And yet, when we first graduate, we often run immediately into a new barrier standing between ourselves and our dream positions. Before we can pick and choose between the units and schedules we like best, we’ll need something to show for it – namely, a couple of years of experience.
Does that feel unfair? Certainly, we need experience for all the good jobs, but without jobs, there is little chance of gaining experience. What’s more, without direct experience it can be difficult to determine what counts as a “good” job offer.
What Makes a Good First Job?
Although harder to find, the truth is that many places are willing to hire recent graduates. Naturally, many won’t pay as well as jobs geared toward experienced nurses, and a few might come with a few “hidden” downsides that are not immediately obvious.
The first thing to remember here is that your first job is just that: a stepping stone on the bottom third of your nursing career. This means you shouldn’t hold out for the perfect fit forever, but you shouldn’t take the first offer you find, either. Unless you’re in a financial emergency, it will pay off to be a little picky to ensure you stay en route toward your dream specialty or career path.
Depending on local demand, hospitals in your area might offer other incentives, ranging from cash bonuses to pension plans and even gym memberships. Only some of these perks will add value to you, and often, flashy perks come with some trade-offs. Instead, look at the benefits and features that will have a deeper impact on you, a brand-new nurse looking for their first job.
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The take-home pay 💵
An obvious consideration for any job hunt is salary, even if it shouldn’t be the only thing you look at. Salaries for new nursing graduates will vary vastly depending on your state and the cost of living in your area. The easiest way to compare pay is usually looking at the base rate per hour – but sometimes, this only tells half of the story.
A higher hourly salary can quickly disappear if you don’t have a guaranteed number of hours per week or month. If you are willing to (or prefer to!) work night shifts, overtime pay and bonuses can easily make up the difference. So make sure to crunch those numbers!
The length of orientation ⏳
Any new nursing job will require some time to find your footing. Never is this leap more pronounced than when starting your first shift as a nurse. Suddenly, you’ll be missing the guidance and supervision of your preceptor or clinical instructor – and the patient’s outcomes will be signed with your name. Most hospitals know this and have special “new graduate programs” and even “nursing residencies.”
Residences are usually designed to prepare you for critical care positions, which would otherwise require you to have at least two years of bedside experience. They often combine direct nursing practice with classroom hours and even a close preceptorship or mentor.
But even if you’d rather start at a regular medical unit, a “new graduate program” will provide a longer orientation and the chance to ease into independent nursing more slowly. Think of it like a prolonged orientation. You might be paid slightly less or require a senior nurse to sign off on specific procedures – but it beats a “sink or swim” experience.
The opportunities for internal transfer ↔️
Generally speaking, small private facilities tend to be more welcoming to new graduates than large hospital systems. At their best, close-knit units mean that senior nurses will probably keep an eye out for you while you perfect your advanced nursing skills and gain confidence.
On the other hand, large hospitals and government facilities are more likely to offer a wider variety of units and experiences. Are you still trying to determine which specialty suits you best? Then after your first year, you can sign up for their “pool” and cover staffing gaps on various floors until you find your fit. Do you dream of being an ER or labor and delivery provider? Make a good impression and wait for the chance to request a transfer.
The length of the contract ⏱
Both nursing residencies and sign-on bonuses have an important drawback: they often require you to stay put for a minimum time (usually between three and five years). If you leave before this initial contract is up, you will have to pay back some or all of your bonus or some sort of “breakup fee.”
On the one hand, job stability is great, especially if you want to cover as much student debt as possible. However, not all hospitals provide welcoming work environments, and some might simply not be a good personal fit. It will be up to you to counter your safety versus your freedom.
The presence (or strength) of their union 🤝
According to the Bureau of Labor Statistics, approximately 20% of all RNs in the United States belong to a union. Once again, this varies depending on the state: in California, union participation is mandatory, while in South Carolina and Utah, union nurses account for less than 3% of the total.
There are definite pros and cons to union membership: according to some studies, unionized nurses have slightly higher rates of job dissatisfaction, but they are also more likely to work in well-staffed units, which protects them from burnout. Union membership will also provide you with better benefits, health insurance, and yearly raises – even if their “seniority rules” can feel confining.
Where Can You Find Good Openings for Newbies?
Before you can bring contract terms and staffing ratios to the negotiating table, you’ll have to find a few job openings to apply to. This is often the most discouraging part: most recruitment ads quickly ask for experience up front. You can expect competition to be stiff and even to run into an old classmate or two in the few who don’t!
The key? Go beyond the full-page ads and typical online job boards.
Only a minority of nursing jobs make it to the front page. Most hospitals prefer to fill vacancies with internal transfers first, followed by word-of-mouth recommendations. After all, these are much cheaper than making large recruitment drives!
Some strategies include the following:
- Approaching the nurses you met during clinicals – and if you’re still in school and currently rotating somewhere you’d like to work, make sure to save a few numbers!
- Ask your former classmates, especially those who signed up with a temporary staffing agency. Some of these will offer small referral bonuses, so it’s a win-win.
- Scout every hospital in the area and look up their main website or that of their parent company. Most have a Jobs portal where you can upload your resume or create email alerts for new openings.
Once you spot a gap where you can squeeze through, make sure to check out Nurse Liz’s tips to ace your application and turn the doors wide open.
4 Myths and Mishaps to Avoid While Job Hunting
During nursing school, I was treated to regular nuggets of career advice. Most of them came from instructors or lecturers, and they were all well-meaning – except that some of my lecturers had not job-hunted in a decade. I ran a few of these ideas through some of the recent graduates on my friends list and dispelled a few myths.
1. You don’t have to start at a medical-surgical unit
This was practically a mantra for my lecturers: “When you graduate, your first job will necessarily be at a general medical-surgical unit, especially with long-haulers who are not critically ill. Those are the only ones who will hire newbies!”
However, it appears that the market has changed a bit since that was true. For starters, the point of nursing residencies is to let you skip med-surg! Plus, in some areas, non-critical specialized areas such as labor and delivery or primary care will hire new graduates. Increase your chances by taking a few electives or extra certificates that well match your dream area.
Also: Hospitals are not the only option. Depending on your career goals and interests, working in a nursing home, outside of clinical practice, or as a concierge nurse might be worth looking into even for your first steps as a nurse.
2. You don’t need to hold out for the perfect position
Although no hospital administrator will be happy to see you leave the week after orientation, the truth is that jobs come and go. Even if you locked yourself into a three-year contract, you will find that it is but a fraction of your future nursing career.
This is all to say that while you don’t want to settle for an unlivable salary or horrible shifts, you don’t need to wait eternally until you find your dream job. If you’re an okay fit but will be one step closer to your dream job after a year, that’s good enough.
3. Good jobs are not confined to big cities
Large cities will usually have two or three competing hospitals covering almost every conceivable specialty – but they will also have a much deeper pool of applicants and a cost of living to match.
If moving is possible, consider looking into rural hospitals and urgent care clinics. You may not have access to the same equipment as you would in a big city hospital system, but you’ll also find fewer applicants and more open vacancies.
4. A nursing license is not ALL you need
Throughout most of your nursing school years, your aim has been to obtain that golden nursing license, which will allow you to call yourself a “registered nurse.” Ultimately, every class you took and every NCLEX® study session was really about meeting the requirements for licensure – yet that’s not where professional development ends.
Many hospitals will also want to see a valid Basic Life Support or CPR certificate before hiring, as well as proof of your last flu shot. Best to have them ready before the interview!
Final Thoughts: Think Strategically
After years of stress and hard work, it is natural to want a great, fulfilling position right away. And yet, there is so much we don’t know yet! In healthcare, there is almost no end to the possibilities and specialties you can pursue. Your first nursing job should help you get there, but it is not the end of the road.