Nearly one in five newly licensed registered nurses leaves his or her first job within a year and about one in four leaves within two years. To understand factors that promote retention of Newly Licensed Registered Nurses (NLRNs) and those that contribute to turnover, three leading academics conducted a survey of a national sample of NLRNs. “What newly licensed registered nurses have to say about their first experiences” uncovered five themes:
- Colliding expectations describes conflicts between nurses’ personal view of nursing and their lived experience.
- The need for speed describes the pressure related to a variety of temporal issues.
- You want too much expresses the pressure and stress NLRNs feel personally and professionally.
- How dare you describes unacceptable communication patterns between providers.
- Change is on the horizon suggests optimism for the future as NLRNs speak of transforming the systems where care is provided.
The content analysis in the study reveals that the working environment where NLRNs begin their career is in need of reform, and offers suggestions for improvements from nurses themselves.
“Nurses are on the front lines of an increasingly demanding hospital work environment,” said Linda Honan Pellico, Ph.D., A.P.R.N., an assistant professor at Yale University’s School of Nursing and the lead researcher of the study. “Many feel they could be more effective caregivers to patients if they simply had more time to spend with them. Instead, they feel mounting pressure to rush through rounds and fill out paperwork, which is not why they chose to go into nursing.”
Changes to nursing school pedagogy could also better prepare new nurses for their first jobs. Survey respondents recommended nursing school curricula changes such as eight-hour clinical days for student nurses, more realistic nurse-to-patient ratios, and a greater focus on communications skills.
The study was published in the July/August issue of Nursing Outlook and analyzed survey comments of 612 new nurses in 34 states and the District of Columbia. Co-authors on the study were Christine Tassone Kovner R.N., Ph.D., F.A.A.N., of the College of Nursing, New York University; and Carol S. Brewer, Ph.D., R.N., of the University at Buffalo School of Nursing and New York State System AHEC Statewide Office Department of Family Practice.