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Easy. Tenured Professor. One of my professors is 80+ years old, and the university can't touch him.
Good program on NBC right now on doctor life
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Easy. Tenured Professor. One of my professors is 80+ years old, and the university can't touch him.
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Great Video, Thanks for the link🙂
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Well once your tenured you're very secure, but to get to that point is difficult. I have professors that are in their early 40s and not yet tenured. That means when the university has budget cuts, they risk losing their position. I've seen many professors either let go or demoted to half time.
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It depends on the person. There are people finishing residency that are in their late 30s to 50s, because they got into medical school when they were older. The same applies to grad students. The average age of a new grad student is 24 - 26. Add on 4-6 years of graduate school, and the average person is already in their mid-30s. Then they have to find a job after doing a postdoc. So the average person would be in their mid-30s to early 40s when they start their tenured-track. On the bright side, the majority of people on a tenured track do end up with tenure.
That was the average grad student. Some grad students get tenured tracked at 26-30, and have tenure before they turn 40. A PhD depends on the quality of the research, not just getting a degree. So I would say if you are a young intelligent individual, becoming a tenured professor is about the most secure job you can get.
So, NOT buying that at all. People have very REAL limits. When you haven't slept, you better believe you have less patience and can easily make MORE mistakes. You have to get the right experiences over time.
Put it this way, How often would you say simply cramming all night without sleep, week in and week out, is good for long-term learning and effectiveness in understanding something? People are physical beings with limitations.
It's the ultimate of hypocrisy in medicine to constantly tell and teach people in mouth only to take care of themselves as you train/educate people (and are trained/educated) by doing the direct opposite for themselves/yourself. It's beyond illogical. Yet b/c it is tradition and saves money, it has been done for way too long.
Besides, hand-off errors have to do with effectiveness in communication and proper logistics in maintaining continuity.
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Public school teacher, a UAW employee, garbage man, fire fighter, police officer, nurse, soldier/sailor/Marine, college professor, etc.
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That's the point. Taking call more often = fewer hand-offs.
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This is really awesome to see the hospital I work at in a national tv program. ACH is truly a remarkable and wonderful place of hope.
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The bolded are potentially life threatening. I always kind of felt that job security should include life security 😕
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In the UK, I believe residency lasts 8-10 years compared to 3-4 years in the US. This is doable if medical schools start accepting students straight out of high school and not require 4 year college degrees; until that happens, no thanks on 8-10 years in residency.
Not following. . .either you aren't following me or vice versa.
My point is that working call and in hospital time where they go back to the old days set people up for more problems, errors, all kinds of things. You don't know how difficult it is to work with folks that are that sleep deprived. And they are dealing with sick or agitated people as pts that are somehow sleep deprived d/t pain or any number of things. Where do you think the drive for hospitalists, at least in part, has come from???? It's ridiculous to even consider going back to those days.
Handing off patients is a necessity that continues whether one is in residency or not-or even when if one is a hospitalist or not. It has to do with effective communication between people and developing and using logistics that fosters continuity. It's not about you or some other guys ALWAYS trying to be there.
The ball will get passed at some point to someone; it's more about team logistics and effective communication skills.
Besides, patients, especially in the units can change status so quickly, it wouldn't matter necessarily if you had more call or not. Unless you think you are an omnipresent, omniscient freaking superman, which is something that medicine has NOT been realistic about in the past, you have to have someone takeover responsibility at some point, and it goes back and forth. No one can do it all all of the time or even most of the time. And what the hell do you think they have nurses in there for as well?
It's time to get realistic. And just b/c you are on call doesn't mean you are NOT also in the hospitals most days anyway knowing the basic status of those patients that on your service. You will be. So you will be up-to-date, not necessarily up-to-the-second--b/c sh it with patients changes often quickly.
This is ridiculous. I'm not having this argument. I know what the hell I'm speaking of.
Also, for the love of God, those other jobs that you mentioned don't necessarily have great "security" in a down economy. In the tri-state area alone, even in light of increased murder rates and fires, they have cut p.officers and firepeople. And as far as nurses, whoa. Don't even go there. Again, I know of what I speak.
Nursing is one of the MOST cut-throat areas ever--at least teachers, even if you're not a fan of the teacher's union, have that for security. Mostly, nurse do not, and they weed and cut each other's throat more times than any person in the general population ever knows about. It is often VERY dog-eat-dog.
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Okay? Taken as a whole, your chances of dying are fairly minimal. More Marines died in '08 on motorcycles while off-duty than in actual combat. I've never even heard of a local firefighter (in a county of one million plus) dying in the line of work. I do know of a surgery resident getting hepatitis C, so being a doctor can be life-threatening too.
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This has very little to do with what I said, and how many times do you need to say you know what you're talking about?
Nurses have great job security. My wife and mother have gotten multiple nursing jobs on short notice with little trouble. I can't think of anyone who had an easier time than they did finding jobs.
First,
my reply was to Kaushik.
Second, your mother and wife in the past have nothing to do with the economy now, and they are two anecdotals.
I addressed this in another thread. Nursing, again, is cut-throat, which causes great instability in terms of job security. On top of that hospitals are in hiring freeze mode for nursing. It is the hightest expenditure in the hospital. They will Always limit them first, and that has been the case for the 20 years I've been in it. Will there pretty much often be med-surg jobs? Probably. Good luck with that. Most don't want to stay in that endlessly, but that's another story.
I really don't want to go into this whole thing again, as I did this whole long thing in another thread--a thread about some person questioning nursing or medicine or something--can't remember.
Nursing is not the sweet secure cake job with "great" pay that people think it is. And the high turnover rates prove this as well.
I can say all this and more, and I've had a pretty great run in nursing and gained a lot of respect in my specialized areas.
At any rate, don't take it personally. I am miffed that the media keeps pushing nursing, lol, as this savior kind of profession for people in a down economy. *insanity*
Hospitals are businesses. In the last year, across the country, they have frozen more jobs than we can even begin to post on this site. They will do what they always do with nurses--push those with higher salaries out by attrition and ridiculous administrative antics--hire some new grads in a limited way and keep salaries low, and make nurses work more with less as they hold tight on hiring or they recycle the posted postions and recruits. It's nuts. I could go on and on.
Yes, I should write a book on this; but people see and believe whatever they want. It's the same thing with trying to get some folks to re-think medicine. Yes there is a need for physicians. But it's amazing what people actually believe about what it is like to be one. It's no glory road. It's not a Bill Gates kind of networth lkind of life--not even close. And even shadowing experiences can only give people tiny snippets about what it really entails for a lifetime.
It's a great field. Just as nursing is a great field. But the more realistic people are about what they are getting into, the better it is for everyone all the way around.
As far as my original response, I'm not sure why you responded to it. I addressed someone else, and I don't think we necessarily disagree on the things stated, really. Maybe I'm wrong.
Oh well. Sugar is low. It's time to finally eat. 🙂
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You quoted me.
Except that my mom just got the job, in the economy now 🙄 Besides, my two anecdotes outnumber your one anecdote.
Gee, maybe because you quoted my post?
http://forums.studentdoctor.net/showpost.php?p=9202495&postcount=62
Nope Prowler. I quoted you AFTER you quoted me: see the time: yesterday 7:20 PM. But don't worry about it.
Great for your two anecdotals. Now, if you REALLY care about the reality of the situation, I will direct you to several boards AND online magazines that are currently addressing this very problem with HIRING FREEZES and nurses looking for jobs.
LOL. My anecdotals, reviewed documentation and other things could well exceed yours on this subject. Hmm, and what of the details from a major meeting I was invited to attend recently with a VP of Nursing for a huge inner city hospital--in a room of no less than 80 nurses--as she discussed the massive job posting deletions AND the hiring freezes throughout the country and the suspension of tuition reimbursement for nurses all DUE TO THE ECONOMIC CRUNCH. I'm sure she and others would find your two anecdotals and your own "insight" into this situation "enlightening." LOL
Prowler, no one is saying that there are NO jobs anywhere for nurses. What we are saying is they are nowhere near as plentious, and nurse-grads and experienced nurses are having trouble finding positions. This is a reality.
Now, are there more medical-surgical floor nursing jobs then other specialty area jobs? Yep. There always have been. Even then, most of them are nights or days with night rotation. And many nurses do NOT stay working on the floor FULL TIME for the long haul. You'd have to work it to know why. LOL
But that too is another story.
There are also nursing home pill-pushing jobs too. But how many people do you think went to nursing school and spent over $60,000 to do that--crush and administer pills to no less than 50-100 pts that have much problem taking pills or medicine in various ways, only to have to turn around and do it again in an hour? A nurse really has to want to work in a nursing home. I'd venture to say that most that went to nursing school didn't do so to do that, even though, honestly, someone has to do it. Also, unfortunately the nursing home investor-owners are often worse than those that run the hospitals, and so they will make one nurse do the work and documentation and supervision of 5. Why? B/c nursing homes function, sadly or not, for profit too. They get away with a lot, and again. . .that's yet another story.
OK, so now all those in nursing school and after that wanted to go into areas such as critical care, emergency, OB, Peds ICU, NICU, Cardiothoracic Surgical Recovery, Trauma, and PACU and other specialized areas are currently crap out of luck in many hospitals across the country. But that ALSO gets to be too detailed to get into here.
Now, if you would like to post a separate thread on this particular issue, be my guest. If I have time, I will join in and demonstrate with hard documentation what I speak.
But keep in mind something. The hospitals don't want to go public with the fact that they have frozen many nursing positions. And for Magnet purposes they don't want this out either--but they play games in their HR and newly hired positions too. I've seen a sad trend to ridiculous turnovers of newly hired nurses after 90 days probation, and much of it has everything to do with playing the Magnet game. I have unfortunately seen no less than 8 nurses recently in one institution in merely to connected units get churned in and out as they were hired, cycled through orientation and "precepting," and then spit out again for idiotic reasons--only to have the position cycled through HR again, and again.
In fact I've watched this at a few hospitals. One is a major hosital chain. They talk about how much it costs to orient a new nurse; but often enough, it's a BS game.
Sure, not every new nurse will make it through or even should make it through orientation/precepting/probation. But many times they are set up for failure, plain and simple, only to re-post the position and recyle it through the whole thing again.
They also have moved to paying a reduced orientation rate, and they severly limit the in-class didactic time as well to save money on orientation. They also cover things by way of their intra-net, and this saves them money. There are many games that go on. But it's looks good it terms of meeting Magnet requirements. If you turn the new hires out before or exactly at the end of probation, you don't have to worry about it being an inside retention issue, even though many times it is precisely that, b/c the cycling is set up for failure, and they know it.
Even in the meeting with the VP, she forthrightly admitted that there are hiring freezes everywhere for nurses, but the hospitals don't want to publicize this. How the heck do you think that looks to people--potential patients--customers? Hospitals are already nervous b/c people are cutting back on elective surgeries and other types of elective procedures for God's sake!
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Finally Prowler, you and the media can keep leading folks down this rosey path of nursing about which they know little to nothing. When I tell you it is a disfunctional field as well, I'm serious and any nurse with serious experience and honesty knows it--even though admitting it could cause them to lose a vertical move in the field. Nursing in theory and in practice can be wonderful; but professionally, admininstratively, and organizationally it is fraught with dysfunction in many ways.
But this bears repeating. Hospitals that actually had posted postions for nurses took them down or cut them dramatically when the economy took an even bigger downturn in 2008-2009.
Most of them have CUT their online postings by 2/3s or more. Even now, a lot of what you see posted in other career search sites are homecare positions, like with say Bayada. I've seen it go up and down, but I've never seen positions slashed across the board like this. And neither has my mother or her colleagues--oooh, now that makes even more than two. Her RN work in EDs and hospitals goes back to the 70's. Wow, and now I can easily include a great number of nurse colleagues that I've worked with or know and up, up, up the numbers will jump in agreement, b/c they know and could testify to what I'm saying.
Furthermore, I find NO shame whatsoever in stating that I've been nursing a long time and paid my dues and have also worked in administration and education. So don't even again try to influence me in the negative on that by trying to put me down for 'repeating' myself.
I am certain I've earned the right to speak on this and other nursing and healthcare related issues. It is simply too bad if you don't like it. It's reality. Deal with it.
I won't simply continue to argue you with you in this thread for the "fun" of it. You've got to be kidding me. At the end of the day, you can believe and peddle whatever you want.
It's just that it well may not be based in the "solid truth" you think it is.
You can also go over to a place like allnurses and type in the search on nurses and graduate nurses that are having trouble finding jobs.
Of course if folks are willing to relocate to some places, like certain areas of southern FL, where the pay is seriously less than what nurses make in other areas of the country, that's OK too. I have my own opinions on many "medical centers" and hospitals down there, and I clearly understand why many that reside there come up north or out west for various treatments. I am sure there are some good centers down there, but by and large, many nurse travellers have shared nightmarish stories, and many folks do fly up or out for other opinions and treatments. I hope this improves in the future.
With regard to the freezes--when they are addressed, interestingly enough, they are referred to as mere "freezes" as to suggest that they are merely "temporary,"-- well, they will improve. I am betting, however, that it will be quite some time before we see the massive recruitment and hiring and successful orienting of nurses that we saw in the 80's, 90's and early 2000. I can remember when they were offering us cars and tuition reimbursement with No cap. I don't think we will be seeing that again any time soon. And I definitely do not believe we will see capless tuition reimbursement again. LOL, not even in people's dreams.
So, I'm not talking about some sporadic and limited regional thing across the country. Once more, there are nursing positions, but they are more limited, and they are no where near as plentious as they were even a few years ago or in decades past. It is NOT simply b/c all positions are filled. It's greatly d/t to. . . HELLO. . .HIRING FREEZES. . .HELLO. . .r/t current economic crunch time in this country, and the whole escalated costs in healthcare overall--the hospital mergers in the late 90's and early 2000, and other factors. It's also the fact that more and more things are being MOVED OUT of the hospital for cost control and d/t to reimbursement limitations.
Again, hospitals are businesses--even not-for-profit can turn profit and still function as businesses. So a lot of the freeze business is about the economic crunch, but there are other factors as well.
Take care Prowler. If you want to discuss this further start a different thread on it. But I'm not going to argue back and forth just for the sake of arguing or b/c of some silly pizzing contest. That idiotic. You aren't armed with the knowledge on this that you think you are. If you want to fantasize otherwise, have at it.
But I'm done here.
But this bears repeating. Hospitals that actually had posted postions for nurses took them down or cut them dramatically when the economy took an even bigger downturn in 2008-2009.
Most of them have CUT their online postings by 2/3s or more. Even now, a lot of what you see posted in other career search sites are homecare positions, like with say Bayada. I've seen it go up and down, but I've never seen positions slashed across the board like this. And neither has my mother or her colleagues--oooh, now that makes even more than two. Her RN work in EDs and hospitals goes back to the 70's. Wow, and now I can easily include a great number of nurse colleagues that I've worked with or know and up, up, up the numbers will jump in agreement, b/c they know and could testify to what I'm saying.
Furthermore, I find NO shame whatsoever in stating that I've been nursing a long time and paid my dues and have also worked in administration and education. So don't even again try to influence me in the negative on that by trying to put me down for 'repeating' myself.
I am certain I've earned the right to speak on this and other nursing and healthcare related issues. It is simply too bad if you don't like it. It's reality. Deal with it.
I won't simply continue to argue you with you in this thread for the "fun" of it. You've got to be kidding me. At the end of the day, you can believe and peddle whatever you want.
It's just that it well may not be based in the "solid truth" you think it is.
You can also go over to a place like allnurses and type in the search on nurses and graduate nurses that are having trouble finding jobs.
Of course if folks are willing to relocate to some places, like certain areas of southern FL, where the pay is seriously less than what nurses make in other areas of the country, that's OK too. I have my own opinions on many "medical centers" and hospitals down there, and I clearly understand why many that reside there come up north or out west for various treatments. I am sure there are some good centers down there, but by and large, many nurse travellers have shared nightmarish stories, and many folks do fly up or out for other opinions and treatments. I hope this improves in the future.
With regard to the freezes--when they are addressed, interestingly enough, they are referred to as mere "freezes" as to suggest that they are merely "temporary,"-- well, they will improve. I am betting, however, that it will be quite some time before we see the massive recruitment and hiring and successful orienting of nurses that we saw in the 80's, 90's and early 2000. I can remember when they were offering us cars and tuition reimbursement with No cap. I don't think we will be seeing that again any time soon. And I definitely do not believe we will see capless tuition reimbursement again. LOL, not even in people's dreams.
So, I'm not talking about some sporadic and limited regional thing across the country. Once more, there are nursing positions, but they are more limited, and they are no where near as plentious as they were even a few years ago or in decades past. It is NOT simply b/c all positions are filled. It's greatly d/t to. . . HELLO. . .HIRING FREEZES. . .HELLO. . .r/t current economic crunch time in this country, and the whole escalated costs in healthcare overall--the hospital mergers in the late 90's and early 2000, and other factors. It's also the fact that more and more things are being MOVED OUT of the hospital for cost control and d/t to reimbursement limitations.
Again, hospitals are businesses--even not-for-profit can turn profit and still function as businesses. So a lot of the freeze business is about the economic crunch, but there are other factors as well.
Take care Prowler. If you want to discuss this further start a different thread on it. But I'm not going to argue back and forth just for the sake of arguing or b/c of some silly pizzing contest. That idiotic. You aren't armed with the knowledge on this that you think you are. If you want to fantasize otherwise, have at it.
But I'm done here.
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oooh I watched this before, very good show. They need more TV shows like this and Hopkins or the NOVA episode on med students. Grey's Anatomy and House are nowhere near as interesting as the real stuff.
That's fine, and it's your perogative, just as it is mine to relate the reality--the devil in the details.
This takes the effort to relate the details. Luckily I can type pretty fast.
So if you don't know the details AND you don't want to know them or become informed, OK then. So don't get into debate/argument mode if you aren't prepared to put up the necessary details and perspectives to make a sound point. Just state something is your limited opinion, and leave it at that. If you can't back up what you say with something substantial that is based in reality, just say OK and move on. It's like pushing the "EASY" button.
By your statement, I can see you will probably not be posting a separate thread (as I suggested) on this to rationally discuss this further. Good. Highjacking of this thread is done then.
Brevity just like reality and truth can be your friend too prowler. What do I mean? Here's brevity for you: There is NO need to reply back that you are not going to read something, if you choose not to do so--no reason whatsoever.
There's no point at all to state that other than to be childish. Here's all you had to do:
1. Admit you don't know all the facts and details and that you really don't care to know or discuss them. You stated a limited insight opinion, and that is that.
or
2. Simply don't respond back that you aren't going to read something, period.
If you aren't going to discuss anything based upon rational means or measuring reality, that's fine.
But see, motivation goes to why a person would post that they aren't going to read something. JUST DON"T READ IT and move on. Think about it.
I'm tired of people getting into fight or debate mode, but then they are not prepared or willing to explore facts and perspectives from all sides.
It's utterly lame.
Just address some other post or go to another thread. Please don't waste your time replying back to this. I will most definitely NOT be returning to this thread.
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LOL, you already said you were done with this thread once, so I'm sure you'll be peeking back again.That's fine, and it's your perogative, just as it is mine to relate the reality--the devil in the details.
This takes the effort to relate the details. Luckily I can type pretty fast.
So if you don't know the details AND you don't want to know them or become informed, OK then. So don't get into debate/argument mode if you aren't prepared to put up the necessary details and perspectives to make a sound point. Just state something is your limited opinion, and leave it at that. If you can't back up what you say with something substantial that is based in reality, just say OK and move on. It's like pushing the "EASY" button.
By your statement, I can see you will probably not be posting a separate thread (as I suggested) on this to rationally discuss this further. Good. Highjacking of this thread is done then.
Brevity just like reality and truth can be your friend too prowler. What do I mean? Here's brevity for you: There is NO need to reply back that you are not going to read something, if you choose not to do so--no reason whatsoever.
There's no point at all to state that other than to be childish. Here's all you had to do:
1. Admit you don't know all the facts and details and that you really don't care to know or discuss them. You stated a limited insight opinion, and that is that.
or
2. Simply don't respond back that you aren't going to read something, period.
If you aren't going to discuss anything based upon rational means or measuring reality, that's fine.
But see, motivation goes to why a person would post that they aren't going to read something. JUST DON"T READ IT and move on. Think about it.
I'm tired of people getting into fight or debate mode, but then they are not prepared or willing to explore facts and perspectives from all sides.
It's utterly lame.
Please don't waste your time replying back to this. I will most definitely NOT be returning to this thread.
If you're going to foretell total economic collapse, I'm pretty sure the digits on your paycheck are going to be far less meaningful than your ability to garden your own food and maintain solar panels and a rainwater catchment system. In this future, you'll be doing what the people in Zimbabwe do with their trillion dollar bills...toilet paper.
The areas where NPs and PAs are encroaching are areas that are currently in tremendous demand because physicians aren't filling the positions. What's the point of being in demand if you don't actually want the job?
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PAs aren't really encroaching anything. It's the nursing community that's pushing for more independence.
Just because physicians aren't filling in the primary care slots doesn't mean you replace them with lesser trained individuals. You need a great deal of breadth and depth of knowledge as a PCP. The solution is to make primary care more enticing to med students, not just decide to give up primary care to midlevels.
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There really are some studies that show an increase in mistakes in some fields after the 80hr rule came in. I will admit though that I haven't read them beyond the abstracts just because I don't care at this point, so I don't know if there were any significant flaws that make those studies useless.
Like Prowler said though, more handoffs = more chances to make mistakes. I honestly don't know how much more effective handoffs could be made. Maybe someone further along in training can clarify? Either way, if it's really true that taking less call, etc increases patient errors due to more handoffs, newer residents not knowing the patient as well as the previous one, etc, would you still argue for reducing work hours even more?
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The problem with their arguement is that the PAs and NPs don't take those jobs either. They say they do when lobbying the legislators, but the numbers don't back it.
Yes, the 80-100 hour work week is how it was done in the past, but lets be honest, it's just not safe. When you have doctors giving medications to children where if they are slightly off on their calculations could kill the child, sleep becomes a very important factor. And remember, these doctors leave the hospital after their shift to drive home. I know of many doctors who often times nod off at red lights after or even on the highway while driving home. I think bringing it down to an 80 hour work week was a good solution, although many hospitals will bend this new policy substantially.
But keep in mind something. The hospitals don't want to go public with the fact that they have frozen many nursing positions. And for Magnet purposes they don't want this out either--but they play games in their HR and newly hired positions too. I've seen a sad trend to ridiculous turnovers of newly hired nurses after 90 days probation, and much of it has everything to do with playing the Magnet game. I have unfortunately seen no less than 8 nurses recently in one institution in merely to connected units get churned in and out as they were hired, cycled through orientation and "precepting," and then spit out again for idiotic reasons--only to have the position cycled through HR again, and again.
I thoroughly enjoyed reading your post. I'm in my last semester of nursing school. Before I started, I had an entirely different view of the field. I too, had a very glamorized idea of nursing. I thought it was going to be a very lucrative, secure job, where I would get daily, meaningful patient interaction. As I went through the program, however, I started to realize the truth about nursing. Most of the day is spent charting so you can cover your a**, and the rest of the time is spent giving medications. There really isn't a lot of time spent with the patients. I work on an orthopedic floor as a nursing assistant, and I often times see nurses working 2-3 hours after their 12 hour shifts have ended just to finish their charting for the day! I'm not trying to disrespect the profession, I know a lot of great, intelligent nurses that I really do admire, but it just really bugs me when I hear girls in my class tell me that they can't wait to be pediatric ICU nurses, when they say when the reality is, no one in the class that graduated before me are finding jobs.
I do have one question about your thread though. I realize most hospitals are doing hiring freezes, as the one I work at in Atlanta is currently in a hiring freeze as well. However, you mentioned that many hospitals are just circulating new grads in and out of their programs in order to give off the impression that they are doing well, doesn't this get very costly? I heard a figure once that it costs around $40,000 to train a new grad. I would just think that this would be very wasteful for a hospital that is already financially strapped.
by the way....how did the post go from talking about a show on Dateline featuring 1st year pediatric residents to having a debate about nursing and the recession? I love SDN!! 🙂 LOL
I thoroughly enjoyed reading your post. I'm in my last semester of nursing school. Before I started, I had an entirely different view of the field. I too, had a very glamorized idea of nursing. I thought it was going to be a very lucrative, secure job, where I would get daily, meaningful patient interaction. As I went through the program, however, I started to realize the truth about nursing. Most of the day is spent charting so you can cover your a**, and the rest of the time is spent giving medications. There really isn't a lot of time spent with the patients. I work on an orthopedic floor as a nursing assistant, and I often times see nurses working 2-3 hours after their 12 hour shifts have ended just to finish their charting for the day! I'm not trying to disrespect the profession, I know a lot of great, intelligent nurses that I really do admire, but it just really bugs me when I hear girls in my class tell me that they can't wait to be pediatric ICU nurses, when they say when the reality is, no one in the class that graduated before me are finding jobs.
I do have one question about your thread though. I realize most hospitals are doing hiring freezes, as the one I work at in Atlanta is currently in a hiring freeze as well. However, you mentioned that many hospitals are just circulating new grads in and out of their programs in order to give off the impression that they are doing well, doesn't this get very costly? I heard a figure once that it costs around $40,000 to train a new grad. I would just think that this would be very wasteful for a hospital that is already financially strapped.
by the way....how did the post go from talking about a show on Dateline featuring 1st year pediatric residents to having a debate about nursing and the recession? I love SDN!! 🙂 LOL
First, uh prowler, dude, you got me. I did peek back in.
But I will choose to response to you Smb, b/c you seem sincere.
That number is way over-inflated. First of all, they often will reduce orientation rates for new hires. Second, much stuff gets completed online through the hospital's intranet. They also schedule various courses, like basic critical care courses in a very careful manner. And they will push way back more advanced critical care courses (and split them as well) and push back when they run their own ACLS or PALS. They've shortened things, and they don't run them nearly as often as say back when I was a new grad.
I teach at a local college. Even we don't run classes unless it hits a certain compacity. Yes schools are making money; but hospitals are trying to save money.
And remember that they have the great "write-off" factor. Budgets get moved around in terms of how they work these things. Some of it will go into the general hospital budget--such as general orientation, etc. Some of it will go to nursing dpt in general, and some of it will go to the particular nursing unit's or floor's budgets.
They aren't eating $40,000 at a pop. I'd say that is a modern urban legend. First, that would depend on the particular area--such as clearly it does cost more to educate a GN in critical care or the ED or L&D or NICU or PICU as compared with say a GN for a Med-Surg floor. So they have severely limited GNs into these areas, except for places that run their carefully constructed and budget-conscious Graduate Nurse Internship programs. But they are going to get these folks to work for less over the duration of their two or more year commitment for the internship. Plus they will jerk their schedules any darn way they want to, period. If a GN is up for that, great. But they should know all the dirty details ahead of time--b/c I think most of them require no less than a two-year commitment or a payback. They also work these internships over cycles that run with near graduation periods--so they will go into the schools and recruit those with the highest GPA. OK. So that is perfectly understandable. They can only hire so many new hires into these roles. There's more going on with them, and there are some pluses and minuses to going into them--but I think it depends on how it will all work with your long-term goals.
The other places can circulate new hires in and out. It's At-Will-Employment. They don't need a reason to dump and recycle with the new hires, specifically b/c AWE allows for it. There's no contract. Any reason or no reason at all is good enough to dump and recycle.
If a new tours through for 3 mo.s at about 3,000 or so per mo., that maybe costs them $9,000-10,000 or so per hire. They use their own people to do the courses at limited times that work for them, so there is no loss on that. A lot of stuff is on hospital or hospital system Intranet, and even printed materials can be limited. But much of that material is recycled, minimally updated, and run-off.
So the biggest expense is to have the RN (often at a lower rate) orienting paired with a "preceptor" and then they have to pay for more than one RN per acuity ratio--depending on whether you are in the unit, ED, floor, wherever and what that means for the particular area. It's easily written off, and they ultimately budget for this game. Do some places lose more money that others on this? Probably but that has to do with how they run things anyway.
I would tell any new GN or RN seeking employment in a hospital to make sure you get consistency (and objective balance) in week to week evaluation as well as to evaluate them for the regular, consistent use or lack thereof of objective measures and standards in terms of where you are in the process. If not you could easily be at the mercy of whomever, and you can waste time and feel totally sucker punched.
There have been a number at allnurses that have complained about the kinds of things to which I speak, but people are afraid to be "out" with it. If they get too specific in detail, they feel they could hurt their chances of getting a position elsewhere in an already down economy. When nurses just start to pick anything in terms of nursing positions b/c they just want a job, I will tell you: "CAVEAT EMPTOR!" BIG TIME!!! If you are sensing a lack of real balance and commitment, keep interviewing. There are so many games going on right now it's not funny. You might be a lucky one. OTOH, you might easily get screwed. And definitely if you see a bad trend re: the kinds of things which I have shared, and you've already taken a position, keep your mouth shut, eyes open, and start looking elsewhere.
Personally I hate paying union dues, and I think a union is only as good as it's members demand; but nurses generally don't work under contract.
It's nice to be able to say you can negotiate your own terms, but there are reasons for contracts in the first place.
If people and businesses and administrators always lived up to the highest standards, sure contracts wouldn't be necessary.
But you just have to face reality. When people can get away with falling short, b/c it meets their agenda or bottom line, often enough they will.
I've lived to see it more times than I can count, and again, I am not a big union person. I have held the hanky one too many times for people.
Personally I think nurses should start pushing for independent contracts. Because At-Will-Employment will more often than not go toward helping the employer more than the individual--or individual nurses, even though the AWE doctrine (old and passe' really) is worded such that it looks like it goes both ways. Again, I can be conservative on things; but life has taught me some realities that I would be foolish to ignore. I only wish I've seen less nurses get screwed than I have. And a good amount of those nurses were good to excellent in practice. Not kidding.
Good luck to you. Got to leave before the big black cat claws me. At least I think he's a scary-looking cat in that avatar. LOL
But I will choose to response to you Smb, b/c you seem sincere.
That number is way over-inflated. First of all, they often will reduce orientation rates for new hires. Second, much stuff gets completed online through the hospital's intranet. They also schedule various courses, like basic critical care courses in a very careful manner. And they will push way back more advanced critical care courses (and split them as well) and push back when they run their own ACLS or PALS. They've shortened things, and they don't run them nearly as often as say back when I was a new grad.
I teach at a local college. Even we don't run classes unless it hits a certain compacity. Yes schools are making money; but hospitals are trying to save money.
And remember that they have the great "write-off" factor. Budgets get moved around in terms of how they work these things. Some of it will go into the general hospital budget--such as general orientation, etc. Some of it will go to nursing dpt in general, and some of it will go to the particular nursing unit's or floor's budgets.
They aren't eating $40,000 at a pop. I'd say that is a modern urban legend. First, that would depend on the particular area--such as clearly it does cost more to educate a GN in critical care or the ED or L&D or NICU or PICU as compared with say a GN for a Med-Surg floor. So they have severely limited GNs into these areas, except for places that run their carefully constructed and budget-conscious Graduate Nurse Internship programs. But they are going to get these folks to work for less over the duration of their two or more year commitment for the internship. Plus they will jerk their schedules any darn way they want to, period. If a GN is up for that, great. But they should know all the dirty details ahead of time--b/c I think most of them require no less than a two-year commitment or a payback. They also work these internships over cycles that run with near graduation periods--so they will go into the schools and recruit those with the highest GPA. OK. So that is perfectly understandable. They can only hire so many new hires into these roles. There's more going on with them, and there are some pluses and minuses to going into them--but I think it depends on how it will all work with your long-term goals.
The other places can circulate new hires in and out. It's At-Will-Employment. They don't need a reason to dump and recycle with the new hires, specifically b/c AWE allows for it. There's no contract. Any reason or no reason at all is good enough to dump and recycle.
If a new tours through for 3 mo.s at about 3,000 or so per mo., that maybe costs them $9,000-10,000 or so per hire. They use their own people to do the courses at limited times that work for them, so there is no loss on that. A lot of stuff is on hospital or hospital system Intranet, and even printed materials can be limited. But much of that material is recycled, minimally updated, and run-off.
So the biggest expense is to have the RN (often at a lower rate) orienting paired with a "preceptor" and then they have to pay for more than one RN per acuity ratio--depending on whether you are in the unit, ED, floor, wherever and what that means for the particular area. It's easily written off, and they ultimately budget for this game. Do some places lose more money that others on this? Probably but that has to do with how they run things anyway.
I would tell any new GN or RN seeking employment in a hospital to make sure you get consistency (and objective balance) in week to week evaluation as well as to evaluate them for the regular, consistent use or lack thereof of objective measures and standards in terms of where you are in the process. If not you could easily be at the mercy of whomever, and you can waste time and feel totally sucker punched.
There have been a number at allnurses that have complained about the kinds of things to which I speak, but people are afraid to be "out" with it. If they get too specific in detail, they feel they could hurt their chances of getting a position elsewhere in an already down economy. When nurses just start to pick anything in terms of nursing positions b/c they just want a job, I will tell you: "CAVEAT EMPTOR!" BIG TIME!!! If you are sensing a lack of real balance and commitment, keep interviewing. There are so many games going on right now it's not funny. You might be a lucky one. OTOH, you might easily get screwed. And definitely if you see a bad trend re: the kinds of things which I have shared, and you've already taken a position, keep your mouth shut, eyes open, and start looking elsewhere.
Personally I hate paying union dues, and I think a union is only as good as it's members demand; but nurses generally don't work under contract.
It's nice to be able to say you can negotiate your own terms, but there are reasons for contracts in the first place.
If people and businesses and administrators always lived up to the highest standards, sure contracts wouldn't be necessary.
But you just have to face reality. When people can get away with falling short, b/c it meets their agenda or bottom line, often enough they will.
I've lived to see it more times than I can count, and again, I am not a big union person. I have held the hanky one too many times for people.
Personally I think nurses should start pushing for independent contracts. Because At-Will-Employment will more often than not go toward helping the employer more than the individual--or individual nurses, even though the AWE doctrine (old and passe' really) is worded such that it looks like it goes both ways. Again, I can be conservative on things; but life has taught me some realities that I would be foolish to ignore. I only wish I've seen less nurses get screwed than I have. And a good amount of those nurses were good to excellent in practice. Not kidding.
Good luck to you. Got to leave before the big black cat claws me. At least I think he's a scary-looking cat in that avatar. LOL
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