Learning Objective #1: Describe four factors affecting perceptions of recent RN graduates regarding their educational preparation and their first job experiences

Learning Objective #2: Identify four strategies to improve educational preparation and work environment in the first job experience of RN graduates

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Nursing academia and nursing practice are increasingly challenged to develop and support new nurses in the chaotic and rapidly changing environments in which patient health care takes place. Unfortunately, little is known regarding recently graduated registered nurse (RN) perceptions of either educational preparation or first job experiences. This descriptive survey had two purposes: first to determine RN perceptions of their first job, and, if they left the position, why. Secondly, to determine how well the RN's believed their nursing educational program prepared them for their first nursing position. The Survey of Nurses' Perception of First Job Experience and Educational Preparation was mailed to 3077 nurses who were registered in the state of Nevada and graduated from their basic nursing educational program within the last 5 years. A total of 352 participants returned the survey. Thirty percent of respondents left their first job within one year and 57% had left before 2 years. Patient care issues such as stress associated with high patient acuity, unacceptable nurse-to-patient ratios, and feeling patient care was unsafe were perceived as the most frequent reasons for leaving their first job. Additionally, lack of administrative support for improving the work environment contributed to negative job perceptions and reasons for leaving. Respondents indicated that their educational preparation was most lacking in the areas of pharmacology, clinical experience, physical assessment, and electronic patient data management. Over half of the respondents felt their program prepared them more for state boards than nursing practice. A significant positive relationship was found between perceptions of first job experience and nursing educational program preparation. The findings offer implications for nurse educators for improving nursing education curricula to better meet the demands of the first RN job and for hospital nursing administrators for improving the work environment and retention rates of recent RN graduates.