Deadweek: Surviving, thriving, and driving down first year turnover

Purpose:
The nursing shortage has led to an increase in hiring new graduate nurses into the Intensive Care Unit. Nationally, first year new graduate turnover is 35%. The purpose of our innovation was to improve the orientation, engage the learner, and drive down first year new grad turnover.

Significance:
We must mentor our young to become professionally engaged individuals. First year turnover costs $68,000. This innovation incorporates socialization which is seldom addressed in the initial months of hire. We have demonstrated that by including a networking strategy turnover has decreased.

Strategy and Implementation:
We coined the term “deadweek” as a label for a two week period of time between hospital orientation and the Critical Care Internship in our institution. We used this time to socialize new graduates to the institution and each other. We have 6 ICUs and this provided an excellent forum for networking and collaboration. It also afforded us an opportunity to explore resources in an interactive way, and to talk about best practices and quality nursing care. Free from the pressures of clinical and long hours in the classroom, this approach was interactive, informative, and fun. Our strategies included: network night to meet the interdisciplinary team and other new grads; a meet-the-chain-of-command in person game; navigating the hospital intranet to access important resources; and identifying safety hazards in a Clinical Safety Investigation (CSI) room. Implementation was managed by critical care educators, and decisions for content were based on previous evaluations of orientation.

Evaluation:
The deadweek concept was well received by new graduates and the Intensive Care Units. The effectiveness of the program was measured via new graduate feedback following the program, and NDNQI data demonstrating a dramatic decrease in first year new graduate turnover.

Implications for Practice:
The deadweek concept affords the opportunity to focus on areas that were not prioritized: resources, networking, best practices, quality indicators, and more. This innovative strategy impacts turnover, socializes new graduates, and eases the transition from student nurse to engaged professional.