Job Perspectives

Have you watched TV, listened to the radio or driven down the road lately? Depending where you live you might be bombarded with frequent advertising about nursing degrees, especially from for-profit colleges. For some of us, these advertisements have influenced us to get a degree in nursing. Major news outlets also echo the great opportunity of employment with a nursing degree. CNBC¹ and Salary.com² state that Nursing is among the top ten most recession proof jobs. US News & World Report Best Jobs of 2014 ranks nursing as the number 6 best jobs, evening adding that “nursing is an indispensable profession in health care” (if only actual facilities felt the same way, that’ll be a discussion for a letter date) ³.  The media outlets aren’t the only source of positive employment opportunities for nurse, The United States Depart of Labor’s Bureau of Labor Statistics have calculated a 19% increase of available jobs for registered nurses ⁴. Due to such advertisement in 2011 the AACN reported that 169,000 people were enrolled into entry-level BSN programs, excluded are the entry-level ASN and MSN programs.

So is there really a large enough job market for newly graduated nurses and those enrolled in a nursing program? The American Association of Colleges of Nursing conducted a study of on entry-level baccalaureate and master’s of nursing job offers for 2011 graduates. The AACN found that at graduation 57% of BSN graduates and 73% of MSN graduates received a job offer, higher than the 25.5% average for all college graduate degrees ⁵. By 4-6 months AACN found that 88% BSN graduates had received a job offer, 92% for MSN graduates. But these findings are all dependent on where you live, and the same study of the AACN shows that it is more difficult for graduates in the West, only 42% of BSN graduates had job offers by graduation with 77% of BSN graduates having an offer by 6 months. Personally living in the South I found the AACN’s 66% job offer rate for BSN graduates hard to believe, in fact by 6 months the AACN found that 92% of BSN graduates in the south had job offers.

The AACN also reported that more than 39% of hospitals surveyed require a BSN for employment and more than 77% “strongly” prefer the BSN. Although I am currently pursuing my BSN degree, it has been my own personal experience that hospitals in Florida aren’t really hiring a large portion of the graduates from nursing programs in either BSN or ASN programs. The Florida Board of Nursing has 61 schools that offer BSN programs and 164 schools that offer an Associates of Science in Nursing listed on their website ⁶. Many new grads in Florida are accepting positions outside of hospitals due to the small amount of graduate nurses positions are available. I started in a long-term care (LTC) facility, and my first graduate nurse job offer in a hospital facility was outside of the state.

There isn’t a problem with LTC facilities in themselves; the problem is that outside of hospitals, there is little graduate nurse training. Even some hospitals do not have proper clinical orientation programs, which puts grad nurses straight to the floor without preceptors or any other guidance.  The lack of proper training or orientation for new RNs can lead to dissatisfaction, burn out, and turnovers. These turnovers are expensive, according to a Voluntary Hospitals of America study in 2002, it cost on average $46,000 to fill a lost position ⁷. Add a few more thousands and the cost of putting a new grad through a nurse residency can make some hospitals decide to provide only a limited number of entry level openings or none at all.

Other ways hospitals are protecting themselves from these costly investment gamble is by setting contracts for new grads that will assure the position will be filled for 2-3 years. On top of the initial contract some facilities can pay for these new assets’ education by tacking additional years of contracted employment in relations to the amount of money they hand over for tuition assistance. Breaching such contracts could leave a new grad owing the facility a few thousand dollars. Is this really what us new nurses need to jump through just to get into the profession?

There are 5 things that Adam Starr says you have to forgo if you want a nursing job; first, your dream job, second, your sense of entitlement, third, a great salary, fourth, lots of vacation time, and last being the boss ⁸. The positive thing here is that this is just your first job in nursing, and once you gain experience, well, more doors will be opened. Although it might be easy to become disillusioned with all the overwhelming difficulties facing new nurses today, the situation at hand is an opportunity for those with a struggle to advocate for changes in the nursing profession. Do not struggle alone and allow yourself to be burnt out of nursing never desiring to return. Nursing can be very rewarding professionally, emotionally and financially. Find a mentor who can guide you through tough times, have a support system in place to turn to after a long day, and continue to grow professionally so you can find that job that satisfies you. 

Like I mentioned before there are other health care facilities outside of hospitals that are hiring recent grads, like LTC and home health. With the so-called nursing shortage you’ll be able to find a job where your RN degree will be of use. Johnson & Johnson has a list of 104 nursing specialties, but there are a lot more. Ever thought about combining another degree with nursing? This is how forensic nursing and nursing informatics came about, blending two disciplines to fulfill a need. Here’s an idea, a science of nursing and architecture degree in this time where hospitals are now refocusing on the environmental affects on patients and families. Since nurses are an integral part of any health care facility, have the nurses’ perspective would benefit the design for nurses and patients alike; just look at the new John’s Hopkins building in Baltimore or Nemours Children’s Hospital in Orlando.

¹ CNBC. 10 Recession-proof jobs. Retrieved from http://www.cnbc.com/id/25702610/page/1

² Salary.com. Ten recession-proof jobs Retrieved from http://www.salary.com/Articles/ArticleDetail.asp?part=par1098

³ US News & World Report (2014). The 100 best jobs. Money career. Retrieved from http://money.usnews.com/careers/best-jobs/rankings/the-100-best-jobs

⁴ Bureau of Labor Statistics, US Department of Labor (2014). Registered Nurses. Occupational outlook handbook (2014-15 Edition). Retrieved from http://www.bls.gov/ooh/healthcare/registered-nurses.htm

⁵ American Association of Colleges of Nursing (2012). Employment of new nurses graduates and employer preferences for baccalaureate-prepared nurses. Research brief. Retrieved from http://www.aacn.nche.edu/leading_initiatives_news/news/2012/employment12

⁶ Florida Board of Nursing (2014). Education program search. Education and training programs. Retrieved from http://floridasnursing.gov/education-and-training-programs/

⁷ Kosel, Keith C., Olivo, Tom (2002). The business case for workforce stability. Voluntary Hospitals of America.

⁸ Starr, Adam (2014). 5 things you need to give up to get a nursing job. Scrubs: the nurse’s guide to good living. Retrieved from http://scrubsmag.com/5-things-you-need-to-give-up-to-get-a-nursing-job/