By Glenna Murdock, RN, contributor
The shortage of nurses in this country is real and it is serious. To achieve adequate staffing, hospitals must vie to attract new nursing graduates and strive to retain them. When Children’s Memorial Hospital (CMH) in Chicago took a look at the statistics surrounding attrition of its nursing staff, it found the largest percentage of those leaving, 29.5 percent, were new graduates in their first year of employment.
The obvious impact to a hospital brought about by a nurse’s leaving is financial—each RN exiting his or her job results in a cost to the hospital equal to the nurse’s annual salary—but other areas also feel the punch. Prime among them is the disruption of the delivery of quality care when a void in the health care team occurs.
Children’s Memorial attacked the problem by interviewing its new graduate workforce to find what issues were make or break factors in their job satisfaction. As a result of those findings, along with professional input from other research, institutions and organizations, Children’s put in place an innovative new nurse internship program that nurtures the new graduates by easing them through the transition from student to professional nurse. The results have been dramatic. The rate of attrition has dropped to 12.3 percent since the program began in 2003.
The New Nurse Internship Program is a method of orientation exclusively for new graduates. Experienced nurses who are new hires at Children’s are oriented separately. The internship curriculum composed of five components:
1. The Individual Preceptor. A seasoned nurse, who works in the same area of subspecialty as the new graduate, provides one-on-one instruction that focuses on clinical skills that are specific to that specialty.
2. Clinical Exchange Opportunities. New RNs are periodically exposed to areas of care within the hospital, other than that for which they were hired. Primarily an observation experience, this exposure familiarizes the new graduate with the makeup of the institution and employment possibilities elsewhere in the hospital.
3. RN Transition. Transition sessions serve as a support group for those who are newly hired. Regularly scheduled meetings for novice nurses allow them to interact with one another, to voice concerns, frustrations and successes.
4. Clinical Mentor. The mentor is a veteran nurse who works in an area different from that of the new graduate. The mentor’s role is that of a counselor, advice giver and friend. The mentor might, for instance, give advice regarding questions about balancing a personal life with a professional life, or relating anecdotal stories concerning career advancement.
5. Classroom Instruction. Aimed to reinforce and build upon the new RN’s undergraduate knowledge, there is an 80-hour core curriculum for new nurses, followed by a focus on the nurse’s particular subspecialty. The focus classes range in length from 32 to 72 hours depending upon the subspecialty.
“The program is designed to not only ease the new RN into the role of professional nurse, but also to help the new RN become a good match with Children’s Hospital culture,” according to human resources nurse recruiter Jodi Dahlgren. “Professional growth is a high priority here at Children’s,” she said. “Continuing to support and encourage the quality and education of our employees allows CMH to retain well-trained staff and to promote from within.”
CMH, a private 270-bed facility, hires approximately 100 new graduates each year who have specific start dates in March, July, September or November. The new nurse internship begins shortly after each of those four start dates and is, therefore, an ongoing program in various stages of progress throughout the year.
Participants in the program report a significant increase in their levels of confidence due to feeling better prepared in many areas of their jobs, feeling more supported by the hospital and senior nurses and enjoying the benefits of having a mentor.
“Finding the talent to build a strong nursing staff is not the hard part,” Dahlgren commented. “Having the talent match the Children’s culture and satisfying and retaining that talent has always been more difficult.”
The success of the New Nurse Internship program has significantly smoothed those difficulties to the benefit of both the hospital and the nurses, and, ultimately, of the patient.
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