The RN Work Project

A Study of Newly-Licensed Registered Nurses

    • September 1, 2009

The Project

There is evidence based on anecdotal or small-scale studies that first-time, newly-licensed nurses have the highest turnover rates. The reasons for these early career choices are not clear, and to improve the work environment for nurses, better information is needed to understand when and why new nurses leave. Funded by the Robert Wood Johnson Foundation (RWJF), the RN Work Project aims to better understand these issues by following a nationally representative sample of newly licensed registered nurses during the first years of their careers. The research project provides a unique opportunity to study the careers of new nurses over 10 years. A series of planned papers and publications will promote dissemination of findings and spread of the new information about nurse retention.

The principal investigators for this project are Christine Kovner, R.N., Ph.D., FAAN, Professor, New York University College of Nursing; and Carol Brewer, R.N., Ph.D., FAAN, Professor, University at Buffalo, The State University of New York, School of Nursing.

Major Research Questions

The main questions addressed include:

  • What is the first work setting of newly-licensed RNs following successful completion of the National Council Licensing Examination and at intervals following the first year?
  • What factors influence the setting new graduates choose for their first job?
  • What factors influence RNs’ intent to leave their first job?
  • Where is their second job? Is the setting the same or different?
  • If the RN leaves the organization or workforce, why did he or she leave?
  • If they changed to a similar setting (e.g., another hospital), what was more attractive about the second setting? Is there anything the first setting could have done to retain them?

Summary of Methods

The sample includes RNs who obtained their first license to practice as RNs between August 1, 2004 and July 31, 2005. The researchers collected information from 3,266 eligible respondents from 34 states and the District of Columbia. Data were collected in the winters of 2006, 2007, 2009 and 2011.

Knowledge and Impact

  • A majority of participants held an associate’s degree (58%) as their first professional degree, one-third obtained bachelor’s degrees (38%) and 4 percent held a master's degree or higher.
  • A majority of RNs (66%) worked 12-hour shifts. RNs working in hospital settings were more likely to work 12-hour shifts (72%).
  • Some 75 percent of RNs reported that individuals in their workgroup were helpful “quite a bit” or “a great deal.” A majority (53%) reported that supervisors encouraged them to express their opinions to a great or very great extent.
  • RNs reported a moderate amount of autonomy and 49 percent agreed or strongly agreed that there were opportunities for promotion.
  • Verbal abuse was the most frequently encountered injury at work (62%).
  • A total of 87 percent worked in hospitals. Overall, 77 percent of respondents held one RN job since graduation; 12 percent reported holding two jobs at the same time.
  • Overall, more than 60 percent of RNs were satisfied or very satisfied with their jobs; 47 percent described their job as very much like the job they wanted.
  • A consistent subset of RNs answered individual items less positively: 42 percent answered they would want another job if they were free to go to any type of job and 37 percent of RNs stated they planned to look for another job within the year.
  • Overall, RNs were neutral toward leaving their current employment. Among those who had already left their first job, the most common reasons for leaving included poor management, stressful work and wanting experience in a different clinical area.
  • Associate’s degree graduates were more intent on leaving than those whose first professional degree was a bachelor’s degree.

The RN Work Project

  1. 1. Newly Licensed RNs' Characteristics, Work Attitudes, and Intentions to Work
  2. 2. Addressing the Complexities of Survey Research
  3. 3. A Comparison of Second-Degree Baccalaureate and Traditional-Baccalaureate New Graduate RNs
  4. 4. Understanding New Registered Nurses' Intent to Stay at Their Jobs
  5. 5. The Nursing Career Process from Application Through the First 2 Years of Employment
  6. 6. What Newly Licensed Registered Nurses Have to Say about Their First Experiences
  7. 7. Moving on, Up, or Out
  8. 8. Generational Differences Among Newly Licensed Registered Nurses
  9. 9. New Nurses Views of Quality Improvement Education
  10. 10. Newly Licensed RNs Describe What They Like Best about Being a Nurse
  11. 11. Early Career RNs' Perceptions of Quality Care in the Hospital Setting
  12. 12. Commuting to Work
  13. 13. State Mandatory Overtime Regulations and Newly Licensed Nurses' Mandatory and Voluntary Overtime and Total Work Hours
  14. 14. Work Environment Factors Other Than Staffing Associated with Nurses' Ratings of Patient Care Quality
  15. 15. The Relative Geographic Immobility of New Registered Nurses Calls for New Strategies to Augment that Workforce
  16. 16. Predictors of Actual Turnover in a National Sample of Newly Licensed Registered Nurses Employed in Hospitals
  17. 17. Charting the Course for Nurses' Achievement of Higher Education Levels
  18. 18. Verbal Abuse From Nurse Colleagues and Work Environment of Early Career Registered Nurses
  19. 19. Early-Career Registered Nurses' Participation in Hospital Quality Improvement Activities
  20. 20. Positive Work Environments of Early-Career Registered Nurses and the Correlation with Physician Verbal Abuse