DiversityNursing Blog

Healthcare organizations must recognize the importance of investing in resources and training for graduate Nurses during their first 2 to 3 years of employment in order to retain them in direct patient care roles. While some top Nursing schools are striving to produce practice-ready Nurses, not all graduates possess the expertise needed upon entering the workforce and may require time to build confidence in various situations. Consequently, new Nurse graduates face the highest risk of turn over within their initial years of employment.

In order to retain new Nurses and reduce turnover, it is essential to invest in their training and development. This can be done through programs such as Nurse residencies, mentorship, and access to clinical decision support resources. By providing these resources, healthcare organizations demonstrate their value and support for new Nurses. Collaboration between academia and practice settings is crucial to determine the necessary competencies for beginner Nurses.

The initial period of a Nurse's career is pivotal for their professional development, job satisfaction, and commitment to the organization. Here are some reasons why investing in new Nurses is good for retention:

Training and Development Opportunities

Offering comprehensive training programs is essential in equipping new Nurses with the skills and knowledge they need to excel in their roles. By providing ongoing professional development opportunities, healthcare organizations demonstrate a commitment to the growth and success of their Nursing staff, fostering a sense of value and investment in their development.

Mentorship Programs

Introducing mentorship programs connects novice nurses with seasoned mentors, fostering a nurturing atmosphere for growth and adaptation. Mentorship goes beyond imparting knowledge and helps Nurses feel a sense of inclusion, empowering them to navigate the demands of their roles with confidence and effectiveness.

Competitive Compensation and Benefits

Providing competitive salaries and attractive benefits is a clear indication of the organization's appreciation for the invaluable contribution of its staff. Adequate compensation plays a vital role in retaining highly skilled and motivated Nurses, ensuring their continued commitment to the organization's success.

Work-Life Balance

Promoting a harmonious work-life balance not only enhances Nurse satisfaction but also mitigates the risk of burnout. Implementing policies that prioritize scheduling flexibility, reasonable work hours, and ample time off significantly contribute to the overall well-being of Nurses.

Recognition and Appreciation

Acknowledging and valuing the hard work and dedication of new Nurses cultivates a nurturing work environment. Consistently providing feedback and recognizing their contributions not only instills a sense of pride but also enhances job satisfaction.

Career Advancement Opportunities

Creating a roadmap for career progression within the organization not only motivates new Nurses to stay for the long haul but also demonstrates a dedication to their professional development. Offering avenues for advancement, such as promotions, leadership positions, or specialized training, indicates a commitment to nurturing their growth and success.

Supportive Work Environment

Fostering a nurturing and inclusive work environment builds a strong sense of camaraderie among staff. Proactively addressing concerns such as Nurse bullying or workplace incivility plays a significant role in cultivating a positive workplace culture that values respect and collaboration.

Wellness Programs

Investing in wellness programs that prioritize the physical and mental well-being of staff showcases a genuine dedication to their overall health. These programs encompass a range of resources, such as stress management tools, mental health support, and initiatives promoting fitness and well-being.

Feedback Mechanisms

Encouraging a culture of open communication allows new Nurses to freely express their concerns, share valuable feedback, and actively contribute to the ongoing improvements within the workplace. By promoting an environment of transparency and responsiveness, healthcare organizations not only enhance job satisfaction but also create a strong foundation for collaboration and growth.

Investing in new Nurses not only supports their professional development but also creates a positive work environment that contributes to overall job satisfaction and retention. Organizations prioritizing the well-being and growth of their Nursing staff are likely to see increased loyalty and reduced turnover.

Healthcare organizations must ensure Nurses are equipped with resources and the support they need to provide quality care. Hospitals must invest in initiatives that attract and keep Nurses, such as:

• Developing An Employee First Culture

Dr. Linda Shell, DNP, MA, BSN, DNS-CT, Chief Learning Officer suggests Nurse leaders cultivate an “Employee First Culture” approach in their facilities.

“An Employee First Culture is built on the concept that employees are the best asset of any company, and they need to be encouraged and appreciated,” says Dr. Shell. “When appreciation goes up in an organization, quality tends to go up. I really believe that for us as Nurses, the more we can do to create a positive work environment and develop our leadership skills, the more opportunities we are going to have to improve the quality of care that we provide every day for patients, as well as the residents that we serve.”

• Staff Recognition Programs

"A person who feels appreciated will always do more than what is expected." This quote has been scientifically proven to be factual. 

According to research, giving thanks can have important implications for encouraging actions that promote cooperation.

Whether it be a hand written note, or a brief one on one meeting, managers should take the time to recognize the hard work Nurses are putting in.

Recognizing Nurses on their birthdays and work anniversaries is a simple way for organizations to show appreciation for their staff.

Celebrating Nurses with a themed party or gift bags is another way to give thanks.

According to Nursing Management, realistically, quarterly recognition will suffice for larger units; however, if you have a small unit, monthly recognition is recommended.

• Mental Health Resources

Many Nurses are experiencing severe, adverse mental health effects as a result of the pandemic, and a lot of them are considering leaving the profession entirely.

Organizations must support employee self-care by establishing evidence-based preventive strategies, providing mental health resources, and demonstrating that leadership supports and prioritizes mental health and well-being.

Some health systems are hiring a Chief Wellness Officer (CWO) to support their wellness initiatives.

Dr. Maureen “Mo” Leffler, the first enterprise-wide CWO at Nemours Children’s Health said, “The goal of the Chief Wellness Officer is to promote professional well-being, which is characterized by having everything in place in both the individual and in the system, so those two things work together optimally. When we do that, we can provide the highest quality of care, the safest care, the best care. We can derive meaning in the work we’re doing.”

• Tuition Assistance Programs

Tuition reimbursement is becoming a popular way for hospitals to attract and retain quality Nurses, especially in areas where demand is high. 

These programs are designed to help Nurses continue their education by relieving some of their financial stress.

• Good Communication

Routine unit or individual staff meetings should be held to discuss any issues or concerns. Nurses want to feel heard. So it's important management truly listens to what they have to say and then set up action plans and follow up.  

• Flexible Work Hours

According to a recent McKinsey survey, Nurses that experienced more flexibility in hours and scheduling during the pandemic were highly interested in retaining that flexibility going forward. For Nurses who indicated plans to stay in their current direct patient care role, flexibility in hours and shifts was an influential factor.

Bottom line, health systems must prove to their Nurses that they are Valued, Appreciated, Heard, and Supported if they want to keep them. There are thousands of Nursing opportunities out there and you must work to retain the Nurses you have. This is just as important as recruiting Nurses.

If your hospital is experiencing high turnover among your newly licensed Nurses, this article may give you an idea of why they’re leaving and areas where you can improve your work environment.

Some factors influencing low unit-level turnover: first professional degree was a baccalaureate or higher, greater variety and autonomy, and better perceived RN-MD relations

“About 80% of newly licensed nurses find their first work in hospitals,” says New York University Rory Meyers College of Nursing (NYU Meyers) Professor Christine T. Kovner, PhD, RN, FAAN. “Turnovers are one of the costliest expenditures in our profession. In fact, costs are estimated at $62,000 to $67,000 per departure, amounting to $1.4 to 2.1 billion in expenses for new nurses who leave their first jobs within three years of starting.”

Prior research on newly licensed nurses tended to focus on organizational turnover, where a nurse leaves the hospital or organization. However, there is scant literature on internal or unit-level turnover, which occurs when a nurse leaves their current assignment to take up new roles or positions within the organization or hospital.

Recently, Dr. Kovner led a team of researchers at NYU Meyers and the School of Nursing at SUNY Buffalo in conducting a study to fill in the gaps. Published in the International Journal of Nursing Studies, the study of a nationally representative sample of new nurses working in hospitals, sought to better inform unit-level retention strategies by pinpointing factors associated with job retention among newly licensed nurses.

“The internal turnover rate for the one year between the two waves of the survey was nearly 30%,” said Dr. Kovner. “This turnover is in addition to those leaving the organization. This figure is substantially larger than previously reported in other studies, which estimated a 13% one-year internal turnover rate among new nurses.”

The researchers looked to bolster the existing evidence on internal turnover to determine precursors to remaining on the same title and unit-type from the first to the second year of employment.

The nurses (n=1,569) were classified into four categories based their unit and title retention. 1090 nurses (69.5%) remained in the same title and unit-type at wave two, while 129 (8.2%) saw a change in title, but not in unit-type. A similarly small group of 185 (11.8%) had no change in title, but changed unit-types, while 165 (10.5%) had a change in their title and unit-type.

In addition to collecting the new nurses’ demographical data, Dr. Kovner and her team assessed their perceptions of their work environment in both surveys.

“In doing this we were able to examine the changes in work environment perceptions over time between nurses who remained in the same unit and title to those who changed unit and/or title,” said Dr. Kovner.

Upon analysis, the researchers found five factors most strongly associated with retention: holding more than one job for pay (negative), first professional degree was a baccalaureate or higher, negative affectivity, greater variety and autonomy, and better perceived RN-MD relations, all positively related.

“Our results point to the variables on which managers can focus to improve unit-level retention of new nurses,” said Kovner.

Related Article: Fellowship Program Improves New Nurse Retention, Nets Savings

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Funding. Funding for this research was provided by the Robert Wood Johnson Foundation.
www.nyu.edu