Are we jeopardizing healthcare’s future by not hiring our new grads today?

You’re probably aware that many hospitals (and other healthcare facilities) across the country are not hiring new graduate nurses or are hiring very few. This has resulted in the newest members of our profession being forced to work in non-clinical settings right out of school, not finding any employment in health care for over a year after graduation, or leaving the profession entirely.  Hospitals cite that they do not have the funds, the personnel, or the desire to hire and train these new nurses. But, while as much as half of the current nursing workforce is poised to retire en masse and the healthcare system is increasingly stressed by the aging population, this trend will likely result in a catastrophic lack of experienced nurses over the next decade.   

To compound matters further, if a new nurse has been out of school for over a year, most hospitals will not place that nurse in its new graduate nurse orientation program, even if he or she does not have hospital experience. Additionally, it takes years for a new nurse to gain the valuable experience he or she needs to work independently, safely, and competently.  In other words, it takes a village, and time, to mold a newly minted nurse.

The impending nursing shortage is real and is predicted to be the worst one we have ever experienced. We had a similar situation in the 1990’s when hospitals were downsizing and laying off experienced nurses and not hiring new nurses. Then the need expanded and suddenly there weren’t enough experienced nurses to meet the demand. Patient care suffered. The next shortage will likely hit like a tsunami and where we all be then? We already know what happens when there aren’t enough experienced nurses at the bedside: mortality and morbidity rates soar.

What’s maddening to me (and even more so to new grads) is that many recruiters are telling these newbies that they must have one year’s nursing experience. This is confusing and frustrating to the new nurse. It’s better to just say that you are not hiring new nurses and leave it at that. And even though you may not want or need these nurses today, you will likely be begging them to come work for you in the not so distant future. So be kind, professional, and compassionate; they are your future workforce.
 
None of this is meant to imply that every nurse must start out in a hospital or even an in-patient setting because that simply isn’t the case. In fact, much care is rapidly shifting out of the hospital into the ambulatory and primary care setting and alternative in-patient settings. Some nurses entered the profession with the intent of working immediately in alternate areas such as public health, rehab and so on. Likewise, others and I are encouraging new grads to seek alternative work settings rather than stay unemployed. But that is easier said than done.

And for those of you who still think the problem lies in new nurses being too picky about shifts, specialties, and salaries, there are hordes of new nurses who would do just about anything for any type of nursing work on any shift, in any specialty, at any salary at this point in time. The new nurse job shortage is much more severe than many experienced nurses realize.

Healthcare/nursing administrators need to have a long-range plan for providing expert nurses at the bedside in years to come. You must prepare novice nurses to carry the torch when your current staff is ready to retire or move on. Each in-patient facility should commit to hiring a good number of new graduate nurses annually, support them in their professional development, and maintain a healthy balance of new and experienced staff nurses. New nurse orientation programs need to be extended to a two-year period of time post graduation. Facilities should consider offering fee-based refresher courses and internships for those who need or want them, regardless of how long it’s been since they’ve graduated. Otherwise, we will all pay the price in the future and the biggest loser will be the patients, who could be any of us or our loved ones.   

* Orirginally posted at American Nurse Today Online