Treat students as potential employees
Create a friendly and caring culture to retain staff, say Constance McIntosh and Cynthia Thomas
In today’s complex, chaotic, and rapidly changing healthcare environment, a newly registered nurse will face many obstacles on the journey into a professional role.
It's everyone's job to nurture students. Picture: Getty
According to Twibell and Pierre (2012), in the US alone 30% of new nurses leave their job within the first year of practice and nearly 60% leave in the second year. This trend places a burden on employers trying to maintain quality, safety and financial standards and leaves the new nurse wondering what to do next.
Schools of nursing and healthcare employers may be failing to provide a seamless transition process from student to nurse. A collaborative approach to helping new nurses make the transition into practice is needed by educators and nurse leaders.
Skills development
There are several factors contributing to the problem. A lack of available clinical placements can result in students getting more simulated experiences in place of real patient encounters. Learning experiences on clinical placement may be limited because of tired and overworked nurses in budget-constrained organisations, leading students to feel that they are not welcome or are a burden on the unit.
As a result, some nursing students graduate without the opportunity to develop the basic skills required to take on professional practice roles, such as administering medications, caring for multiple patients at once, handling time management, functioning in a team, using critical thinking and decision making.
Nurse managers often believe that newly qualified nurses are unprepared to practise in a safe and effective manner, citing poor communication and critical thinking skills (Thomas et al 2011). New nurses, on the other hand, name poor management and lack of support as the main reason for quitting their job (Johnson 2015).
Welcoming culture
Pre-registration nurses should be viewed as potential employees, so it is everyone’s job to welcome and nurture them.
Successful transition to a professional role requires teaching, mentoring, coaching and support from nurse educators, managers and colleagues, in a collaborative manner.
Providing clinical placements where students gradually care for an increasing number of patients will give them confidence.
Once qualified, a new nurse should be paired with the right preceptor to oversee orientation and early transition.
Tailored approach
A manager working with the newly qualified nurse and preceptor to develop a tailored orientation approach with clinical and career goals can reduce frustration and burnout. Preceptors should monitor new nurses for signs of increased stress or compassion fatigue, and make adjustments to the orientation process when necessary.
Preceptors and managers should encourage newly registered nurses to take scheduled breaks. During the orientation period, overtime should be limited or prohibited, to promote healthy habits.
Creating a friendly and caring climate that is free of intimidation, gossip or bullying promotes a culture of safety. Familiarising the new nurse with the unit’s culture and with other employees will build trust and positive relationships.
Working together, nurse educators and practice leaders will improve nurse satisfaction and retention in the process of overseeing a successful transition from student into newly registered nurse.
References
Johnson N (2015) Why good nurses leave the profession. Minority Nurse
Thomas CM, Ryan M, Hodson-Carlton K (2011) What are your perceptions of new RN competency levels? Nursing Management. 42, 12, 15-18.
Authors
Constance McIntosh is assistant professor in the School of Nursing, Ball State University, Indianapolis US
Cynthia Thomas is associate professor in the School of Nursing, Ball State University, Indianapolis US
