Retaining early career registered nurses: a case study

Abstract

BackgroundA core objective of the Australian health system is to provide high quality, safe health care that meets the needs of all Australians. To achieve this, an adequate and effective workforce must support the delivery of care. With rapidly changing health care systems and consumer demographics, demand for care is increasing and retention of sufficient numbers of skilled staff is now a critical priority to meet current and future health care demands. Nurses are the largest cohort of professionals within the health workforce. Reducing the rates at which nurses leave the profession and supporting nurses to practice in their profession longer will have beneficial implications for the sustainability of a nursing workforce and, ultimately, to patient outcomes. The aim of the study was to describe and explain early career registered nurses’ (ECRNs) experiences and support requirements during the first five years of practice for the purposes of identifying strategies that would support greater retention of ECRNs.MethodsA single case study design focused on early career registered nurses (ECRNs) working in a hospital and health service in northern Australia. The research team adopted Djukic et al’s definition of ECRNs as “RNs who have practiced for less than 5 years”. Data was collected via three individual interviews and two focus groups. Thirty-five ECRNs participated in the study.ResultsQualitative analysis of data generated during interviews and focus groups, identified the key themes of receiving career advice and choice or no choice. Analysis of study data in the context of the broader literature resulted in the researchers identifying six areas of focus for ECRN retention: 1) well-planned, supported and structured transition periods; 2) consideration of rotation through different areas with a six month minimum for skills development; 3) empowering decision making; 4) placement opportunities and choice in decisions of where to work; 5) career advice and support that considers ECRNs’ personalities and skills; and 6) encouragement to reflect on career choices.ConclusionsReducing turnover and improving retention relies on understanding the factors that influence nurses’ decisions to leave or remain within an organisation and the profession. Ensuring nurses in the current workforce remain engaged and productive, rather than leave the profession, is reliant on addressing factors that cause attrition and implementing strategies that strengthen retention rates and workforce sustainability.

Fostering graduate nurse practice readiness in context

“…This, coupled with increasing healthcare demand, provides an imperative for universities and industry to adequately prepare and retain those new to the nursing profession as a key priority. Evidence from recent years indicates that the rates of graduates who leave or intend to leave is increasing and costly (Booth, 2011;D'Ambra & Andrews, 2014;Flinkman & Salanterä, 2015;Hayes et al, 2012;Health Workforce Australia, 2012b;Laschinger, 2012;Laschinger, Finegan, & Wilk, 2009;North et al, 2013;Mills, Chamberlain-Salaun, Harrison, Yates, & O'Shea, 2016;Mills, Woods, Harrison, Chamberlain-Salaun, & Spencer, 2017;Trepanier, Early, Ulrich, & Cherry, 2012;Zimmerman & Ward-Smith, 2012). This evidence reinforces suggestions that graduates are not adequately prepared for practice and current healthcare demands.…”

Effective workforce planning: Understanding final‐year nursing and midwifery students’ intentions to migrate after graduation

“…The published research is largely from low‐income countries with a dearth of research from developed countries despite nurse migration resulting in major workforce planning challenges. Studies have identified the need for greater understanding of the factors that influence new graduates’ decisions to migrate, and the importance of examining novel ways of recruiting and retaining new graduates has been identified (Jones, Johnstone, & Duke, 2016; Mills, Chamberlain‐Salaun, Harrison, Yates, & O’Shea, 2016). This exploration requires in‐depth understanding of the factors influencing final‐year nursing/midwifery students’ intentions to migrate after registration.…”

Evaluation of the Allied Health Rural Generalist Program 2017‐2019

“…New graduate health practitioners undergo a challenging period of adjustment that requires support 6 particularly in a rural and remote contexts 32,33 . Well‐structured support programs, with organisational commitment, have been shown to achieve successful outcomes in professional development and retention of early career health professionals 28,34‐37 . In this evaluation, the supervisor role was reported as an enabler to engagement in the RGP, managing workloads and achieving learning outcomes, while conversely, unstable staffing in the supervisor role was reported as a barrier.…”