CONCLUSIONS

  The issue of nurse retention is not new, nor has the problem been solved. As we move forward through the next few years, the nursing shortage is forecasted to worsen. It is critical to keep trained nurses in practice and seek ways to increase the supply of nurses. Focusing on the new nurse, it is important to examine how the transition into practice occurs as it is well-documented that there are stages necessitating different resources and varied types of support throughout the process. Qualitative research conducted surrounding this transition also reveals that there is room for needed improvement regarding organizational culture and views towards new nurses. Many nurses leave the profession within the first year as a result of high levels of psychological stress and factors related to organizational and patient care structure. In order to increase retention rates of new graduate nurses, organizations must be cognizant of the needs of the new graduate through the transition from classroom to practice and seek ways to meet these needs.

  Literature is available regarding strategies implemented that increased new graduate nurse retention rates on an individual level. This review of literature revealed a gap in research related to evidence-based strategies, transferrable among healthcare organizations to increase retention rates of new graduate nurses. Studies need to be undertaken using an experimental design to outline strategies for orientation programs that address the needs of new graduate nurses in order that they may be fully integrated into and prepared for the positions into which they were hired. All programs reviewed here implemented a preceptor design into their orientation. Each organization was able to increase their retention rates and see associated cost savings; however it remains unclear if this is indeed the best method. More research needs to be conducted in regards to how the preceptor relationship should be defined and what is needed in order for both the new nurse and the preceptor to reap the greatest benefit while achieving organizational goals.
 

RECOMMENDATIONS 

  Student nurses about to enter the professional field must take several aspects of an organization into consideration when making a decision as to where to practice. First and foremost, the culture of the organization must be examined. Organizational culture is “the total of an organization’s values, language, traditions, [and] customs” (Marquis & Huston, 2009). As new graduate nurses in transition, aspects of organizational culture that are important include: the attitude of staff toward new nurses, willingness of staff to offer assistance and teach the new graduate, and support of the nurse manager in regards to career development. The nurse manager, as well as nurses on the unit, must be willing to invest time and resources into the new nurse graduate in order to facilitate transition and development into a professional nurse who can make significant contributions to the unit. The organization as a whole should have a formal orientation program in place with explicit goals and objectives, as well as interventions to meet them. Initially the new nurse graduate should be enrolled into an orientation program focusing on the new graduate nurse. This also allows the new nurse graduates to form relationships with those undergoing the same experience, which can serve as a support network. Unit orientation should include a preceptor who can serve as a bridge between the world of academics and the professional world, serving to lead by example and teach competencies. Together the new nurse graduate and the preceptor can also address issues related to the day-to-day working environment such as organization, patient care issues, and work-life balance. In order for this relationship to be successful, it is necessary that the new nurse graduate and the preceptor be compatible, work side by side on similar shifts, and have modified work assignments in order to accomplish the goals of orientation. The preceptor should be trained and willing to take on this role. The nurse manager should also seek ways to integrate the process that the new graduate nurse progresses through during the first year of practice, as well as throughout the new nurse’s career, with his/her performance expectations and develop ways to foster learning and development.

  The research presented here has shown that investment of time and resources initially can produce the beneficial long-term outcome of increased nurse retention. This can help to alleviate the nursing shortage and ultimately ensure that patients get the care they deserve.
 
 
 
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