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Job Seeking Experiences and Challenges Facing Newly Licensed RNs in LouisianaJune 12, 2019Cynthia Bienemy, PhD, RNDirector, Louisiana Center for Nursing Louisiana State Board of Nursing
The Newly Licensed RN Survey included 64 parishes which make up the eight regional labor market areas (RLMAs) identified by the Louisiana Workforce Commission (2018).
On September 5, 2017 an email blast with the link to the 2017 LCN Newly Licensed RN Survey went out to a total of 4,212 new RNs that received their initial RN license between January 1, 2015 and May 31, 2017 via survey monkey.
Follow-up email blasts were sent at two- and three-week intervals, and one week prior to the close of the survey. The survey was closed on November 4, 2017 with a total of 562 new RNs completing the survey yielding a 13.3% response rate.
Methods
Number of Respondents and Response Rate
1,137
1,239
706
562
19.4%
21.8%
16.6%
13.3%
0.0%
5.0%
10.0%
15.0%
20.0%
25.0%
0
200
400
600
800
1,000
1,200
1,400
2011 2013 2015 2017
No. of Respondents Response Rate
Response Rate
Region 2015# %
2017# %
RLMA 1 – New Orleans 206 29% 155 28%RLMA 2 – Baton Rouge 118 17% 117 21%RLMA 3 – Houma 33 5% 26 5%RLMA 4 – Lafayette 72 10% 50 9%RLMA 5 – Lake Charles 49 7% 31 6%RLMA 6 – Alexandria 42 6% 34 6%RLMA 7 – Shreveport 105 15% 92 16%RLMA 8 – Monroe 37 5% 39 7%Not Sure of Region 3 0.4% 2 0.4%Do not live in Louisiana 41 6% 16 3%Total 706 562
Current Residence of Respondents
12%9%
11% 10%
88%91%
89% 90%
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
2011 2013 2015 2017
Gender of Respondents
Male Female
74%
21%
2%
2%
2%
72%
23%
2%
1%
2%
71%
23%
2%
3%
2%
69%
23%
1%
3%
4%
W H I T E / C A U C A S I A N
B L A C K / A F R I C A N A M E R I C A N
H I S P A N I C
A S I A N
O T H E R
T W O O R M O R E R A C E S
Race / Ethnicity of Respondents2011 2013 2015 2017
63%
23%
10%
4%
0.1%
0% 0%
61%
26%
10%
3%
0.2%
0% 0.2%
61%
27%
10%
3%
0.1%
0% 0%
60%
24%
11%
4%
0% 0% 0%
2 0 - 3 0 3 1 - 4 0 4 1 - 5 0 5 1 - 6 0 6 1 - 6 5 6 6 - 7 0 7 0 +
Age of Respondents
2011 2013 2015 2017
90% 89%92% 92%
10% 11%8% 8%
0% 0.1% 0% 0%0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
2011 2013 2015 2017
Location of Nursing Education
Educated in LA Educated Out of State Educated in Another Country
2% 2%1%
2%
49%
53%
43%44%
49%
45%
56%54%
0.4%
0%
10%
20%
30%
40%
50%
60%
2011 2013 2015 2017
Educational Preparation
Diploma AD BSN Other
6%
56%
13%
2% 2%
9%
12%
6%
51%
16%
3% 3%
8%
13%
5%
49%
17%
1%
7%
15%
6%
M A S T E R S B A C H E L O R S A S S O C I A T E P H A R M A C Y T E C H
C E R T I F I C A T E L P N O T H E R
Degrees or Certificates in Another Field
2013 2015 2017
27%29%
27%
73%71%
73%
0%
10%
20%
30%
40%
50%
60%
70%
80%
2013 2015 2017
Graduated from an Accelerated Nursing Program
Yes No
76%
84% 84% 85%
24%
16% 16% 15%
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
2011 2013 2015 2017
Plans to Advance Education
Yes No
33%
38%
16%
9%
4%
29%
39%
21%
9%
2%
0%
5%
10%
15%
20%
25%
30%
35%
40%
45%
2-4 weeks 5-7 weeks 2 months 3 months Greater than 3months
Length of Time Between Graduation and Taking the NCLEX-RN Exam
2015 2017
89%
11%
92%
8%
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
Yes No
Passage on the NCLEX-RN Exam on 1st Take
2015 2017
57%
23%
14%
5%
1% 1%
62%
15%17%
4%1% 1%
73%
12% 11%
2% 1% 1%
0%
10%
20%
30%
40%
50%
60%
70%
80%
Prior tograduation
Immediatelyafter graduation
Immediatelyafter passing the
NCLEX-RN
1-3 months afterpassing theNCLEX-RN
4-6 months afterpassing theNCLEX-RN
Greater than 6months afterpassing theNCLEX-RN
Point at Which Graduates Began Seeking Employment
2013 2015 2017
31%
50%
61%57%
87%
5%
31%
50% 54% 53%
87%
6%
18%
46%
35%
41%
71% 72%
7%
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
Collegecredit
StudentLoan
Deferment
Exposureto
Employers
Enhanceresume
Increaseskills and
confidence
Salary /stipend
Other
What would motivate newly licensed RNs to participate in a residency program?
2013 2015 2017
94% 94%97% 98%
6% 6%3% 2%
0%
20%
40%
60%
80%
100%
120%
2011 2013 2015 2017
Working as a RN at the Time of the Survey
Yes No
8%
3%
2%
2%
11%
16%
23%
17%
8%
7%
9%
8%
62%
66%
57%
66%
0% 10% 20% 30% 40% 50% 60% 70%
2011
2013
2015
2017
Length of Employment as a RN at the Time of the Survey
greater than a year 10 to 12 months 7 to 10 months
3 to 6 months less than 3 months
91%
5%0.5%
4%
92%
5%3%
94%
3% 3%
97%
2% 1%0%
20%
40%
60%
80%
100%
120%
Full-time Part-time Per diem / On-call Not working as aRN
Employment Status as a RN
2011 2013 2015 2017
68%80%
91%97%
19%
16%
7%2%
0%
20%
40%
60%
80%
100%
120%
2011 2013 2015 2017
How long did it take you to find a job as a RN?
Less than 3 months 4 to 6 months
7 to 9 months 10 to 12 months
Greater than 12 months
85%
71%
76%80%
15%
27%
22%18%
2% 1% 2%
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
2011 2013 2015 2017
Job of Choice
Yes No Other
53% 56%
74%
88%
12%15%
15%
9%
0%
20%
40%
60%
80%
100%
120%
2011 2013 2015 2017
How many jobs did you apply for before you were successful?
Less than 3 4 to 6 7 to 9 10 to 12 More than 12
0% 10% 20% 30% 40% 50% 60% 70% 80% 90%
Acute Care Hospital
Long Term Care / Skilled Nursing Facility
Clinic / Ambulatory Care
Home Health/Community/Public Health
Physician office
Dialysis Center
Psychiatric Hospital
Hospice
Rehabilitation Hospital
Other
Acute CareHospital
Long TermCare /
SkilledNursingFacility
Clinic /Ambulatory
Care
HomeHealth/Community/Publ
ic Health
Physicianoffice
DialysisCenter
PsychiatricHospital
HospiceRehabilitation Hospital
Other
2017 75% 4% 5% 3% 1% 2% 2% 0.56% 1% 7%2015 79% 5% 3% 3% 1% 0.59% 2% 0.59% 1% 5%2013 72% 7% 4% 4% 1% 1% 2% 1% 1% 6%2011 75% 5% 3% 2% 2% 1% 1% 1% 1% 9%
Where are you currently working?
2017 2015 2013 2011
Less than$16 / hour
$16 - $18/ hour
$19 - $21/ hour
$22 -$24 /hour
$25 - $27 /hour
Greaterthan $28 /
hourOther
2013 0.4% 4% 39% 39% 10% 6% 0.5%
2015 0% 2% 31% 51% 9% 7% 1%
2017 0% 0.2% 14% 64% 13% 8% 0.6%
0.0%
10.0%
20.0%
30.0%
40.0%
50.0%
60.0%
70.0%
Starting Salary as a Newly Licensed RN in LA
2013 2015 2017
6%
3%
2%
0%
1%
2%
3%
4%
5%
6%
7%
Newly Licensed RNs that were not Employed
2013 2015 2017
Reasons Given for Not Being Employed
Lack of experienceNo positions for new graduatesCurrently not hiringBaccalaureate prepared nurses preferredOut of school too longDid not pass the pre-hire assessment test
Qualitative Findings
“Finding employment was easy as a new nurse. I was offered 3 positions before I had even graduated due to under staffing issues. It was nice that it was easy to find a job, however it is extremely hard as a new grad to keep up with all the demands of a busy hospital that is not adequately staffed.”
“Some hospitals have very short orientation periods, forcing new nurses to be fully responsible before being ready. Nursing school does what it can to prepare its graduates, but employers need to understand we not come out of school knowing everything and fully competent. “Throwing new graduates to the wolves” only increases the chance for failure, death, and lawsuits.”
Qualitative Findings
Qualitative Findings
“I was already employed as an LPN for 8 yrs. then went back to school for RN degree through education assistance program offered thru my job. I love my job and didn’t want to leave so was able to stay after finishing school.”
“Finding employment is not a difficult task, it’s the lack of pay for what Nurses are worth, that makes it difficult to decide to stay and practice in LA. I have had and heard of a lot of Nurses leaving LA to practice due to being underpaid and underappreciated. It’s not all about the money, but it is a risky job that take a huge toll on both the RN and their families. What can we do to increase pay for RN’s. We are worth it!!!”
Qualitative Findings
Qualitative Findings
“You have to do more than just fill out the application. In today’s online world you have to go above and beyond to be noticed. My advice would be to pick the job you really want and market yourself to that facility and position. Contact the supervisor of the unit. Contact the director. Send emails, letters and make phone calls. Make sure they know who you are.”
“Employment opportunities are plentiful however the concept “Nurses eat their Young” makes it hard for novice nurses to gain confidence in their newly attained skills in the delivery of competent holistic care.”
Qualitative Findings
Qualitative Findings
“As a new RN, the problem is not finding a job, but finding a career that is rewarding and satisfying. Nursing offers a diverse range of areas in which to practice. As a new grad, I took the first job I was offered (as a med/surg RN) and now feel stuck in a job I dislike. Several of my co-workers, also new grads, feel as I do and may explain why our turnover rate is so high. We’ve barely trained/oriented new hires before they’ve quit because they’re looking to find “greener and better pastures.”
“Patient to nurse ratio is too much. Everywhere is ran by profit and workload is a lot for even experienced nurses.”
Qualitative Findings
Next Steps
• Leaders in academia and practice should work together to identify the competencies that are needed by newly licensed RNs and ensure that they obtain these competencies and are acclimated as valued members of the profession.
• Develop comprehensive nurse residency programs across the state that will allow for a seamless transition from academia to practice for newly licensed RNs.
• Develop nurse mentoring / coaching programs for newly licensed RNs that will allow them to achieve competency, confidence, and autonomy as a RN.
• Create a work environment that is supportive, safe, and provides opportunities for newly licensed RNs to increase their skills and advance professionally within the organization.
Recommendations
Next Steps
Recommendations
• Utilize innovative strategies such as flex scheduling and decreased nurse patient ratios on large units, such as medical surgical units, to create an environment where newly licensed RNs can enhance their skills, feel valued and productive, and grow as leaders.
• Develop collaborative innovative partnerships between universities and community colleges that will allow newly licensed RNs prepared at the Diploma and Associate Degree level to advance their education.
• Explore the role of repayment of student loans as a determent to newly licensed RNs advancing their education.
• Repeat the New Graduate Survey every two years to monitor trends in hiring practices experienced by newly licensed RNs as changes occur in the state’s health care system, economy, and nursing workforce, in order to better inform policy makers, schools of nursing, prospective nursing students, and other interested stakeholders.
For More InformationContact: Dr. Cynthia Bienemy at
[email protected]: http://lcn.lsbn.state.la.us
Thank You!
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