Return on Investment: Benefits and Challenges of a Baccalaureate Nurse Residency Program

Rosemary Pine, MSN, RN, CDE; Kathryn Tart, EdD, RN, CNE

Disclosures

Nurs Econ. 2007;21(5):13-18, 39. 

In This Article

First-Year Turnover Rates

Although TMH has a world-renowned reputation, the graduate nurse retention rate needed assistance, much like the literature reports. Reported median turnover rates for graduate nurses during their first year of employment range from 35% to 61% (Casey, Fink, Krugman, & Propst, 2004; Nursing Executive Committee, 2001). Still, nurses who stay past 1 year in their first hospital job are likely to resign after 2 years of employment (The Advisory Board Company, 2004). According to a National League for Nursing study (1999), 25.3% of graduate nurses at 6 to 8 months post graduation have already worked for two or more institutions.

There are many reasons for turnover among this vulnerable population. Because reasons range from stress to lack of confidence and competence to an overwhelming lack of support and educational preparation, it is evident the graduate nurse needs an optimal work environment to succeed and to be retained (Goode & Williams, 2005; Oermonn & Moffitt-Wolf, 1997). Acclimation to the setting causes an inordinate amount of emotional pressure on graduate nurses. Santucci (2004) highlighted the pressure the graduate nurse feels in order to fit in with members of the health care team. Dealing with resistant staff, feeling uncomfortable with posing new ideas, or questioning accepted practice and negotiating with physicians is a role expectation for these advanced beginners, yet the literature supports the notion that these tasks are difficult. Boychuk-Duchsher (2001) finds that the baccalaureate graduate nurse experiences enormous frustration being dependent on others to help with teasing out complex or even simple patient problems. From the employers' perspective, a survey conducted by the National Council of State Boards of Nursing revealed that only 41.9% of employers reported the graduate nurse was prepared to give safe and effective care (Smith & Crawford, 2003).

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