Holland Palmgren says she’s in limbo. Unemployment limbo. She works out at the gym. She leads a youth group at New Spring Church in West Ashley every Wednesday night. But mainly she just looks for jobs online and waits to hear from a potential employer.

Since December, when Palmgren graduated from Trident Technical College’s nursing program, she’s applied for 25 jobs at Lowcountry hospitals. No call backs yet.

“When I applied to the nursing program, everyone said whether you graduate with a bachelor’s degree or an associate’s degree, you’ll get the same license in the end,” said Palmgren, 23, of North Charleston.

Both nurses who graduate with two-year degrees and nurses with four-year degrees are licensed as registered nurses, or RNs.

“If you’re looking for jobs, there’s no difference,” she said.

Not so anymore. Report after report suggests that jobs in the health care industry are booming. But as hospitals increasingly try to differentiate themselves from the pack and seek to attain the gold standard “magnet” status by the American Nurses Credentialing Center, nurses with two-year degrees are being passed over for those with four-year degrees.

It’s why Palmgren can’t get hired, she said. She can’t even get an interview.

“I’ve heard from hiring managers on the hospital floors where we worked (as students). They said, ‘Trident grads are the best nurses. I would pick a Trident grad over any other grad any day.’ But it’s like they say that, but the hospital still wants someone with a bachelor’s degree over someone with an associate’s degree.”

The ‘lull’

Muriel Horton, dean of Trident Tech’s nursing program, said the school does not track how many December graduates have found work yet.

The program turns out about 200 graduates every year. In 2009, 94 percent of the nursing graduates were hired. In 2010, that percentage dropped to 81.

“Nurses who had been planning to retire didn’t retire when the recession hit,” Horton said. “Nurses who were working part-time then took full-time jobs because a lot of times they became the primary bread winner. There were fewer people seeking health care because they lost their benefits.”

As demand waned, hospitals became more picky, she said.

In 2011, the most recent data available, Horton said 88 percent of Trident’s nursing graduates were employed.

Other hurdles

It’s not just the economy working against nurses with associate’s degrees.

The Future of Nursing Initiative by the Institute of Medicine recommends that 80 percent of all registered nurses should have bachelor’s degrees by 2020.

Another report published by researchers at the University of Pennsylvania in March found that nurses with four-year degrees caused fewer post-surgery deaths in hospitals than nurses with two-year degrees.

“We estimate that if all 134 hospitals in our study had increased the percentage of their nurses with baccalaureates by 10 points during our study’s time period, some 500 deaths among general, orthopedic and vascular surgery patients might have been prevented,” researchers wrote.

Back to school

Marilyn Schaffner, the chief nursing officer at the Medical University of South Carolina’s Medical Center, said close to 60 percent of nurses at the hospital there have bachelor’s degrees.

She said the university hires nurses with associate’s degrees, with a caveat.

“When you come to MUSC, we want you to make a commitment to return to school to complete your bachelors’ degree,” Schaffner said.

MUSC and other area hospitals provide some level of tuition reimbursement to its nurses who go back to school.

Palmgren wishes someone had encouraged her to apply to a four-year program to start with.

“Two-year schools are cheaper. I mean my financial aid covered all my classes, but it’s really not much of a benefit if I now have to drop $30,000 to get a bachelor’s degree,” she said.

Horton, Trident’s nursing school dean, said the school encourages its graduates to pursue a more advanced degree after graduation.

“We tell our students that the associate degree level is an entry level into nursing and they need to continue their education. That’s not new,” Horton said. “We believe in lifelong learning for all our nurses.”

Free advice

Palmgren said she’d eventually like to get a bachelor’s degree in nursing, maybe even a higher-level nurse practitioner degree. In the meantime, she’s applying for positions in nursing homes — not her dream job.

She is also talking with Air Force recruiters; she’d like to work overseas.

She encourages future nurses to get four-year degrees because she said Trident wasn’t truthful about her prospects after graduation.

“What school is going to tell you something that is going to make you not want to go to their school? Let’s just be honest. If I’m trying to sell you a product, I’m not going to tell you how the other product down the road is so much better, you know?”

Reach Lauren Sausser at 937-5598.