Retaining the New Nurse: What does it Take?

Purpose:
High vacancy and turnover rates in the first year of hire prompted our efforts to develop a program that would retain nurses during this very difficult period of transition.

Significance:
Estimated costs of hiring, orientation and specialty training run between $35,000 - $49,000 per new hire. Therefore, high turnover results in significant financial loss. In addition the emotional toll preceptors and new hires experience is not to be underestimated.

Strategy and Implementation:
Borrowing from best practices implemented accross the country our insitution secured a HRSA grant(D11HP07332) to develop among other strategies, a New Nurse Fellow Program. The New Nurse Fellow program pairs a newly hired nurse with a Clinical Coach whose responsibility it is to mentor and support the transition of that new hire into the organization. In addition, monthly meetings for a period of 6 months are provided to the New Nurse Fellow where they have the opportunity to learn more about the heritage of the organization and how they align with the bigger vision and mission of the institution. New Nurse Fellows also are re-introduced in greater detail to the resources that are available to them in the institution, both personal and profesional, providing them with an even greater sense of support and connection. This program was implemented with four cohorts over a two year period. Program modifications were made after each cohort to improve the program based on feedback.

Evaluation:
Participants via focus group feedback at the end of each cohort identified key program components that made a positive difference in RN retention. Over the two years of the New Nurse Fellow program vacany rates went from 11.98% to 2.1% and turnover in the first year decreased from 48.81% to 31.18%.

Implications for Practice:
Retention is a critical indicator for any organization. The ability to identify which key program components promote retention over others is relevant as we look for innovative, effective and affordable models of onboarding new staff.