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Experienced/senior nurses are being denied jobs in hospitals because their salary step would be "too expensive". Newer RNs get the jobs.

Nation wide many nurses with 20-35 years of excellent experience and credentials are being turned away from hospital jobs because the collective bargaining unit for the hospitals set the wage requirements and we are at the top of the pay scale. Why hire 1 RN for $50.00/hr when you can get 2 or 3 for the same or similar cost. Expertise and experience do not seem to count for much.
I have encountered this same topic on LinkedIn.

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    Apr 28 2014: Debbie,
    You are aware of this situation in Nursing and it has been said that this occurs in other professions.
    I think the why of this needs the discussion.
    It is easy to blame the Hospitals or the big corporations for looking at the bottom line.
    But, it is the bottom line. Hospitals are after all, large businesses. They have shareholders who have invested in the hospitals and are looking to make a profit. Now, the laws and regulations and liability have a cost to comply associated with them. Then with the costs of a hospital to include facilities, material and equipment, Doctors, nurses, medical support persons, etc, etc. Then consider that treating illness and injury is not science so much as an art. Every patient is unique, presenting differing challenges. Why is this important, because the hospital business office has a terrible time to cost out treatments. They have to price out every pill, every minute, every CT scanner, etc. to find the cost. But, Health Insurance pays for most all treatments in Hospitals. Medicare is the county's largest insurer and they have priced out tens of thousands of pills and minutes and CT scans, and that's the pay. Other insurers say "Hey, what's good for Medicare is good for us" The end result is that the Hospital is faced with fluid costs and fixed prices.
    So, what does this mean to our senior nurse looking for a job. From the Hospital's point of view, it could be that they already have senior nurses and these nurses are usually tasked with conducting on the job training to junior nurses. Further, they can hire 2 juniors for 1 senior ? Cost could be equal, but the Hospital has more people for shift work, and the new nurses although inexperienced have been taught on the latest equipment and techniques.
    So, what can our senior do? First. I hope they consider the work situation before they left the old job. Then they'll have to take a lower salary and work their way back to where they were. It happened to me,
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    Apr 29 2014: you can expect nothing better from an employer that puts the bean counting and profits/costs first and foremost while discounting and even ignoring the quality of service and the needs of the customer.
    • Apr 29 2014: Well, William, you have hit the proverbial nail on the head!! I wanted to be a nurse since 4th grade-drew a poster as me as a nurse helping a patient in bed. THAT'S why I went into nursing-Because I care. I care for and about my patients and their families; I care about my co-workers and their need for help with patient care and their need to get breaks when they need them. I care-Period. There are other nurses with whom I have worked who also care deeply-but many aren't as altruistic (some would say unrealistic) as I am.
      I don't know what it is like in many business settings (maybe it's the same) but unit managers in hospitals are "middle men" (their "power" is ephemeral) and often put in untenable situations. e.g. Upper management has absolutely NO clue what we nurses have to do and deal with on a daily basis, yet they hand down policies and procedures that fill some bureaucratic/political desire to make the hospital look better, yet are virtually unrealistic or impossible to implement in a real world setting. The middle manager knows it's ridiculous, however, his/her job is on the line if every effort to implement this new (whatever it is) is not taken. The manager can't stand up for the nurses under his/her charge (even though they know it is the right thing to do-call "bullshit" to the ivory tower dudes) so mid-managers have to choose: the staff & reality of patient care on their unit or placating the upper (clueless) echelon. I've had 1 manager in 35 years that negotiated the tightrope very well. He left after about 5 years because it was getting too ridiculous. I am not "political", never have been. I DO have high standards and honesty (which I have been told many times is "to a fault"). Integrity is mine.

      So essentially I am agreeing with you. What can one do when, as a nurse, you are essentially a minion? As I told Keith-like the movie "Network"- "I'm mad as hell and I'm not going to take it anymore". Hmmm... But what, exactly, can I do? Thanks again!
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        Apr 29 2014: Screw them then. Fortunately nursing is a skill that is highly mobile and it is possible to seek employment in other regions and nation's that have more respect for experience and knowledge gained. You gain while the small-minded and tight fisted lose.
  • Apr 28 2014: I'm really surprised to hear this is going on, especially in light of the general shortage of nurses. I was under the impression that experienced nurses were highly sought after to teach, but were largely unavailable do to a shortage overall. Is this no longer the case?
    • Apr 28 2014: Yes-a nursing shortage continues-as it has been for over 20 years.
      As I stated before, hospitals can't lower the pay offered to a prospective employee because their contract with the "union" (I use that term loosely as WSNA [WA state nurses association] & 1199 NW aren't real unions. They don't do much for individual employees that need assistance with grievances or disciplinary action). But they HAVE set the standard for nursing pay scale.
      In the past when you hired on you were placed at a salary (or "step") equivalent to half your years of service (Nurse for 20 years would be hired at step 10 or maybe 12). Now we are given a 1:1 step ratio, though many steps only go to 25 or 30 years.
      If a hospital hires me they must give me credit for 35 years experience, which puts me at the top of the pay scale.
      See the other posts by some others.
  • Apr 29 2014: How old are you, Lawren and how many careers have you had?

    I've sincerely wanted to be a nurse since the 4th grade (that's about 9 years old). It's the only thing I really know how to do. I got my real estate license last year & quickly found out that it's not for me. I'm 58 years old and have been in healthcare for 40 years (counting being a nursing assistant and school). I have no retail, finance or business experience or skills.(I can't even type very well).
    There are, however, lots of healthcare related jobs that my experience would transfer well to. But, again, if the employer is a hospital I can't seem to get hired.

    I think it's interesting that what you gleaned from my post was that I didn't "like the available pay" or "working conditions". You really didn't get my point.
    I'm glad for you if changing careers "really is that simple".
    Your posts have a very lazze-fare or devil-may-care sound to them.
  • Apr 28 2014: I don't know what field of employment you are in.
    Hospitals are notoriously understaffed with nurses. This is the reality:

    1) patients get less attention because the RN has 7 or 8 pts to care for vs the 5 or 6 if they were able to meet the nurse/pt ratio for their unit
    2) to fill these needs we work overtime (an 8 hr shift becomes a 12 hr shift, a 12 hr shift becomes a 16 hr shift.) Instead of working the typical 40hrs/ wk (for a full time 8 hr shift RN), you see 48-52 hrs/wk or 36hrs/wk (for a full time 12 hr shift RN), you see 48 or even 60hrs/wk.
    3) nurses are tired when they work such overtime, errors or omissions happen-and we are grumpy.
    4) ** patients don't get their pain medicines in a timely fashion**, etc. because the RNs are so overwhelmed/over worked.
    5) in an intensive care setting this could mean missing the subtle signs or symptoms that a patient's condition is deteriorating and, instead of proactively warding off a code blue, the patient does indeed "code" or cardiac arrest.

    Did you know that, by federal law, employees are to get a 15 min break for every 4 hrs they work? And a meal break-30 min if the building you're employed in has food services (vending machines don't count) and 1 hr if you must leave your building to procure food.

    A 12 hour shift RN is entitled to 2-15 min breaks and a 30 min lunch. (really should be 1.25hrs total)
    At least half of the ICU RNs, including myself, are lucky to get to eat at all. We run into the lounge and take a couple of bites of food and rush back out.

    You see, unlike a lot of business settings, nurses are absolutely forbidden to have ANY food or drink (even water bottles) outside of the break room. Everything outside that break room is considered "patient care areas".
    And rarely are their water fountains that are easily accessible.

    So I hear you-"so what"... If in business setting you screw up-it costs $$ or ??. If a NURSE screws up it may cost someone their life!! I've seen it
    So what isn't in my vocab.
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      Apr 28 2014: If you don't like the available pay, or you don't like the working conditions, change to another career. It really is that simple. Only don't choose teaching - they're already full of people with entitlement complexes.
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        Apr 29 2014: how small minded
        • Apr 29 2014: Thank you, William, for your support!
          Advice to not tell a prospective employer, esp in nursing, how much experience/years of experience one has doesn't really fly. They are going to ask when you graduated from school and who your last few employers were.
          The crucial issue is I will NOT lie. I may not have much, we've sold everything we could, but I have my integrity and NOTHING will make me compromise that.
  • Apr 28 2014: Thank you, Mike. By your narrative I am surmising that you are also in healthcare. Poss a physician?
    I do hear what you are saying-healthcare/nursing is about 180 degrees from where it was when I entered the profession in 1978.
    Trends or practices began changing decades ago with the advent of DRG's (which isn't a bad thing). The latest black cloud on the horizon, of course, is "Obama care" which anyone even remotely familiar with socialized medicine (e.g. Canadian system), or our very own managed healthcare (which isn't bad if managed properly) knows is absolutely inane - it doesn't even look feasible on paper- not withstanding actual implementation.

    So what am I trying to say? Yes hospitals, like any other company must be fiscally responsible. Yet there IS a nursing shortage. There are an unbelievable number of nursing positions posted on the web sites for the healthcare conglomerates (the Catholic Health Init., Franciscan Health Syst., Multicare Health Syst.)- as in the Puget Sound area- as well as the ,often duplicate, postings on the many job search engines.
    Jobs are posted, warm bodies are needed to fill those slots, and I know for an absolute fact that nursing units are frequently under staffed which means the quality and safety of nursing care delivered is greatly compromised. I worked overtime and extra to fill those needs over again in the last 20 years.

    As you know there is no panacea or easy answer. I would be more than happy to work for 40 or 45% less than I received at my last position. As I stated in a previous post the hospitals are bound by the collective bargaining agreement made with the hospital by whatever "Union" with which the entity has the contract. So I can't just "take a lower salary" for a hospital job. I've applied for many others and am still turned down.
    I left my previous job because of a "med error" and had to resign. This was the first of it's kind in 35 years.
    So now I am applying for minimum wage jobs-just to pay the bills!
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      Apr 29 2014: Hi Debbie,
      No, not in the medical field... a sight of blood thing. I was in Engineering. In September 1980, I left my position after 20 years as a manager for new job at twice the salary with a growing company. My wife and I decided we could now afford to build our dream house. So, we went to see the builders and got started..... A large split level with a party room and wet bar in the lower level and a two car garage. They broke ground Oct 15. On 30 Oct. my boss came down from headquarters and told be that the company had been bought out by a huge multinational, there was to be a reduction in management staff. Since the LIFO rule applied, I was to be terminated on Nov 15. However, he said he got me a months salary to help me. Well, the new house was out, but the builder telling us it was a great house, and he could get it sold and returned our down payments. This in 1980, unemployment was like it is now. After dozens of Resumes, one came back from across the country with a position as an soils lab technician. Salary less then a third of what I had the past September. Luckily, we had no debt and my wife got a job at a childcare center, so we downsized and survived, When I finally retired, 25 years later, I had worked my way back up the ladder from greying lab tech to upper management. I was lucky, But among other things, the company did not have union contracts that effected taking me on. They needed a lab tech and I had the skills.
      There maybe something out there where your skills can be used, Maybe in another city, Another venue, like a Hospice Service or Visiting Nurses, there has to be something out there better then Burger King with your skills.
      • Apr 29 2014: Thanks, Mike. You've been through the ringer, I see.
        I HAVE applied to both hospice and home health care/visiting nurse.
        As I replied to Lawren Jones-I really don't have any skills other than nursing. No retail, finance, business or insurance background. I couldn't even be a pharmacy tech unless I got certified - and that's probably a $12-15/hr job. Heck, I don't even type very well.
        I'll just have to keep trying
  • Apr 28 2014: I would try lying about my qualifications - omitting them, not making them up.
    • Apr 28 2014: Thank you, Rodrigo. That is not the solution, however. The hospitals look at years of service (regardless of experience or expertise) and are bound by the "union" contract as to what they must pay in wages.
      Please see some of the other posts & replies in this forum.
      Thank You
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    Apr 27 2014: This happens in all job markets. It's happened to me more than once, so I have to say, "So what?"
  • Apr 26 2014: When you enter the job market again you should and do compete with the entire market. Would you want regulation telling you how to run your business and who you have to hire? I think not.
    • Apr 26 2014: Hello, Keith.
      Let me ask you this question:
      If you were going to have a hip or knee replacement or open heart surgery would you choose a doctor that had been in practice for 5 years or one who had been in practice for 20 years-given that neither physician had any negative reports on his/her license?
      It's no different in nursing care. I've been doing something for 25-30 years and have invaluable experience and expertise to offer to a company.
      The choices of who to hire is not being made on competency/experience. It's being made on money.
      Ultimately it is the patients who suffer.
      • Apr 27 2014: No doubt what you say is absolutely true and it is true across the board for professionals everywhere in all fields. The fault is not at the people level, the fault is at the Corporate Level and let me put this in bold letters so you don't forget it. "CORPORATIONS ARE NOT PEOPLE" no matter what the Supreme Court or Government (another Corporation) says. For Corporations money is the bottom line, people rarely if ever matter.

        SO, what do you think, is it time for a change?

        This country used to thrive with thousands of small businesses all up and down the street, now you have one big Walmart Corporation Monoploy from coast to coast. Sherman Act 1890, the Clayton Act 1914 and the Federal Trade Commission Act 1914 prohibited monopolies but all have been gutted along with the Constitution by the very people we reelect over and over to the Senate! It is a big joke and it's on us. We have a sitting President that declared himself (Lawyer, Judge and Jury) for anyone he declares is a suspected terrorist and anyone (man, women or child) who happened to be within a huge bombs reach of them at the time he personally pulls the trigger (American or not). We have a sitting Attorney General who was called before congress and held in "Contempt of Congress". Above the Law? Way, way above the law..... George W Crazy style above the Law.

        What is my solution? I think "every" person should spend the $300 and be a Corporation. When kids are born they are automatically Corporatized by their parents. This way we can "all" hide our money in offshore accounts and the Corporation will pay for all our expenses for the rest of our lives, health care, pension, education, vacations, business trips all over the world... come join the club it is only $300 and live a carefree life.

        Don't miss this cartoon of the Senate:
        • Apr 29 2014: Typically the largest building you see when driving into a city is some kind of Insurance company.
          I agree whole heartedly that the government and corporations are rampant with greed and that seriously has to change. We have to stop paying wash DC officials salaries for a lifetime (X-presidents get $450,000/year for life when they leave office).
          There SHOULD be tight term limits on time in congress and when they leave they get some severance pay and a wave bye-bye.
          Congressional salaries should be half or one third what they are now and all in congress should share the same health care benefits as their constituents.
          Folks on welfare should be active in job training programs and be cut off after____years. Money appropriated for military spending should be overseen by unbiased parties so we don't have $100 hammers and $350 toilet seats. ALL of these things are true and many folks are striving to help them come to fruition-but like the saying goes "you can't fight city hall". "Money rules" because "he who has the money makes the rules". I am for all of these things. In the mean time my family is slipping closer to the poor house (or no house). I'm trying to find a job at a fair & livable wage. Just like the 1976 film Network, starring Peter Finch - "I'm mad as hell and I'm not going to take it any more". But for now I just need a job!!
      • Apr 29 2014: Debbie for what it is worth hear is my recommendations. A) Take your resume and tear it in half - don't tell them about all the advanced experience and years you have or rank. Get hired as a regular nurse with a few years experience and go to work. Sure you will have to bite your lip and then later you slowly show them what you got which will keep you in a job and because of all your experience you should advance real fast anyway. The point is you got to get back to work asap and worry about your next move later. B) You may not be able to get another nursing job at your rank and pay but you have a lot of great experience that could be used for many related fields for instance you could make a website and business and sell products related to that field and because you already know how to talk to and who to talk to your foot is in the door. Whatever business you do, start a corporation so you can compete with the big dogs and make a run for it. Fight fire with fire. C) Whatever you do you may not ever make as much money as you did before so you may have to downsize your spending budget and the sooner the better.
        • Apr 29 2014: Thank you, Keith. However it absolutely doesn't work that way in nursing. As I posted to William, the crucial issue is that I will NOT lie! I have my honesty and integrity integrity and I won't compromise that.
          We have downsized most everything (sold most all that we could)-except our home. (that is a very complex issue that I won't go into).
          I have searched for and applied where I could to be a representative for durable medical equipment (such as IV pumps up to sophisticated life support equipment as used in ICUs). The majority of there positions are also sales positions. I'm not really a sales person.

          Your suggestion for me to start something on my own is an interesting thought. I would have to solidify in my mind how that would work/what services would I offer and how. I need to overcome the disappointing and demoralizing experiences I've had.
          That is food for thought and I'll run some ideas past a few of my nurse friends.
          I most certainly appreciate the support and suggestions everyone has offered in this forum on this issue. (I still like to hear back from Lawren. His responses have been enigmatic to me!)
          I must continue to pursue all avenues (as I have been) and pray that the light at the end of the tunnel is not a train. Ha Ha!
  • Apr 25 2014: Well here I am, 58 years old, with 35 years in my career in Neonatal, Pediatric and adult ICU. You name it I've probably done it (I spent my first 7 years in the Puget Sound area exclusively as an agency RN-working at every hospital large and small-learning & practicing in trauma, burns, neuro, open heart, transplant etc.). Now that I have taken some time off for some orthopedic surgeries I no longer wish to continue the back breaking, high stress, life-and-death ICU career. You would think that with my background I could find a non-bedside job. Not the case. A stumbling block is my lack of a BSN. Of course any number of agencies want to place me in local hospitals in a variety of ICU settings. But the hospitals themselves will not hire me. I've applied for ICU (even though I really didn't want that), IV Therapy (which I did as an agency nurse then as staff for 6 years), endoscopy, cardiac rehab, ambulatory care, pre-op admission clinic, etc, I have pursued home health, admissions to ECFs and Insurance companies.
    The form rejection letters from the hospitals are pretty much the same: "Although you meet the minimum requirements for this position, we have decided to pursue candidates who more closely meet the needs of the department at this time." The other is that I don't meet the requirements...
    Read: "You are too expensive and we don't want to spend that much..." Thanks to the collective bargaining units for these facilities the wages are set & determined by the contract and step progression for years of experience.
    Never did I dream that my expertise would count for so little compared to the financial bottom line of employers.
    I am pursuing positions outside of the blanket covered by the hospitals.
    I refuse to go the "fast food" route but I have applied with the vendor at my local Costco to do the food demos!!
    Demoralizing? I'd say so. Some of the nurses I've heard from via LinkedIn have had the same experience.
    So-how is it going for you?