperately need. But the worst part is that not only you have the humiliation of working for free but you actually have to pay to have this experience! With an average 80,000 debt in student loans the last thing you need is to spend more money trying to become a nurse.
The desperation of nurses who can’t get jobs after graduation is so great it pushes them into the hands of abuse. They end up paying for the opportunity to practice nursing for free. Such was the case with the “transition to practice” program at Sutter California Pacific Medical Center where students had to pay tuition fees of $200 plus fees for background checks, health exams, vaccination, and their own malpractice and liability insurance, among other costs.
Even more disturbing are the private companies who are partnering up with hospitals. These programs have no public transparency and should be reported. Please read more about transitioning programs in a article from the National Nurses United. Please report programs who are taking advantage of nurses to: NationalNurse@NationalNursesUnited.org
So without having any place to go people flock to the net. That’s great and there are so many resources on the net. But the internet has it’s own evils too. The internet can help you but it can also be used as a tool to keep you cast away.
- The internet helps your would be employer keep a distance from you
If you are a determined individual and most nurses are, you go out of your comfort zone and meet people one on one. You introduce yourself, shake hands and hand out resumes. These actions are now for the most part a waste of time. Managers will talk to you, or not. Sometimes they simply hide from you. The reason is because they now have little power to make recommendations to HR.
The new corporate model hospitals have now adopted removes the power of managers to make indications. Everything is handled by people in other departments or above them. Large hospitals have HR in different locations and everything is done online and not at a local level. Because there are so many nurses looking for work they will hand pick who they want. Your efforts in showcasing yourself are basically useless. The only currency with value today is experience, and that you wont be getting unless they train you.
- What can you do if you do if you’re drowning in this nursing nightmare
Now that I have made you completely depressed let me say a few words of encouragement. Don’t be negative, things change. In fact they might change quite quickly, suddenly and unexpectedly. I know how hard is to keep you skills and hopes alive but if you do you’ll be rewarded in the end.
- Start working in anything health care
- Continue to apply to every job you can
- Move to areas where no one wants to go
- Network, network, network
- Work in Nursing Skilled Facilities
- Despair or be negative
- Volunteer your way to a job
- Transition programs
- Wait for the perfect job
- Work in something else other then nursing
Again, I believe nursing is a incredible, noble, worthwhile, and rewarding profession. The obstacles we now have may be temporary and relative to a ever changing economy. Nursing changes and it is just like working on a floor; everything changes unexpectedly and quickly. Remember that if you become a nurse, only you can do the job of a nurse. This translates to something like: “when they need you they really need you”.
If hospitals are not hiring other places might be. Nursing homes and clinics can be a good place to start and there is always something to learn in these places in fact there is a lot to learn in these places. I think one mistake some new grads make is to not do anything and wait until a hospital job or “the perfect jog” comes up.
Things will get better. They are already getting better. In the Bay Area, a highly competitive market where pay is one of the best in the country, hospitals are staring to hire again. Unfortunately because there are so many experienced nurses looking for work, untrained nurses are at the end of the line.
However the new grads who have been busy are first in line to be hired. So get busy. Volunteering might be good but don’t expect to be hired by the institution who you volunteer to. In a few years from now things might quite different but no one knows for certain when will that be. Good luck and keep trying.
- Article on the National Nurse Magazine
- Lost Generation
- Decrease New Graduate Nurse Orientation Costs by Using HESI Exit Exam Scores
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Image credit: Andrés Nieto Porras