The RN Work Project

A national study to track career changes among newly licensed registered nurses

Dates of Project: 2005–2016

A 10-year longitudinal study of newly licensed nurses is shedding light on how many leave their jobs, why they leave, and other information that can improve workforce training and retention.

Description: Researchers surveyed a cohort of newly licensed registered nurses in 2006, 2007, 2009, 2011, and 2013, and will survey them again in 2015. (The cohort was originally about 3,350 and through attrition was reduced to about 1500 by 2013.) The purpose is to describe changes in nurses’ work patterns and the factors associated with those changes over an extended time period and to learn more about the nurses’ educational trajectories.

They surveyed two additional cohorts in 2009 and 2012, to compare their educational backgrounds, work settings, and work satisfaction with those of the main cohort and determine whether environmental factors could be affecting job choices or quality improvement efforts. A subset of nurses was surveyed to learn how often nurses engaged in quality improvement activities and whether nurses thought those activities had an effect on patient safety.

Key Findings to Date:

  • The turnover rate among nurses is much lower than it was originally thought to be. About 17 percent leave their first RN job within the first year, 31 percent by the second year, and by four and a half years, the turnover rate is close to 49 percent. By six years after graduation, the rate is about 55 percent.
  • Most (92%) new nurses who leave their first jobs do not actually leave the profession; they take a nursing position in another organization.
  • Despite a growing trend toward quality improvement programs in the workplace, less than one-third of RNs reported being very prepared to participate in quality improvement activities such as the Plan-Do-Study-Act model or flow charting, for instance, and more than half (55%) reported no training in identifying good care based on scientific evidence. A majority (73%) said they had not been trained to assess gaps in current practice, and many (46%) said they had not been trained to work as a team to improve care.

“The bottom line is that nurses compose the largest segment of the healthcare workforce and deliver the most care in hospitals. Increasing their knowledge of system improvement and engaging them in improving systems of care are critical actions for improving nurse quality indicators.” (Co-investigator Maja Djukic)

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