A magnetic strategy for new graduate nurses

With the shortfall of nurses, more health care organizations are actively recruiting new graduate nurses. To translate active recruitment to successful retention, however, these newest nurses need support to make the adjustment from the security of a protected academic environment to the demands of a professional nursing career. Nursing turnover occurs when their role transition is unsuccessful. A unique model implemented in 2003 transformed new graduate nurses into confident staff nurses in an acute care setting. The insights gained and the investments required for a "magnetic" strategy to make new graduate nurses successful new staff nurses who stay with the organization are revealed.     

Improving retention, confidence, and competence of new graduate nurses: results from a 10-year longitudinal database

Developing competent and confident new graduate nurses who remain with their hospitals is a major challenge. A structured evidence-based RN residency was developed and implemented in hospitals across the United States. Outcomes data were collected from over 6000 new graduate nurses who completed the RN residency over a 10-year period. The results indicate an accelerated increase in competence and self-confidence and a significant decrease in turnover intent and actual turnover. This study provides persuasive evidence that both new graduate nurses and their organizations benefit from the implementation of a structured, clinical immersion RN residency.     

How work environment impacts retention

Work environment is a major aspect of the day-to-day grind that drives the retention (or turnover) of RNs. When opportunities abound, it is easy to jump ship, and when turnover begins, it is usually the best and brightest who are first to depart. Recent research reported a whopping 27.1% average voluntary turnover rate among new graduate nurses during their first year of employment. Aging of the nurse workforce may be the largest factor impacting health care work environments, as employers struggle to diminish the physical effect of lifting thousands of pounds and walking several miles during each shift. Every influence on the work environment (management, peer behavior, patient acuity, equipment availability, the physical plant) should be assessed for impact on the workforce. While we cannot hope to create paradise in each work setting, we can promote an environment that is healing both to patient and to caregiver.     

Specialized new graduate RN critical care orientation: retention and financial impact

New graduate RN retention in the first year of employment is a challenge for hospitals, ranging from a low of 25% to a high of 64%. he objectives of this study were to determine the retention and costs associated with the employment of new graduate RNs before and after the initiation of a specialized year-long critical care orientation program. Retention was compared between two independent groups of graduate RNs in the critical care units of two tertiary hospitals in a multi-hospital health care system in metropolitan New York. The major study findings were a significant difference in retention between the two groups at 3 months, 9 months, and 12 months, and an annual financial savings related to decreased nursing turnover. Specialized orientation programs that support new graduate RNs have documented increased retention and decreased turnover. Health care finances are positively impacted by specialized orientation programs.     

Nurturing nursing's future through nurse executive partnerships

At a time when nurses are becoming an endangered species, nurse executives have a unique opportunity to respond by forging new and responsive relationships with graduate students who express interest in nursing administration and leadership as a preferred career choice. In this article, a case example demonstrates how a senior faculty member and a graduate student formed a partnership, conducted research, and nurtured an appreciation of the nurse educator role. Using this experience, senior nurse executives can too form partnerships with graduate students as a way to recruit into nursing leadership roles.     

Work unit transformation to welcome new graduate nurses: using nurses' wisdom

While providers, consumers, and administrators recognize the need to attract and retain nurses, recruiting, transitioning, and retaining new graduate nurses (NGRNs) remains problematic. The first 3-12 months of NGRN employment is a perilous and stressful time, with experiences during the transition period profoundly influencing their careers. The purpose of this project was to develop a dedicated transition unit using a theory-driven approach. It addressed employee on-boarding and practice environment issues and it focused on attracting and retaining experienced and newly graduated RNs on an active inpatient unit. Implications are described for those interested in improving the work environment for hospital nurses.     

Graduate nurse perceptions of the work experience

Findings from a longitudinal study on the perceptions of the work environment and job satisfaction for new graduate nurses in the first 18 months of employment at a Magnet Midwestern urban academic pediatric medical center are described. The findings indicated that orientation assisted the new graduate to become confident in his/her clinical competence and work management. By 18 months, the new graduate felt satisfied with access to resources and the ability to participate in professional development opportunities. The results suggest that the new graduate nurse's career adjustment extends beyond mastering clinical skills and includes a lifestyle adjustment to a profession that requires service 24 hours a day, 7 days a week.     

护士自愿离职成本的研究进展

新医改和优质护理工程都要求对护士的离职问题予以重视,但目前的研究多是集中于护士离职的前因变量或结果因素的分析,而对护士离职成本这一组织最关心的问题却很少涉及。根据文献研究和综合分析对护士自愿离职成本的因素和计算进行分类整理,显示护士自愿离职成本可分为直接成本和间接成本。关注护士离职成本,可采取有效措施解决护士离职率过高的问题,对未来的理论研究和医疗实践提供了参考。     

员工离职倾向影响因素研究——以“80后”离职员工为例

研究采用问卷调查法和单变量方差分析法探讨了"80后"员工的离职倾向在个体和组织因素上的差异。研究发现"80后"员工的离职倾向在性别、年龄、目前组织工作时间、岗位性质和组织类型等因素上差异不显著;在受教育程度、工作年限和组织规模等因素上差异显著。由此得出,"80后"员工在离职倾向方面具有较强的一致性,他们的职业主体意识较强,具有职业化取代企业化的倾向。在管理实践中,由于本科比专科和研究生学历的"80后"员工有更强的离职倾向,组织需要更加关注本科学历"80后"员工的离职情况;由于小规模组织中的"80后"员工与较大规模组织中的员工相比,有着较高的离职倾向,小规模组织需要更为关注"80后"员工的离职问题。     

Economic,psychological, and sociological determinants of voluntary turnover

Economists, psychologists, and sociologists have all contributed to the understanding of voluntary labor turnover. We argue for an integrated explanatory model which incorporates variables from each perspective. Such a model is presented and then estimated. Data from a cohort of 135 recently hired registered nurses employed by a university hospital are analyzed to assess the effects of the various explanatory variables on turnover during one year of employment. Turnover is measured by organization records for 12 months following the administration of the questionnaire designed to measure the independent variables. The integrated model portrays the work conditions, environmental conditions, and employee characteristics as primarily affecting turnover by impacting on the intervening variables of job satisfaction, organizational commitment and intent to stay. Ordinary least square (OLS) regression and logistic regression are used in the analysis. The data indicate support for sociological, economic, and psychological determinants of voluntary turnover. These findings are discussed from the perspective of Etzioni's claims about the importance of the moral dimension for explaining economic behavior such as turnover.     

The California Nurse Mentor Project: every nurse deserves a mentor

In the rush to fill positions, newly hired and transitioning RNs are increasingly put into demanding roles without adequate clinical or organizational preparation. One approach that has shown promising preliminary success in enhancing nursing job satisfaction and increasing long-term retention is the use of trained nurse mentors who are paired with newly hired or new graduate nurses to provide ongoing support, guidance, and assistance. The California Nurse Mentor Project was a 3-year pilot project whose goal was to create a replicable program designed to improve the quality, sensitivity, and effectiveness of patient care through enhanced retention of nurses, including multicultural, multilingual, and male nurses. The pilot implementation of the California Nurse Mentor project has been extremely successful. Attrition rates are lower for nurses who are enrolled in the program than those who did not. Both mentors and mentees report that the program has impacted several areas, including their job satisfaction and professional confidence. Preceptor training, according to participant feedback, shows lasting effects on their pedagogy even a year after attending the training.     

Taking action to close the nursing-finance gap: learning from success

Nurse leaders control the largest part of a hospital labor budget, in some cases the largest part of the overall budget. The effectiveness of overseeing this responsibility can mean the difference between an organization's financial stability and financial turmoil. The nursing department at Northwestern Memorial Hospital took ownership of its financial performance. Over the past 2 years, their financial performance saved $4.9 million in productivity while reducing nurses turnover costs by $7.6 million. Valuable lessons from their experience are offered for improving health care's financial and operational outlook.     

Nursing career fulfillment: statistics and statements from registered nurses

A state-level survey of registered nurses confirmed national findings and raised new issues. Findings revealed that while nurses love the intrinsic reward of nursing, they report workplace, relationship, and stress issues which contribute to frustration and exhaustion. These issues may prevent registered nurses from giving the nursing care they desire to deliver, hastening preventable retirement and costly turnover decisions.     

Workplace adjustment and intergenerational differences between matures, boomers, and xers

The authors explored the factors influencing occupational adjustment related to workplace stress among 413 nurses at a Midwestern pediatric hospital. Among critical factors found in responses to their questionnaire and follow-up focus groups were differences in work adjustment and intergenerational conflicts. Both real and perceived workplace stress can manifest itself both fiscal and human costs by increasing turnover, absenteeism and worker's compensation claims as well as "faulty products and negative behaviors." Baby boomers (those born between 1946 and 1964) and Generation Xers (those born between 1965 and 1981) reported quite different issues and perceptions of occupational stress.     

Worker turnover and job reallocation in Taiwanese manufacturing

The paper examines time-series patterns of job and worker flows in a newly industrializing economy (NIE). Using plant-level data from the Taiwan manufacturing sector, the cyclical behaviour of job reallocation and its relation with worker turnover is analysed. It is found that job reallocation and labour turnover are procyclical, at both the aggregate and (two-digit) industry levels. The share of worker turnover caused by gross job reallocation is 17%, suggesting the majority of observed worker turnover reflects rotations of positions that are neither created or destroyed. There is substantial heterogeneity in plant-specific job and worker turnover patterns. Job creation and job destruction rates are higher among small plants and private-sector plants. The private plants are more dynamic than public plants in terms of worker turnover. Controlling for year and industry effects, it is found that job creation and worker turnover are both higher in export-oriented industries.     

Nurse retention: is it worth it?

Nurse turnover costs thousands of dollars and negatively affects patient outcomes. Study results indicate experienced nurses perceive decreased autonomy and task orientation, and increased work pressure in their work environments. Strategies are presented to help retain RNs, save money, and improve patient outcomes.     

Overeducation,job mobility and earnings mobility among holders of first degrees

Overeducation has been researched extensively for nearly three decades, but some major issues in regard to it are still topics of ongoing debate. By using a panel data, that combines a survey of two cohorts of Israeli first-degree holders and data from administrative sources on jobs and wages, we examine the contribution of job turnover, cognitive abilities and continuing graduate studies to the likelihood of overeducation and wage dynamics. The study produces four main findings. First, rapid job-switching makes a negative contribution to the increase in employee’s wage and there is a negative correlation between two variables – an employee’s tenure and the number of past employers in the years after the completion of degree studies – and the probability of being overeducated. Second, the contribution of the individual’s cognitive abilities and quantitative reasoning skills to the likelihood of becoming overeducated is negative. Third, the wages of overeducated employees are some 11% lower and rise more slowly than the wages of those whose level of schooling corresponds to their jobs; this outcome may be interpreted as indicating that the ‘scars’ of being overeducated tend to be long-lasting. Fourth, the overeducated workers have lower propensity to continue to advanced academic studies.     

工作倦怠与离职意愿:基于浙江省19家高新技术企业的实证研究

针对高新技术企业人才流失严重的现象,以我国浙江省19家高新技术企业的员工为研究对象,对中国背景下工作倦怠和离职意愿之间的关系问题进行了实证研究。研究结果表明,工作倦怠中的情绪耗竭、讥诮态度这两个维度可用于解释员工的离职意愿;并且,不同的年龄、教育水平、工龄、企业性质的员工在工作倦怠和离职意愿上存在显著性差异。