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

bienemyc@lsbn.state.la.usWebsite: http://lcn.lsbn.state.la.us

Thank You!

Questions ?