New Graduate Nursing Retention in Acute Care Hospitals
New graduate nurses are registered nurses who are in transition from the novice stage to becoming competent. Nurses that are going through the transition need support and encouragement, so they provide the best possible care to their patients. The issue to address would be that new graduate nurses are leaving acute care hospital settings due to high stress and lack of support. Once these new graduates leave the hospital, the hospitals are becoming short-staffed and causing the hospital to lose money. The high turnover rate due to new graduate nurses’ cost “approximately $88,000 per nurse due to the lost revenue spent on training and having to place the nurse” (Eckerson, 2018, pp. 84). Three reasons the issue exist include lack of support from peers and superiors, lack of training, and lack of resources or money. When new graduate nurses graduate from school, they often “have little trust in their capabilities and experiences” (Hossein et al., 2016, pp 11). The little trust these nurses have in themselves causes them to doubt their professional ability and critical thinking. Doughty et al., (2018) explains that through the first-year nurses have challenges in time management, status adjustment, and balancing life and work. These issues cause three adverse outcomes that include the organization: short-staffed, dissatisfied workers (leading to unhappy patients), and registered nurses changing professions overall. Hossein et al. (2016, pp. 11) explain that when new graduate nurses do not receive the support, it may coerce them to leave the profession. Often, new graduate nurses need the proper support to continue throughout their occupation. Doughty et al. (2018) address the fact that through the support of new nurses have improved clinical outcomes. The nursing profession must implement a specific program in every hospital to help new graduates perform to their highest potential.
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Peer to Peer Support Group
The nursing profession recommends a peer to peer support group for new nurses to the lack of support associated with new graduate registered nurse retention. The peer to peer support group will provide meetings at either the unit level or some of the hospital rooms. Outside of a traditional residency program, this program allows for psychological support through the transition from novice to competent. The essential components of this group would need to be a counselor, expert nurses, novice nurses, and leadership. Within this support group, the new nurses will have activities, one-on-one conversations, group conversations, and reflection time to cope with the transition. Once new nurses can feel supported, they could feel comfortable, open to learning, and expand the mindset from a student nurse to a registered nurse. This program should be the first implemented due to the long list of stressors during the first year of nursing. The nursing profession will be in full support to treat and continue to manage the psychological conflict many nurses face during their first years.
New nurses that feel supported by their peers tend to provide better patient care, want to improve themselves and continue working in their environment. For the nurses to feel supported, “research studying the impact of hospital work environments on retention of new nurses hires found that new nurses experience less anxiety and stress in environments that foster a safe learning environment and effective communication and support” (Eckerson, 2018, pp. 84). Feeling supported by one’s peers enhances the mindset in which one works. Nurses that were in school along with a teacher during clinical felt helped. When the nurses were working on the acute care floors, the support was lacking due to the complexity of taking care of patients and assisting others. This program that is to be implemented will “promote a bond and connection with their colleagues and facilitators through a sense of sharing and of ‘not being alone’ in their journey” (Sledge, 2016, pg. 359). The support group will enhance the workflow of a new graduate nurse because they know someone will be there to listen to any struggles they may face. This group will create lessons to foster a safe, confidential learning environment where a registered nurse can discuss any sensitive topics with a counselor, a peer, or other nurses. According to Tyndall et al., (2019, pp. 94), evidence shows there is a long-lasting relationship between the environment and one’s job satisfaction. This support group will begin with a pre-survey, intermission survey, post-survey, and a one-week post-survey. Each of these surveys will be kept confidential. Some topics that have been written down could be a group discussion or a lesson in which everyone could learn. Addressing the psychological needs of a new graduate nurse will implement a field of learning, safety, and growth. Outcomes from this system will be tested by looking at the survey scores, along with interviews with individual new graduate nurses. Studies show that “thirteen of the sixteen articles reviewed presented 1-year retention rates of 90%-100%, indicating less than 10% turnover of new graduates” (Asber, 2019, pp. 433). This support group will encourage nurses to speak up, implement change, and encourage learning among each other.
New graduate nurses are registered nurses who have less than one-year experience. As student nurses’ transition to become nurses taking care of patients, they must have the proper support to maintain the best psychological health. Implementing the new graduate peer-to-peer support group allows for the new, experienced, and competent knowledge to encourage in healthy dialogue about the struggles within the first year. Furthermore, discussing these trials with a counselor will allow for interventions that the new nurse can practice in their life. New graduate nursing retention is a continual issue we could face for years to come. Implementations to embody the new nurse and foster growth helps the nurse, organization, peers, leaders, and most importantly, patients to have consistent care to improve the health of our patients long-term.
- Asher, S. R. (2019). “Retention Outcomes of New Graduate New Residency Programs: An Integrative Review.” The Journal of Nursing Administration, vol. 49 (no. 9), pp. 430-435, doi:10.1097/NNA.0000000000000780.
- Doughty, L., McKillop, A., Dixon, R., Sinnema, C. (2017). Nurse Education in Practice, vol. 30, pp. 101-105, doi: 10.1016/j.nepr.2018.03.006
- Eckerson, C. M. (2018). “The Impact of Nurse Residency Programs in the United States on Improving Retention and Satisfaction of New Nurse Hires: An Evidence-Based Literature Review.” Nurse Education Today, vol. 71, pp.84-90, doi:10.1016/j.nedt.2018.09.003.
- Hosking, J. A., Knox, K. G., Montgomery, L., Valde, J., Cullen, L. (2016). “Evidence Into Practice: Leading New Graduate Nurses to Evidence-Based Practice Through a Nurse Residency Program.” Journal of PeriAnesthesia Nursing, vol. 31 (no. 3), pp. 260-265., doi:10.1016/j.jopan.2016.02.006.
- Hossein, E., Hassankhani, H., Negarandeh, R., Gillespie, M., Azizi, A. (2016). “Emotional Support for New Graduated Nurses in Clinical Setting: A Qualitative Study.” Journal of Caring sciences, vol. 5 (no. 1), pp. 11-21., doi: 10.15171/jcs.2016.002
- Sledge, J, A., Potter, P. A., Stapleton, P. A. (2016). “Participant Voices: Making a Nurse Residency Program Better.” Nurse Leader, vol. 15 (no. 5)., pp. 358-364. doi:10.1016/j.mnl.2016.03.010.
- Tyndall, D. E., Scott, E. S., Jones, L. R., Cook, K. J. (2019). “Changing New Graduate Nurse Profiles and Retention Recommendations For Nurse Leaders.” The Journal of Nursing Administration, vol. 49 (no. 2)., pp. 93-98. doi:10.1097/NNA.0000000000000716.
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