Improving Turnover, Confidence, Competence, and Professional Engagement of New Graduate Nurses: Results of a 10-Year Longitudinal Study

Wednesday, 14 July 2010: 9:10 AM

Beth T. Ulrich, EdD, RN, FACHE, FAAN
Research, Versant, Pearland, TX

Learning Objective 1: Identify best practices for new graduate nurse onboarding and retention.

Learning Objective 2: Understand the predictors of new graduate nurse turnover and the relationships of organizational commitment, satisfaction, and group cohesion to turnover intent and actual turnover.

Developing excellent new graduate nurses who will remain with their hospitals is a major challenge. This presentation summarizes the outcomes of using a structured, evidence-based RN Residency to achieve those results with data collected from over 6000 new graduate nurses over a ten-year period.

Outcomes of the RN Residency were measured using a wide variety of metrics including turnover at 12, 24, 36, and 60 months; organizational impact and return on investment; 13 instruments that measure such metrics as satisfaction, organizational commitment, empowerment, turnover intent, group cohesion, and self-confidence; competency assessment; residency evaluations; residency status reports; and focus groups. Data was collected at various points throughout and following the RN Residency as well as from organizational comparison groups.

The results indicated an increase in competence and self confidence across the immersion portion of the RN Residency which generally exceeded the mean results of the organization comparison groups; a significant decrease in turnover intent and actual turnover; and correlations between various metrics (i.e., work satisfaction, job satisfaction, group cohesion, conditions for work effectiveness), turnover intent, and turnover. A qualitative study completed in 2009 found a number of areas of positive organizational impact as a result of engagement of numerous stakeholders in the development and implementation of the RN Residency.

In conclusion, this longitudinal ten-year study presents persuasive evidence that both new graduate nurses and their organizations benefit from the implementation of a structured, immersion RN Residency that includes classroom instruction, guided opportunities to develop hands-on mastery of nursing skills, support, professional guidance, and engagement of stakeholders.