Blue Skies
Alicia Hugg, RN, MA

Experts suggest that new grads carefully sort through job offers
and make the choice based on the facility offering the best long-term benefits.

Job prospects for new graduates could not be better, according to the experts. “It’s a buyer’s market out there,” says one.

With the nursing shortage looming large and no improvement in sight for the foreseeable future, most new graduates are plucked up by employers as soon as they pass their NCLEX examinations. In many cases, graduate nurses who spent summers working in local hospitals as nursing assistants have guaranteed employment. So what can a new graduate expect on that exciting yet challenging first job quest?

Fay Bower, RN, DNSc, FAAN, nursing department chair at Holy Names College in Oakland, advises new graduates to be careful that they ask the right questions during the interview or preinterview process. Benefits, including advanced education options and available working hours, should be explored. She thinks it is a good idea to visit the hospital units and find out what kind of environment it is.

“Do your homework. Talk to the nurses on the units. Are they happy? Some hospitals are good, some are horrible. You don’t want to jump in too fast. You will get a job right away. The issue is the choices nurses make. Think beyond tomorrow. Where am I going? Get job counseling at your school. Counselors can help you decide where you want to go and the best clinical pathway instead of your just falling into a career path. Be proactive,” Bower says.

As dean and professor at the University of Iowa in Iowa City, Melanie Dreher, RN, PhD, FAAN, agrees that new graduates will have no problems getting that first job.

“They can pick and choose. The challenge is finding a job in which they can have greater job development opportunities,” she says. Dreher cautions new graduates not to fall for sign up bonuses, but to consider the resentment they might feel from the other nurses who were not offered the bonuses. She suggests new graduates negotiate instead. For example, instead of taking a $5,000 bonus, ask that $2,500 be incorporated into the first year base pay followed by a 5% salary increase.

Dreher recommends that job seekers ask themselves: What can I learn? Am I going to be mentored? What are the goals? Other questions might include: Are they committed to continuing education and participatory activity in self-governance?

“So many times new graduates ask about vacation perks or other creature comforts.

If they care about career, they will ask themselves can I grow here? Get on their website, find out about the institution and where your talents might fit in. Don’t be persuaded by cars — those things are ridiculous and the hospitals that offer them are suspect. Ask about their retention rate,” says Dreher.

Linda Cronenwett, RN, PhD, FAAN, dean at the University of North Carolina at Chapel Hill School of Nursing says her school is trying to reach the point where a residency is required for all new graduates, noting this is a trend across the country.

“In North Carolina, a statewide task force on nursing residency just completed its report after a year’s work. We must do better in the transitioning of new graduates into the hospital work environment,” Cronenwett says.

UNC hospital piloted a nursing residency program last year when they observed that hospitals with good residency or transition programs had no retention problems. UNC students were employed in a summer work program between their junior and senior years. This “capstone” program provides another bridge for students allowing intensive clinical experience in their last semester. Students work in the hospital with a preceptor, an experienced clinician, and a visiting faculty member.

“This gets them used to handling a full load and the ability to watch their mentor,” Cronenwett says. There is a shortage of preceptors and the problem is complicated by the lack of experienced clinicians who are strapped during periods of turnover when they must also orient travel and temporary agency nurses.

Kathleen Sanford, RN, DBS, FACHE, vice president of nursing and administrator at Harrison Memorial Hospital in Bremerton, Wash., finds herself in the rare position of sometimes not being able to hire new graduates. The reason is the lack of enough mentors to oversee new graduate residencies required by most hospitals in Washington.

Nursing students who work as nurse technicians during the summers have the advantage in securing jobs following graduation. These students may perform skilled nursing tasks for which they have been checked off in school. Not only is this a good way to make money, but it gives hospital staff the opportunity to see how they fit into the hospital culture.

Some hospitals allow new graduates to apply for specialty residencies, such as pediatrics, while others require them to work medical/surgical units for initial job experience. “At my hospital if they want to go into critical care nursing a six-month residency is required,” Sanford says.

As a result of the preceptor requirement, some new graduates are beginning their careers in nursing homes and may pursue geriatrics as a career. Shortages have eased slightly, but Sanford still encourages people to go to nursing school if they have the passion.

“We are looking for people who know nursing is a profession, are willing to learn and can articulate to us what it means to have people’s lives in your hands, what it means to be a nurse,” Sanford says.

Alicia Hugg, RN, MA is a freelance writer. To comment on this story, send e-mail to editorca@nurseweek.com.