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How new graduates can gain a competitive edge

Elwood, Theresa MSN, RN; Larsen, Ruth A. RN

AJN, American Journal of Nursing: January 2011 - Volume 111 - Issue 1 - p 14,16
doi: 10.1097/01.NAJ.0000392853.50404.59

First, stay positive! Then follow this practical advice that will help you stand out in the crowd.

Theresa Elwood and Ruth A. Larsen are nursing placement coordinators at the Mayo Clinic in Rochester, Minn.

MANY NURSES WHO graduated in the past year and are seeking employment in a hospital are facing a shortage of open positions due to the economic downturn. Because hospitals are seeing less employee turnover, the nursing workforce has stabilized.1 Also, some experienced nurses may be delaying retirement because their retirement funds or their homes lost value, and some employed nurses may be working more overtime if other family members are unemployed.

This article suggests strategies for new graduates who want to enhance their marketability in today's competitive market.

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Changing settings

Healthcare reform may cause a change in hospital hiring patterns, but there's little doubt that the demand for nurses will stay strong.2 The mandate for cost-effective healthcare may prompt an increase in demand for nurse practitioners in primary care.3

The recent passage of healthcare insurance reform should result in more Americans having access to quality healthcare in the future. But until these changes take place, what can you, the new graduate, do?

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Break with tradition

Consider nontraditional opportunities to begin your nursing career. Alternatives to the acute care setting include areas of healthcare continuing to have unmet staffing needs, such as ambulatory, home health, and long-term care nursing.



In the past, new graduate nurses needed hospital experience to gain entry into many nursing career pathways. Nursing applicants with long-term care or home health experience weren't usually considered competitive with applicants with current hospital experience.

But this perception is changing. An emphasis on primary and preventive care is increasing the number of patients in the ambulatory, long-term, and home health settings. This shift is creating demand for nurses competent to practice in these specialty areas. As a new nurse, you may find that building a career by working in long-term care or home health may give you the experiences you need to be more competitive in pursuing hospital employment in the future.

Pursuing employment outside the hospital setting will give you valuable insight into the daily challenges faced by aging and ailing patients and their caregivers. By working with long-term or home care clients, you'll gain special understanding of patients' needs and challenges that you wouldn't find in the hospital setting.

Practicing in outpatient areas also lets you build relationships with patients in their own homes. This perspective will enable you to provide holistic care while gaining clinical experience for any nursing career path you choose to pursue in the future. Working with aging and chronically ill patients may give you a greater understanding of their needs and how to use community resources for their benefit.

Working outside the hospital lets you build organizational, assessment, and patient advocacy skills at a different level of independence. For instance, in the hospital, if a patient's medical status deteriorates, the nurse may call a rapid response team; in the home care setting, the nurse may need to use different communication skills and channels to advocate for the patient's needs.

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Benefits of volunteering

What will help you gain a competitive edge over other nursing applicants when traditional entry-level positions aren't available? Volunteerism can help you "get on base." While seeking employment, volunteering at a local healthcare clinic or with organizations that serve the community keeps you connected to the world of healthcare and lets you demonstrate your compassion.

While volunteering, you may develop relationships with healthcare professionals from the community. They'll be able to see you as a potential nurse applicant and form a favorable opinion of you outside of a formal interview.

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Continuing your education and branching out

If you can't readily find a job, seeking advanced education now is a wise investment for your career. If you're an associate-degree nurse, you can work on a bachelor's degree in nursing, and if you're a bachelor's prepared nurse, you can seek a graduate-level education.

Nursing jobs requiring the most education are expected to grow the most.4 More hospitals are requiring nurses to have bachelor's degrees. Evidence shows that better education improves patient safety and patient care.5

Joining a professional organization will show your professional commitment. You can also take advantage of networking opportunities at meetings.

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Take time to shine

For the best shot at landing a position with any employer, present yourself in the best light during the application and interview process. In today's competitive environment, employers receive many applications for any open position. Prepare a strong résumé that highlights qualifications that will make you stand out. Your concise, up-to-date, and polished résumé must be free of grammatical and spelling errors. Make sure that all content is current and error-free. See Standing out in a crowd.

When you're scheduled for an interview, be prepared to "sell" yourself. This is a time to not only showcase your skills and experiences but also to relate your own experience to professional nursing practice. For example, you might tell the interviewer how you've incorporated evidence-based practice into a project that resulted in an improvement in care.

Employers are impressed with applicants who can be successful in discouraging circumstances. For example, an employer may prefer a nurse applicant with a sense of optimism and perseverance who pursued nontraditional and unique nursing opportunities over an applicant who became disheartened because of the economic situation. Nurses who believe they have the ability to create valuable opportunities to support a developing career and are able to present these experiences in an appealing manner will rise to the top of the applicant pool.

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Prepare for career success

Your time is never wasted when you invest it in activities that enhance your clinical and professional expertise, such as working in a setting outside the hospital, volunteering, polishing a résumé, enhancing an interview presentation, and cultivating a positive perspective. Good luck in your journey!

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Future nursing shortage looms

Despite the current stabilization of the nursing workforce, experts warn that another nursing shortage may be looming. A shortfall of about 260,000 RNs is projected to develop by 2025.6

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Standing out in a crowd

Employers may consider these factors when selecting applicants:

  • level of education and grade point average
  • recent work experience in a patient care environment
  • recent volunteerism experience, demonstrating compassion and commitment in a healthcare setting
  • overall attitude and professionalism during any interactions throughout the application and interview process
  • professionalism and appearance of the application and résumé
  • ability to relay strong critical thinking skills and problem-solving abilities from patient care experiences in any healthcare setting
  • ability to identify ways to incorporate evidence-based practice into systems to improve patient care in any healthcare setting and role.
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1. Carlson J. Nursing shortage eases . . . but only while the recession lasts, experts warn. Modern Healthcare. 2009;39(2):8-9.
2. Rother J, Lavizzo-Mourey R. Addressing the nursing workforce: a critical element for health reform. Health Affairs. 2009;28(4):620-624.
3. Bauer JC. Nurse practitioners as an underutilized resource for health reform: evidence-based demonstrations of cost-effectiveness. J Am Acad Nurse Pract. 2010;22(4):228-231.
4. Roman L. Nursing shortage: looking to the future. RN. 2008;71(3):34-36, 38-41.
5. Boyd T. Hospitals begin to require BSNs, aren't waiting on BSN in 10 legislation. Nursing Spectrum .
6. Buerhaus PI, Auerbach DI, Staiger DO. The recent surge in nurse employment: causes and implications. Health Affairs. 2009;28(4):w657-w668.
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        © 2011 Lippincott Williams & Wilkins, Inc.