Sunday, August 9, 2015

An Open Letter to Every Hospital in Boston (and the Rest of the USA)

Dear Hospital Administrators,

As a hospital, you provide an essential service to the communities where you are located. Your staff saves lives daily. They care for people when they are sick and help them heal so they can return home. This is probably one of the most valuable services in existence, and you have a difficult job. You need to make sure your staff are the best so you can be the best, which is why I understand why hiring experienced doctors and nurses is appealing. Unfortunately, this is causing huge problems for new graduates.

I have spent over two years looking for a permanent job. I have spoken with countless nursing recruitment agencies only to have each one turn me away because I didn't have experience. Well, of course I don't have experience; no one will hire me! I have submitted my resume numerous times to every hospital within an hour's drive of Boston (and sometimes more), yet I can count on one hand how many interviews I've had, and I still do not have a permanent position. Every time I am brought in somewhere, I hear the same refrain: "Oh, we really need to hire someone with experience." Well, I'm very pleased that you brought me in for an interview, but why did you bother when you knew from my resume that I don't have the experience you are looking for?

I became a nurse for the sole purpose of working in women's health, most preferably in labor and delivery. This has been my passion since I was a child, and it is the only type of nursing that I want to do. But for two years I have only been able to give flu shots, work per diem on med/surg, and assist in procedures to combat hair loss. I have not treated a single pregnant woman in the entire two years since I received my nursing license. I am forced to work in fields that I don't enjoy or feel comfortable in, because I need to feed my family, and being out of work entirely for two years (or more) just wasn't an option. If you look poorly on my resume now, can you imagine what a two year gap would look like? " come you haven't been working for the last two years?" "Well, so far no one has given me the chance to work in the field that I am dedicating my life to, so I'm still looking..."

And I am not even close to the only person having this problem. Any beginning nurse who wants to work in a hospital specialty will face the same thing. He or she may need to begin by working in a nursing home, and at some point she may be lucky enough to get a job on med/surg and possibly someone in that hospital will allow her to switch to a specialty after a few years. A few years of doing something you don't enjoy or want to do just for the possibility that eventually someone will take pity on you and let you work in the specialty you joined nursing for! That's unacceptable.

I've been working my brain off in school to become a midwife. I finished an entire 18 month BSN program in 6 months so I could apply to midwifery school. I have a 4.0 GPA in a full-time midwifery MSN program even though I'm working part to full time for an agency. But that means nothing to recruiters who are looking for 2, 3, 5, 10 years of experience when they are hiring nurses for their maternity floors. I would be an absolutely incredible maternity nurse, and I am stuck caring for everyone except pregnant women. I start clinicals for my midwifery program in about 3 months. I will be catching babies myself...managing labors...treating women in the office...diagnosing illness...all under the watchful eye of my preceptor. And when I finish that, I can graduate and become a licensed CNM. Then what?

I am faced with the fear of being unable to find a job even once I have an MSN in midwifery and am licensed to practice as a CNM. Why? Because I have no experience working on L&D or postpartum. New graduate CNMs do not appear to be as discriminated against as new graduate nurses, but hiring administrators still would prefer someone with some type of maternity experience. Great... And once I have my CNM license will someone want to hire me as an L&D nurse now that I'll have about 6 months of experience? No. Because they would know that isn't what I want to do with my life, and they would believe I would take a job as a midwife if one became available.

I am horribly stuck with no foreseeable end. This type of discrimination against new graduate nurses and nurses without direct specialty experience needs to stop. You want someone with experience? Give someone a chance to prove themselves and give them the gift of experience. In some ways, hiring a new graduate is a GOOD thing. She's fresh, not worn out or jaded. She wants to learn and do a great job. She'll learn how to do things YOUR way rather than stick with what she's been doing for the last ten years whether it's evidence-based or not. New grads are up to date on the latest nursing practices, too.

How can we fix this? Have nurse residency programs like the ones for doctors. Teach nurses how to be excellent in a specialty. If you want them to get some med/surg experience first, then put them on a med/surg floor for 6 months or a year before transitioning them to the specialty floor. But that transfer needs to be a guarantee, and they need to be properly trained. Make a commitment to giving jobs to new graduates and nurses without specialty experience. Be a part of the solution. Every time I see a job description that says "2 years L&D or postpartum experience required" I die a little inside. You hospital administrators have no idea how painful it is to be turned away before even applying for a position. And it happens daily, because I check your postings daily for the one that slips by and doesn't have that line added. Had one of you hired me straight out of nursing school, by now I would have two years of experience.

Rather than throwing those "inexperienced" resumes into the trash, I implore you to read through and see if that nurse would be a good fit for your floor, regardless. You might be throwing away the opportunity to shape someone into a fantastic specialty nurse. You could be missing out on having the most energetic, caring, thoughtful, safe, and passionate nurse you could find for that job (i.e. me). Experience isn't everything, though it is definitely valuable. Yesterday was my birthday, so perhaps this year could you give me the gift of experience in a job I would excel at?


Elana Kahn, RN