August 20, 2009 | | Comments 9
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New nursing programs geared towards preparing and retaining nurses

Studies show that up to 60% of new nurse graduates leave their first job within their first year, and many hospitals are focusing on ways to help new nurses through the difficult transition from nursing school to novice nurse to competent, confident practitioner.

Rapid City (SD) Regional Hospital is one such facility looking to help its new grads succeed and remain with the organization. The hospital hires an average of 100 nurse graduates every year, but within two years, 25% of those nurses are no longer with the facility. With the help of a recent grant from the Robert Wood Johnson Foundation, Regional Hospital has launched a two-part program to provide guidance to the new nurses.

The first part of the program is a pilot involving the two university nursing schools. The schools will each pick one class of eight students to participate in a program where they will have extra opportunities to practice clinical skills. The students will work with nurses at Regional Hospital; two students will be paired with a nurse and faculty members will oversee the process.

This part of the program is designed to give students more time with nurses to practice clinical skills, which it is hoped will help them gain confidence and have a more positive first year when they eventually start work as a nurse.

The second part of the program is a new, year-long residency program for each newly-hired nurse. New nurses will be paired with a mentor, who will be someone other than their supervisor or preceptor.

To read more on Regional Hospital’s new programs, click here.

Does your facility offer similar programs? What are some other ways to help with first year nurse retention?

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Filed Under: Hot topicsRetentionStaff motivation

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Sarah Kearns About the Author: Sarah is an Editorial Assistant in the patient safety group at HCPro, Inc. She contributes to two monthly newsletters; Briefings on the Joint Commission and Briefings on Patient Safety, and manages four e-zines; Accreditation Connection, AHAP Staff Challenge, Nurse Manager Weekly, and Healthcare Training Weekly. She also helps research new products for the patient safety and nursing market. She graduated from the University of Connecticut in 2008 where she earned her bachelor's degree in English.

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  1. I feel as though many schools are in too much of a hurry to graduate nurses and don’t truly prepare them. I understand the shortage senario but to not have them adequately prepared only casues confusion, disappointment and a hardship on the employers.

  2. As a full time nurse in Staff Development and part time adjunct faculty member, I strongly support thorough pre-licensure education, orientation programs, etc. However, the numbers being thrown around regarding this topic are often misleading.
    For example, the phrase “up to 60%” in the above article is technically correct, but not at all typical of the situation. To use that figure grossly overstates the problem. Most reported figures for first year turnover are far below that. Note that the South Dakota hospital discussed in the article had only 25% turnover in a 2 year period — that’s only an average of 12.5% per year. That’s a long, long, way from 60% and may not even require a big expensive program to resolve.
    If we are ever going to get a true solution to the problems that exist, we are going to need far better data about new grad retention than is provided in this article. We need the kind of data that will give a clear picture of the true complex situation.

  3. To Jan Brown: I agree with you there. My region has seen a proliferation of new RN programs, most of which provide only a shadow of the education that the older, more established schools provide. They seem to be a factory with an assembly line — bringing students in, charging them a fortune, providing some classroom time and the bare minimum clinical to meet the State Board requirements, and then releasing them unprepared to actually BE nurses. We very rarely hire graduates of those schools. We have learned our lesson.

  4. I believe the problem with the schools lies with the philosopy that says, “It’s not our responsibility to teach clinical skills, but critical thinking”. It is difficult to develop critical thinking skills without task learning.

    Having a mentor the first year was originally the plan for AD graduates. That lasted for about 5 minutes. It’s still a good idea!

  5. In addition to truly preparing them, I would think that more clinical practice may also “weed out” any potential nurses who may not really be suited for such a difficult profession too.

  6. The best teaching tool is experience and you can’t get that from a book. I have been in nursing for 35 years. I started in OB, then long term care, then occupational heatlh and then dialysis. I did not learn much in school to prepare me for those jobs. I learned with on-the-job training. So I agree, that there needs to be a requirement of so many hours of clinical to see who can learn what really needs to be done on the job. Those who don’t want to or can’t perform would not even graduate. Doing the book work is the easy part. Also, a big part of nursing is about the caring. That too could be determined if there was more clinical time required.

  7. I am curious as to why healthcare feels it necessary to provide an “internship” (6-12 month orientation program) for new nurses paid for as part of the hospital’s orientation programs.

    With other degrees such as pharmacy, teaching or engineering, the burden of paying for an internship falls to the student and is a part of the curriculum. I understand the nusring shortage but I am curious why hospitals continue to pay for internship programs despite our tightening reimbursement.

  8. I agree that there needs to be more clinical experience with the AD and the BSN Program nurses. There needs to be more of an emphasis on the “clinical” and “critical thinking” skills with an assignement of a realistic number of patients; not just the one or two you receive as an assignement in nursing school. I feel that both the AD and the BSN need additional “clinical” experience before they are allowed to graduate so that when they come into the workforce they have a better chance to survive the demands of the profession.

    I am a graduate of an AD program in 1970 – started out as a staff nurse, then med/surg floor and to ICU in 1976 – I felt that I was not well prepared for the position as staff nurse in 1970.

    I gained the majority of my advanced skills in ICU and had many additional clinical courses and inservices during that time. In 1978 I became the Head Nurse of ICU – and continued in my management roles in nursing at varius hospitals as the DNS and then in 1994 came to rural America as the DNS.

    In the early 80’s I attempted to get my BSN, but I was the ICU Manager and classes were not offered after 4:00 p.m. for additional higher education at that time. I changed my course of study in 1985 and received a 4 year degree in Hospital and Healthcare Administration and later a Master’s in Healthcare Administration.

    I know well the limitations of an AD education, but I can honestly state that without the AD program in nursing I would not have had the opportunity to become a nurse during that period of time in my life. The AD program gives you an opportunity. What you do with that opportunity and how far you go in the profession, the choice is yours. I am currently the CEO of a small rural hospital and have been in this role for the past 8 years.

  9. I am currently a Director of Health Care Services at a Continuing Care Retirement Community. I have been an RN for 26 years and in nursing management 15 years. I am constantly surprised by the lack of preparation of todays nurses both RN and LPN. I have had new hires that state they have never given an injection! I have local students do part of there clinicals at our facility and have asked the instructors if they teach critical thinking in school. Of course I hear yes. I do not see it. My soon to be daughter in law graduated recently from a RN BSN program and she told me she felt “ripped off” after graduating. Fortunately she was chosen for an internship program in the ICU and when finished was offered a position on that unit. She really needed that extra time with mentoring to feel confident. It is a shame that we have so many people that want to be nurses and so few that want to teach and can’t because of the requirements. I truly believe there are nurses out there who would do a fabulous job teaching and preparing students perhaps without a MSN. The programs are cutting down on clinical time and it is certainly showing all the time.I actually went to an old fashioned diploma program (2 years all year round)and graduated in 1983. I feel as though I was well prepared and did not have any difficulty when I began working as a nurse. I now supervise close to 80 employees including many nurses and c.n.a.s. I can hardly tell the difference between an experienced LPN, RN, or BSN. It isn’t like the BSN shines brighter than the RN and the same for the LPN. I find todays new nurses waiting for everyone to tell them what to do….critical thinking is lacking. I have some cracker jack nurses and immediatelty our experienced LPNS come to mind. Don’t get me wrong we have some great RNs too…..I just wish there were more.

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