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Old 08-10-2012, 08:53 PM
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Default Why New Nurses Don't Stay

"In a recently conducted survey only 10% of nurse executives believed that new graduate nurses were fully prepared to practice safely and effectively. The perceptions of nurse executives seem to be borne out by NGN turnover rates of roughly 30% in the first year of practice and as much as 57% in the second year. At a cost of $82,000 or more per nurse, NGN attrition is costly in economic and professional terms?and can negatively impact patient-care quality".

"The current economic downturn in the United States has reduced nurse turnover, the looming retirement of Baby Boomer nurses will leave a shortfall of 260,000 nurses by 2025. Thus, hospitals seek best practices for retaining NGNs and easing the transition into practice".

"Evidence reveals some contributing factors to NGN turnover and highlights effective retention strategies. New nurses report that low job satisfaction is primarily related to heavy workloads and an inability to ensure patient safety, disillusionment about scheduling, lack of autonomous practice, and the lack of intrinsic and extrinsic workplace rewards. Lastly, new nurses report dissatisfying relationships with peers, managers, and interprofessional colleagues and insufficient time with patients. Discontent peaks between 4 and 6 months and again near the end of the second year".

Medscape: Medscape Access


One of the ways hospitals are trying to retain new graduate nurses is by having them work in a simulation lab for 4-6 weeks which gives them more confidence when starting working in the hospital with a preceptor. I have seen these statistics pan out to be true both where I work and where I used to work. Interesting.
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Old 08-12-2012, 10:58 AM
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I still maintain that to have new graduate nurses prepared is to have them train and work at the same time.

Do your blocks of Med/Surg or what ever then work in that area for 3 months then on to the next block.

Worked for us back in the 'good' ol' days!

I still believe that the only way to truly remember what you have been taught is to have hands on AT that time.

By the time the nurses graduate I am sure they will feel more confident and competent. Maybe just maybe the attrition rate may be less IMHO.
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Old 08-12-2012, 12:31 PM
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Well, if they are anything like me, new grads don't stay because of lack of support- nurse bullying, and the high level of stress. If I didn't have bills to pay, was younger and had the time and resources to go somewhere else, I most certainly would have. But, I need to stick around and that motivated me to stay and I got through the hard part. I can see where a lot of people who have the luxury to just quit, would have after the first few months. Being a new nurse isn't easy, especially with bullies, understaffing and little support.
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Old 08-12-2012, 02:22 PM
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Very high-acuity patients with nurses who haven't mastered the assessment skills and task-oriented skillsets to be able to care for them. In other words, what Sabby said: by the time a RN graduates, he/she has moved so quickly through the various clinical components that there's only a passing familiarity with any of it. Learning to become proficient takes TIME, and once the new grad is flung out on the floor, there IS NO time: here's your stack of patients, your meds and dressings are already behind by the time you get report, and you're off to the races.

Now survive the shift. Rinse, repeat.
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Old 08-12-2012, 05:18 PM
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Quote:
Originally Posted by SVL View Post
Well, if they are anything like me, new grads don't stay because of lack of support- nurse bullying, and the high level of stress. If I didn't have bills to pay, was younger and had the time and resources to go somewhere else, I most certainly would have. But, I need to stick around and that motivated me to stay and I got through the hard part. I can see where a lot of people who have the luxury to just quit, would have after the first few months. Being a new nurse isn't easy, especially with bullies, understaffing and little support.
It's the same with nursing assistants... nurses not only bullying the new GNs or RNs but also the nursing assistants because they "aren't working fast enough"... never mind the nursing assistant has 3 times more patients to take care of, and is doing the best they can.

At HELL, there was one nurse who would never help the nursing assistants because she was "too busy." Then I found out that she would never help the other nurses verify insulin, with chemo, with FFP, or with blood transfusions. Then she complained to me that no one would help her when she needed someone to help her with verifying insulin, etc. I had to shake my head and walk away. And yes, she was the chief bully.

The stuff I have seen, I have asked myself at least 10 times a day why do I want to become a nurse when I have all of this unpleasant stuff to look forward to.

I have to agree with Sabby. Do the rotation, then work the floor, especially Med Surg.
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Old 08-12-2012, 07:07 PM
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Yep, Med/Surg is the bread and butter of nursing. There's a lot to learn there. I'm lucky I go onto a med/surg/oncology floor- because it's where I want to be, in oncology... as for the med/surg, I could do without it because I just plain hate it, but it's good that I'm there because I need it. The skills you learn on a med/surg floor are very valuable.
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Old 08-12-2012, 07:26 PM
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I so agree with Sabby!! Take me as an example. I was hired as a GN. Did NOT get any training r/t nursing. The night after I passed boards, I was ordered to take a patient load. I FLAT REFUSED!! My license was on the line.

We were full. We had a grand total of 19 patients and 2 aids!! I was fired 4 days later. Went to work in LTC and had 28 pts by myself with one aid!! I honestly think every RN should be REQUIRED to work in LTC for at least 3 months!!

If I had had the proper training for the hospital. I would have taken the pt load, with no problems, but I wasn't about to end up in front of the BON!! I got written up for not knowing how to do an assessment for a sub-dural hematoma. I ASKED for help because I didn't know!! That is why I used to/still ask questions that every RN should know! DAMMIT I wasn't taught! That is also why I am doing private duty nursing!


Not a hospital around here will hire me, because I was black balled for protecting my ASS!!
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Old 08-12-2012, 08:48 PM
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I honestly think every RN should be REQUIRED to work in LTC for at least 3 months!!
LTC facilities are far less likely to fund the training that is necessary for a new nurse.

The key is to ask before you go to work how long you will be working with a preceptor? I know where I worked I precepted new nurses for a full 6 weeks and then for the following 4 weeks they only took a half a load of patients, then 2 weeks 3/4 a load. Every new nurse got 12 weeks before being turned out alone with a patient load. I think anything less than 6 weeks is not sufficient and I wouldn't accept the job as a GN.
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Old 08-12-2012, 08:49 PM
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What a shame that such a profession would do this to itself. We " eat our young, ask new nurses to be as skilled as the seasoned, stress each other, talk about each other, work understaffed, work with a full bladder cause we can't take a pee break, are written up for sticking up for ourselves and doing the right thing, made to feel stupid if we dare to ask a question, etc. It is no wonder so many new nurses leave the profession and why so many great nurses retired early or burn out.

Ok, stepping off the soap box now before I really get started.
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Old 08-13-2012, 07:48 AM
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I agree Meli- I was depressed when I first started out on the floor because of the lack of support, and the bullying that I was experiencing. I was crying all the time after work, on my days off, even on the way TO work. I seriously hated life for a while there. I will say, again and again, I'm glad I toughed through it. I don't think everyone does... it's much better now. I will still never understand the "hazing" or "breaking in" that the profession does. It's not necessary.
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