A Grounded Theory Study of Nurse Manager's Preferences in Hiring Newly Licensed RNs

Saturday, 7 November 2015: 3:15 PM

Susan C. Adamek, MSN, RN, NEA-BC, FACHE
Dignity Health-St. Rose Dominican, Las Vegas, NV, USA
Lori Candela, EdD, MS, BSN, ADN, RN, FNP, BC, CNE
School of Nursing, University of Nevada, Las Vegas, Las Vegas, NV, USA
Carolee Dodge Francis, EdD, MA, BS
EOH School of Community Health Sciences, University of Nevada, Las Vegas, Las Vegas, NV, USA

Purpose/Aims: The purpose of this research study was to explain how acute care nurse managers select the newly licansed RNs (NLRNs) they hire.

Rationale/Background: A good process for selecting NLRNs can reduce expensive employee turnover and improve teamwork on units. There has been extensive research regarding interventions that improve the retention of NLRNs after they are hired, such as residency programs, preceptors, mentors and support groups, but there is very little in the literature about nurse managers’ preferred applicant attributes or the processes used by nurse managers to select the right candidates for hire.

 Methods: A qualitative, constructivist approach was used to construct a substantive grounded theory regarding how acute care nurse managers select the newly licensed RNs (NLRNs) they hire.  Eighteen acute care nurse managers who had hired NLRNs within the past year were recruited to participate in semi-structured interviews. Participants also submitted forms or tools used in the NLRN selection process to be examined. Fifteen different acute care hospitals were represented in the sample, including a variety of sizes, for profit or not for profit status, and geographic location within a Southwestern state. Using constructivist grounded theory processes including constant comparison, transcribed interviews were coded in three stages: initial, focused and theoretical.  The qualitative data analysis package QSR NVivo 10 was used to assist in the organization, storage and analysis of data.

Results:  Together this researcher and the 18 participants constructed a substantive theory explaining the processes and preferences used to select NLRNs for hire.  Five theoretical concepts were identified:  Developing Beliefs and Preferences, Expressing Beliefs and Preferences, Gathering Information Throughout the Process, Finding the Fit and Making a Decision. Participants expressed preferences in the categories of NLRN work and life experiences, school factors, gender, personality/attitude, skills and applicant behaviors during the selection process.  About half of the participants expressed no preference between NLRNs with a BSN and those with an associate degree.  The others expressed a preference for hiring BSN graduates, but qualified that preference by stating that the applicant’s fit for the position was more important than the degree.  All but two participants stated that they would hire a NLRN with an associate degree if they felt they were the best fit for the position.  The initial or current educational level of the hiring nurse manager did not appear to be associated with their NLRN degree preferences.

Implications: This study examined NLRN hiring preferences and processes, including the current attitudes of hiring nurse managers toward the recommendation from the Institute of Medicine (2011) to reach 80 percent BSN preparation in the nursing workforce by the year 2020.  Most participants in this study did not demonstrate that they strongly preferred BSN preparation among their new hires, at least at the prelicensure program level.  The findings of this study may be used to inform additional research directed to improving selection processes, and to further examine the hiring preferences expressed by participants.