10 Red Flags to Be Aware of When Applying for Nursing Jobs

The idea behind this blog post has come from the ever so popular *viral* TikTok/Instagram posts that have pointed fingers at what is and is not okay when it comes to being a nurse.  Most of these things you don’t necessarily think of as a new grad, and you certainly don’t know what to ask unless you have previous experience.  Even if you’ve been a nurse for 10 years and have only worked in one place, some of these things you may not have realized are “red flags”.  But having worked in 12+ different units in my career, I can tell you that this list of 10 red flags is just that – red flags.  Does it mean that you shouldn’t work on a unit that exhibits one of these red flags?  Well, not necessarily but it is all about your personal preference.  Does it mean that you shouldn’t work on a unit that exhibits most of these red flags?  Well, to each their own, but I can certainly say that I wouldn’t touch any unit with a 10-foot pole that exhibited 5+ of these red flags.

 

10 Red Flags in Nursing

 

1.  High Staff Turnover

A big red flag on any unit is having a high staff turnover.  By this, I mean that nurses are quitting at an alarming rate.  And usually, this is for a good reason!  If a unit can’t retain its staff it’s probably because of a few reasons.  Maybe the nurses aren’t appropriately paid, maybe the unit demeanor is negative, perhaps the managers aren’t kind.  It can be many things, but very rarely would I ever think that having a high staff turnover would be a positive thing.

 

HOW TO ADDRESS THIS ISSUE IN YOUR INTERVIEW

If you’re interviewing for a new job, a way to ask about this might be to say, “How many positions are open right now?”  And if there are a lot of positions open, I’d simply ask why.  Maybe the unit is expanding and they just need more staff.  But maybe they just have a large number of nurses choosing to leave the unit.

 

2.  Required to Work Extra Shifts With No Incentive

This one is a necessity when you’re talking about red flags in nursing.  That’s because a large number of units require nurses to pick up extra shifts – with NO incentive.  Some units require one call shift per schedule (which is normal and appropriate), but some units require nurses to work 4 shifts/week when the unit census increases – without any incentive.

Let me start by saying, at the very minimum anytime you pick up an extra shift, you should be making time and a half.  (Meaning if you get paid $50/hour, you should be making $75/hour and even more than that after you reach overtime at 40 hours).  Some units, however, go above and beyond and incentivize staff members to pick up extra shifts with bonuses.  I’ve worked places that get anywhere from $200-$1,000 bonuses per shift that are picked up extra.

You should also be wary of this, however, because if you continually have to pick up shifts (even if you’re appropriately incentivized) it can be a red flag.  Why are you needing to pick up so many extra shifts?  Sure the money might be nice and you may want to, but if you take a step back… it isn’t normal to have to work more than 3 shifts/week.

 

HOW TO ADDRESS THIS ISSUE IN YOUR INTERVIEW

I would first address this by asking, “Do you require nurses to pick up call shifts and if yes, how many per schedule?”  I would then go on to say, “If nurses meet their required call shifts and there are still extra shifts that need to be picked up, have you ever offered an incentive for that in the past?”.  I would also clarify that your required call shift (if there is one), means that you’ll be making time and a half if you’re called in.

 

3.  Normalizing Not Taking Breaks

I’ve worked in some places where not taking your break is “normal” and other places where you can’t take your break because you are just so dang busy.  And to me, both are red flags.  Nurses shouldn’t have to break their backs to the point where we don’t have a second to sit down and eat food.  It doesn’t make you a good nurse to miss your break, and it certainly doesn’t make a good unit if nurses are consistently having to miss their breaks to keep up with their work.

I would also go on to say that maybe you’re able to take a lunch break, but you aren’t able to take the other allotted breaks (sometimes it is state law to get a certain number of breaks in a certain number of hours), and I still believe this to be a red flag.

 

HOW TO ADDRESS THIS ISSUE IN YOUR INTERVIEW

This is something that I think you can just come straight out and ask… “Tell me about how breaks work.  Are nurses able to take their breaks?  What is the allotted break time?  Do nurses leave their phones at the bedside or are they required to take them to the break room?”.  If you don’t get the answer you want, at least you can decide whether or not you’re okay with not getting breaks.

 

4.  Managers/Directors Who Are Difficult to Get Ahold of (or Don’t Show Their Face on the Unit)

I always think that a unit is only as good as its manager/director.  Sure, you can have fabulous nurses and an awful manager/director, but the reality is that the manager/director sets the tone of the unit.  If you never see the face of the manager/director or never hear from them, it can be a red flag.  After all, all major decisions are going through them and if they aren’t asking for staff feedback or aren’t available to hear you voice your concerns, then it seems like they don’t care for the people who are working under them.

 

HOW TO ADDRESS THIS ISSUE IN YOUR INTERVIEW

This is something that you just have to follow your gut.  During your interview try to lean into how the manager/director makes you feel.  Are they warm and inviting?  Are they a robot?  It’s best to follow your gut instinct on this one!

 

5.  Being Short Staffed (Continuously)

Not being able to retain nurses is another huge red flag.  To me, being short-staffed could be for many reasons including a high staff turnover, people consistently calling out, or you may even be working at a for-profit hospital (like an HCA hospital).

Being short-staffed because you can’t retain staff is a red flag, but an even bigger red flag is being short-staffed because your hospital is trying to maximize its income.  For example, for my first staff job I worked at a for-profit HCA hospital.  I showed up to work one night after they had canceled 9 (yes 9) nurses, to find out that I had a 4 NICU baby assignment.  When I questioned why someone wasn’t being called in to take one or two of my patients, I was met with, “This is the budget that we’re working with right now”.  How degrading is it to have someone higher up than you decide that your night is only worth X amount of dollars and you’ll have to bust your butt to do your job correctly?

 

HOW TO ADDRESS THIS ISSUE IN YOUR INTERVIEW

I would go ahead and phrase this question like, “How often do you typically have to cancel staff nurses?”.  Depending on their answer, “Oh we never cancel because we’re always so busy” (that might mean they are short-staffed) or, “We have to cancel 1-4 nurses per shift”, you can then decide how you want to proceed.  If you do want to proceed and they cancel 1+ nurses per shift, make sure to ask if there are rules to when you will be canceled.  For instance, usually, you’ll have a 6-month grace period where you won’t be canceled because you’re orienting or because you haven’t earned any PTO yet.

 

6.  Too Many Pizza Parties

…this might seem counterintuitive… but to me, too many pizza parties signal that the “higher-ups” (if you will) are trying to gift the staff with something for a reason.  Sometimes the reason is well-intentioned (i.e. it’s a holiday), but oftentimes the reason is that the unit is short-staffed and everyone has missed lunch (again).  Or maybe there have been some particularly difficult patients and instead of giving the nurses a raise or a bonus, they are being praised with pizza.  It just rubs me wrong.

 

HOW TO ADDRESS THIS IN AN INTERVIEW

This is one that I’m unsure whether you can address or not.  I think that it’s just something you have to see once you start work, unfortunately.

 

7.  Won’t Hire Travel Nurses or Experienced Nurses

There are so many hospitals out there that simply refuse to hire travel nurses (and even experienced nurses over new grads) and instead they let their staff just suffer through being busy.  There are so many things wrong with this.

First off, travel nurses can truly be your greatest asset.  If you treat them with respect, word will get around, and before you know it incredible travel nurses will want to work on your unit.  The hospitals that don’t want to hire travel nurses don’t know how to appropriately treat travel nurses.  Or they may have had a bad experience (fair), but was that a bad experience because they don’t know how to treat travelers and the traveler had an equally awful experience?  And when I say “don’t know how to treat travelers”, the truth is travelers can get shit on sometimes.  If you want to treat them appropriately, treat them how you would treat staff nurses.  And for goodness sakes, they can take a sick patient.

The other side of this is hospitals that refuse to hire anyone but new grad nurses because they like to “train their own”.  This is also a red flag to me because to me it says, “We are closed-minded and stuck in our ways and we want robots to do what we say and not think outside of the box”.  But seriously, new grads are an incredible asset, but the day that continuously hiring new grads over one or two experienced nurses is a good idea – come find me.

 

HOW TO ADDRESS THIS IN AN INTERVIEW

I always ask the ratio of new grad nurses to experienced nurses.  Then I follow it up with, “Have you ever hired travel nurses, or is that something that you’re open to?”.  Their answer will speak volumes.  (Please note, on the chance that there is low staff turnover travelers may be unnecessary because the hospital can maintain their patient load with the number of nurses on staff).

 

8.  Rushes New Grads Through Orientation to Help With Lack of Staff

Another thing to be aware of is how quickly new grads (or even experienced nurses) are going through orientation.  For an ICU setting, orientation should take MONTHS.  And if the hospital you’re working at doesn’t take adequate time to train their staff, there will be major issues down the road.

Another side to this is if the manager is requesting new grads to be done with orientation before they are supposed to be done.  For instance, if orientation is supposed to take 10 weeks but at week 8 the managers are asking if the new grad is ready to be on their own, again, red flag.

 

HOW TO ADDRESS THIS ISSUE IN YOUR INTERVIEW

I would simply ask how long the orientation process is supposed to be for both new grad and experienced nurses.  Sometimes experienced nurses will be more in control and be aloud to dictate when they are done orienting, which is okay.  But new grads should not be coming off of orientation early or dictating when they feel like they are done.

 

9.  Not Having a Safe Space to Grieve

Nursing is a tough profession emotionally, mentally, and physically.  If you don’t have the adequate space to grieve, you’re just going to experience burnout and compassion fatigue.  I think that not only is it important to be able to rely on your managers when something goes wrong but to also be able to talk with a therapist or chaplain, which some hospitals provide.

 

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Read more about How to Take Care of Your Mental Health As a Nurse

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HOW TO ADDRESS THIS ISSUE IN YOUR INTERVIEW

I would ask this question by phrasing it as a mental health issue (which it is).  I may say something like, “What resources do you have to offer if something at work takes a toll on my mental health?  Specifically, if I have a patient pass away or happen to be taking care of sick patients for a period of time that ends up taking a toll on my mental health”.  They should be able to list out what they can offer and if they can’t offer anything, maybe you’ve given them a push to start thinking about it.

 

10.  Having to Go Above and Beyond For a Yearly Raise

This may be another controversial point, but I don’t believe that you should have to go above and beyond for a simple raise.  To me, showing up to work on time, being a good team member, and doing your job well means that you’re going above and beyond.  Especially when human lives are in your hands.

Some units require you to work on a committee and pick up extra shifts and make sure all of your computer modules are complete to get a raise.  And some nurses would argue that if units weren’t run this way, then what incentivizes people to work?  I would argue that every year you’re a nurse on that floor you’re learning, growing, and becoming more and more of an asset.  If your managers fail to see that, then you can walk out the door and they can start a square one with someone else.

 

HOW TO ADDRESS THIS IN YOUR INTERVIEW

You could inquire about raises easily by asking, “Does your unit give yearly raises?  What are they dependent on?  How much is the raise yearly?”.  (By the way, I’d say an average raise is 3-5% per year).

 

Tell me, what are some of your “red flags” in nursing?

 

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Are you planning to interview for a new nursing job?  Don’t miss these posts:

The Best Questions to Ask in a Nursing Interview

Questions to Ask in Your Nursing Interview if You’re Looking for Work-Life Balance

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