Nurse Retention Paper

There are many different fields to choose from while working as a Registered Nurse. “Registered nurses work in hospitals, physicians' offices, home healthcare services, and nursing care facilities. Others work in correctional facilities, schools, or serve in the military.” (bls.gov). You can also specialize in a specific type of nursing by seeking employment in that individual line of work or by taking a certification test. “The Nursing2011 Salary Survey reports that nurses certified in a specialty earn an average of $10,200 per year more than nurses who are not.” (pncb.org). If you choose to go further with your education you can continue past a bachelor’s degree and get a master’s degree becoming a nurse practitioner.

The concept of nurse residency programs is not by any means a new concept. Programs have been grounded on Benner’s theory of novice to expert. Benner established the notation that nurses develop skills and understanding of job skills over time through an education also with hands on experiences. She noted a nurse passes through five levels of proficiency: novice, advanced beginner, competent, proficient, and expert and was generally reached only after years of gaining experience as a practicing nurse. A nurse residency can facilitate new nurse graduates to transition smoothly through the levels and sometimes even more quickly. As a new graduate a nurse residency program is very appealing, not only does it help mentor you through novice period but also helps develop competent nurses for the organization.

I am Amanda Selich, 27 years old, and have been living in San Francisco for roughly 10 years. I grew up in the East Bay with my 3 siblings and was raised by a single father. Much of my childhood was spent taking care of my younger siblings. This responsibility was so demanding I was forced to drop out of high school and become their “surrogate mother”. However at the age of 24 I was able to get my GED and finally attend college. In fact this past May I graduated from City College of San Francisco with highest honors in Science and Math.

The Salary of an RN is about $36.94 per hour, but the work schedule of a nurse is crazy. Nurses never really get a break especially floor nurses. I have talked to quite a few nurses and they have said that since you don’t truly get a break you tend to gain weight do to constantly eating/snacking. The education needed to be a Registered Nurse would be a Bachelor Degree which is a four year process. To be a Registered Nurse or RN you will need no training. On the job you will administer basic health care which is a temporary health coverage program for low-income, uninsured United States citizens or permanent legal residents of Contra Costa County. As an RN you will being giving patients intravenous medications. An intravenous

There are many challenges facing today’s nursing leaders and managers. From staffing and scheduling, to budget cuts and reduced reimbursements, today’s nursing leaders must evolve to meet the ever changing health care environment. Constance Schmidt, Chief Nursing Officer at Cheyenne Regional Medical Center (CRMC), identified retaining experienced registered nurses (RN) as one of the biggest problems she faces as a nursing leader. She went on to state “Nationally, most hospitals have more than 60% of their nurses with at least 5 years of experience. At CRMC, it’s the reverse. We have more than 60% of our nurses with less than 5 years of experience” (personal communication, March 28, 2014). The two largest factors affecting those numbers are the nursing shortage and nursing retention. The first, the nursing shortage, was identified years ago and has been researched countless times. Some projections indicate the number representing the gap between available registered nurses, and the positions needing to be filled, could be over a million before the end of the current decade. The latter, retention of nurses, is a problem in every health care facility in the nation. Nursing turnover results in both a significant financial cost to hospitals, and a significant impact on the community through its effects on patient outcome.

Staff satisfaction is empirical in retention of nurses in any healthcare setting. Although a slight turnover is necessary to maintain the diversity of ideas, too much of it causes instability that might affect patient and employee satisfaction negatively (Marquis & Huston, 2015). The planned change is to be executed at a small, private hospital (SPH) in Los Angeles with a 200-bed capacity, which offers emergency and medical-surgical services for adults. After a six-week hospital orientation, only 20% of new RNs hired at SPH in 2015 rated their confidence levels at >70% (Appendix A). Out of 32 new hires, 7 left during orientation, and 12 left before reaching 1 year- leading to 41% retention or a 59% turnover (Appendix B). The RN turnover of SPH is thrice the

Nurse Outcomes in Magnet® and Non-Magnet Hospitals uniquely address that the Magnet hospitals have their class of performance which sets them apart from non-magnet facilities that can also influence the nurse satisfaction and retention issues (Kelly, McHugh & Aiken, 2011). The study specifically addresses nurse work environments as the cause of retention that leads to improved patient outcomes (Kelly, McHugh & Aiken, 2011). Hospitals

Increasing acuity and rising complexity of acute-care patient populations, lack of a standard national nurse residency program, low job satisfaction scores of graduate nurses, and a high turnover rate of graduate nurses are a few of the important factors that led to the creation of the University HealthSystem Consortium (UHC) and the American Association of Colleges of Nursing (AACN) national nurse residency program (NRP).

My nurse preceptor today was Patricia. Patricia was an amazing preceptor with an immense amount of knowledge. I enjoyed Patricia’s passion for knowledge. She just finished her DNP. She spoke to me about how she also held two bachelors degrees and a masters in nursing. She was very caring of her patient and showed compassion to not only the patient but the family as well. I don’t think I would have done anything differently because she was a great patient advocate, caring healthcare professional, and great at time management. I was fortunate to have worked with her today in the CICU. We had a 1:1 assignment, a 67 year old male who had a STEMI. Ultimately, he ended up needing an intra-aortic balloon pump (IABP) to assist his heart. This was placed 8/31.

The nurse manager I selected to interview is a Baccalaureate degree nurse and has attended several in-house training sessions related to her position within the hospital. She attended Lenoir Rhyne University to obtain her BSN and has been employed with the institution for 13 years and has been in nursing for nearly 20 years. She is currently certified as a Certified Emergency Nurse (CEN) and is also a Sexual Assault Nurse Examiner. The Hospital that she is employed with is a private hospital she manages a 15 bed emergency department and 6 bed express care facility, which also holds several involuntary commitments for several hours at a time waiting on placement.

The researchers surveyed 3186 nurses on staff at 56 hospitals; 52 academic hospitals and 4 non-academic hospitals. The researchers compared the results of the nurses’ surveys with information about the location of the hospital (rural or urban), the hospital environment (managerial support, good relationships among team members, the nurses’ involvement in decision-making), the nurses’ educational levels, and the staffing (nurse:patient ratio). The researchers also interviewed nurse managers and leaders to evaluate their input on nurse retention and nursing shortages in a qualitative portion of the study. In the article “Effective strategies for nurse retention in acute hospitals: A mixed method study”, the researchers state “the results show that nurse staffing and the quality of the nurse practice environment (i.e. managerial support of nursing care, good relations between doctors and nurses, nurse participation in decision-making and organizational priorities on quality of care) are significantly associated with intention-to-leave the hospital” (Van den Heede et al., 2013, p. 192). This association is related with increase nurse satisfaction with environment and staffing is related to decreased intention to leave the hospital, or an inverse relationship. These researchers also shed light on the fact that Magnet hospitals have far better nurse retention and nurse satisfaction. Thus, focusing on and achieving a Magnet status can be an effective

The orientation process for new hires lasts six weeks. The new nurse attends nursing orientation for one week and then is assign a preceptor on the unit for each shift. The DPCS introduces the new employee to their preceptor. This nurse works three weeks on the day shift, one week on the evening shift and one week on the night shift working with both medically acute rehabilitation patients and surgical patients. Nurses receive extra days of their orientation with patients that the nurse has limited clinical experience such as a nurse with postoperative experience will work more with the medically acute rehabilitation patients to practice new skills. For new graduates their orientation is individualize and can last from 8-16 weeks.

Nurse turnover is defined as “the number of nurses changing jobs within an organization or leaving an organization within a given year” (Baumann 2010). Retaining nurses is one of the most important issues in health care as its effects range from challenges in human resource planning, to high costs in financial and organizational productivity (Beecroft et al, 2008), to workgroup processes and morale, to patient safety and quality of care (i.e. patient satisfaction, length of patient stay, patient falls, and medication errors) (Bae et al, 2010). Nursing Solutions Inc (NSI) reported the national average turnover rate for hospitals increased from 13.5% in 2012 to 14.7% last year. Nurses working in Med/Surg had more turnover

In the healthcare field, nursing leaders and managers face consistent issues in their respective practices that force them to alter the way they work and the way they think. In taking on a role as a leader within the field, nursing leaders and managers also take on the role of ensuring that work within an organization runs smoothly regardless of new issues that may arise in the healthcare arena. For instance, in today's healthcare environment, the issues of nurse shortage and nurse turnover have the capacity to alter the healthcare field and many of its respective branches and organizations should these problems not be managed properly by the leaders in the field. In viewing the issue at hand and in discovering how nursing leaders and managers are expected to act, and do act, in order to approach this issues, along with pinpointing the best approach possible to aid this issue, one can better understand which leadership styles are necessary for leaders to function.

By empowering the community of nurses and sustaining employee engagement, patient and employee satisfaction would remain the same, if not increase (6 Leadership strategies for navigating perpetual change in healthcare, 2015). Change is tough for most people and the time to adjust varies with each individual. Taking some time to acknowledge each individual and their needs is an important factor to being a great leader (6 Leadership strategies for navigating perpetual change in healthcare, 2015).