Introduction:
The State of Hawai’i is experiencing a nursing shortage which is expected to
worsen over the next fifteen years. According to the recent report Hawai’i’s Health in the
Balance: A Report on the State of the Nursing Workforce2, there will be a shortage of 2,267
nurses by 2010 and 4,593 nurses by 2020. Several key factors have been identified that impact on
the growing shortage of nurses. These include the population of the State is aging at a higher rate
than most states in the rest of the nation and the average age of nurses in the workforce is 49.3 1
years and increasing.
A key strategy to address the nursing workforce is retention of existing nurses and nowhere is the
difficulty more pronounced than with new graduate RNs. Turnover in the new graduate
workforce is considerably higher than the more experienced nursing workforce. Roche, Lamoreau
and Teehan 3 highlight that between 35% - 60% of new nurses change jobs in their first year 4 and
that despite a specialized internship program, 25% of new graduate registered nurses leave their
first job within the first year. 5 Research also suggests that the first six months may be a crucial
marker for measuring retention of newly hired nurses. 6 High turnover rates are not only costly
for an organization, but create an unstable workforce which impacts patient outcomes, unit
morale and productivity.
A variety of programs have been developed and implemented to enhance the experience of the
new graduate registered nurse including enhanced preceptor/mentoring, 8 extended orientations 4
or residencies, 7 competency based curriculum in schools of nursing, 9 and support/professional
development groups. However, there exists little empirical evidence concerning new graduate
registered nurses’ patterns of employment or perceptions of their jobs in the first five years of
employment, and no data examining newly graduate registered nurses in Hawaii.
Purpose: This study will examine new graduate registered nurses employment patterns and
perceptions of their jobs in the first five years of their nursing career in Hawai’i.
Methods: A longitudinal descriptive design will be used to explore graduating student nurses
transition into nursing practice over 3.5 years. The project will utilize qualitative and quantitative
research methodologies to identify and describe the transitional experiences of new nurses from
their graduation as student nurses until approximately three and half years after graduation. Data
will be collected at graduation (baseline), 6 months, 18 months, 30 months, and 42 months.
Analysis: Descriptive statistics will be used to examine the perceptions of graduating students’
expectations of obtaining their first nursing positions, identify student’s perceptions of
preparedness for nursing after completion of nursing education. In addition, descriptive statistics
will be used to examine frequency of graduated registered nurses finding nursing employment; to
identify whether educational experiences are perceived as valuable in obtaining nursing positions.
The six month survey will analyze frequency of employers providing clinical orientation or some
other form of support that assists in making the transition from student to professional nurse
easier. Analyses will examine 6-month, 18-month, 30-month, and 42-month data to identify and
describe rates of retention and turnover, variability in workplace support, frequency of
employment in non-nursing positions or unemployment. Finally, the data will be examined to
identify and describe new nurses’ future plans to remain working in Hawaii or migration plans
out of the State and trends in the number of nurses planning to continue their nursing education.
Funding: Hawai’i State Center for Nursing will support this project with internal staff.
Additional funding will be sought from nursing and/or local foundations. |
