What Makes Nurses Stay (or Not) in New Grad RN Jobs?


RN Workforce Study finds five factors influencing internal turnover of new nurses

Unit-level nursing retention strategies may be employed to handle both external and internal turnover amongst new grad RNs

As highly coveted as new grad RN jobs have become, the fact that many new nurses don’t stay in them long continues to concern healthcare employers. But not all of these nurses are leaving their first employers altogether.

“About 80 percent of newly licensed nurses find their first work in hospitals,” said Christine T. Kovner, PhD, RN, FAAN, New York University Rory Meyers College of Nursing (NYU Meyers) Professor. “Turnovers are one of the costliest expenditures in our profession. In fact, costs are estimated at $62,000 to $67,000 per departure, amounting to $1.4 to $2.1 billion in expenses for new nurses who leave their first jobs within three years of starting.”

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Prior research on newly licensed nurses tended to focus on organizational turnover, where a nurse leaves the hospital or organization. Little data existed on internal or unit-level turnover, which occurs when nurses leaves their current assignment to take up new roles or positions within the organization or hospital.

Recently, Kovner led a team of researchers at NYU Meyers and the School of Nursing at SUNY Buffalo in conducting a study to fill in the gaps. Published in the International Journal of Nursing Studies, the study sought to better inform unit-level retention strategies by pinpointing factors associated with newly licensed nurses staying with their first nursing jobs.

“The internal turnover rate for the one year between the two waves of the survey was nearly 30 percent,” said Kovner. “This turnover is in addition to those leaving the organization. This figure is substantially larger than previously reported in other studies, which estimated a 13 percent one-year internal turnover rate among new nurses.”

The study’s results? The 1,569 nurses in the nationally representative study were classified into four categories based their unit and title retention of their new grad RN jobs:
1.    1,090 nurses (69.5 percent) remained in the same title and unit-type at wave two;
2.    129 nurses (8.2 percent) saw a change in title, but not in unit-type;
3.    185 nurses (11.8 percent) had no change in title, but changed unit-types;
4.    165 nurses (10.5 percent) had a change in their title and unit-type.

In addition to collecting the new nurses’ demographical data, Kovner and her team assessed their perceptions of their work environment in both surveys.

“In doing this we were able to examine the changes in work environment perceptions over time between nurses who remained in the same unit and title to those who changed unit and/or title,” said Kovner.

The researchers found five factors most strongly associated with new nurse retention:
1.    Holding more than one job for pay (negative effect);
2.    First professional degree was a baccalaureate or higher (negative);
3.    Greater variety (positive);
4.    Greater autonomy (positive);
5.    Better perceived nurse–doctor relations (positive).

“Our results point to the variables on which managers can focus to improve unit-level retention of new nurses,” said Kovner.


Source: NYU.

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