Methods: Starting with a multi-disciplinary team including nurse directors, nurse leaders, nurse educators, and most importantly bedside nurses with one year experience or less, our year-long journey began. This team started with a SWOT analysis and a literature review to plan a house-wide approach to retaining nurses. There were three additions made to our Fellowship program: a new nursing-specific preceptor class was developed, a transition into practice approach of nursing with preceptor was developed, and nursing grand rounds were initiated. The nursing-specific preceptor class seeks to define the role of the preceptor, outline the expected progression of the new nurse, identify adult learning concepts, and discuss feedback theories in conjunction with difficult conversations. In our transition to practice, the new nurse finishes fellowship and begins practicing on his/her own. At scheduled intervals, the new nurse partners back up with their preceptor so that they can further practice skills such as critical thinking, time management, and global concepts of patient care. Nursing Grand Rounds are offered every other month and offer education on concepts that would be valuable to nurses in any service line. Examples of these classes have included: legal implications of nursing documentation, care of the dying patient, and central line infections.
Results: Results from August 2017-August 2018 showed that every service line invested and involved in the Fellowship Strategic Plan, experienced an average decrease in first year turnover of 5.25%. These results showed that thoughtful engagement throughout the entire first year of nursing is imperative to the retention of new nurses. Mercy St. Louis first year voluntary turnover is 0.3% compared to like hospitals in the system of 2.1% and 1.6%. Nursing investment in one’s career throughout the first year of employment is crucial to retention.
Conclusion: Not only do nurses need a strong preceptor during initial training, but time to feel confident in their own personal nursing practice. Throughout the first year, the preceptor can help to establish socialization into the unit, provide emotional support, and help guide critical thinking skills in newly trained nurses. Development of a program that helped produce more confident preceptors combined with ongoing education for new nurses produced a more thoughtful approach to the integration of our new nurses and resulted in a decreased turnover rate.