If there’s a nursing shortage, why can’t I find a job?

No, really. Hospitals, especially those in rural areas, are having a hard time finding nurses to staff their floors. Patient ratios are rising, mandatory overtime is becoming much more common and every nurse you meet has a horror story about unsafe working conditions because of short staffing.

Yet you, the spandy-new nurse, can’t find a gig. How did that happen?

The answer, as it is in most things, boils down to money. In a down economy, with decreasing reimbursements, hospitals don’t want to spend the dough it takes to train a new nurse. Managements all over would rather hire experienced nurses on the cheap—and yeah, that’s possible to do—or short-staff their units than spend the several thousand dollars it takes to make sure a new RN is safe, effective and a good fit.

So how do you find a job? Getting a job out of nursing school is now—and will be more so in the future—predicated on what you do during school. It’s no longer enough to get good grades and have good references. The more experience you can muster during school, whether it’s as a tech on the weekends or in externships during semesters off, the better off you’ll be after graduation. Not only will you have experience, but you’ll have connections.

Unfortunately, things are tough enough now that your first job out of school is not at all likely to be a plum. Chances are you’ll start off working nights or swing shifts, covering weekends and holidays, and not earning as much as I did a decade ago when I started. If you can manage to work for a year, things get much easier and your prospects will improve. Hang on to that first job and use it as a springboard to another if you’re really unhappy.

And finally…you might have to relocate. I’ve heard from nurses in the mountain states who have been looking for a year or more. I’ve talked to nurses in rural Texas who have been looking for six to 18 months. If relocation is truly off the table because of family or finances, then it’s off the table—but if you’re unencumbered and relatively mobile, you can often find work if you’re willing to move.

A word about travel or agency nursing: Although it seems like a great idea to work as a traveler or agency nurse right out of school, I would advise against it. The catch in filling in as a traveler is that you’re working in places that desperately need nurses. While you might get a whole set of mad skills very quickly, the lack of comprehensive training like you’d get in a hospital setting will work against you, big time, in the long haul. Wait a year or so before signing on with Glamour Nurse Staffing, LLC.

And don’t lose hope. There are jobs out there—good ones—but they might take a little more effort to land than they did a few years ago. Keep plugging away, get some hours on the floor under your belt and see what happens.

Oh, and make sure that resume of yours is printed on nice, thick paper.