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Longitudinal Study
Forecasting Hawaii’s
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Workforce 2005 - 2020

Hawaii State Center for Nursing

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Webster Hall 432
Honolulu, Hawaii 96822 - Map -

Ph: (808) 956-5211
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New Graduate Longitudinal Study (download pdf file)





S.A. LeVasseur, B. Mathews, J. Itano, D. Allison



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.



1. Kooker B., Winters-Moorhead C., Acosta M. & Hobbs S. “Nursing Workforce Supply Data Trends in Hawai’i.” Hawai’i Medical Journal. Sept. 2003: 193-197.


2. Raynor CR. and the Hawai’i Nursing Shortage Taskforce. “Hawai’i’s Health in the Balance: A Report on the State of the Nursing Workforce.” Oct. 2004.


3. Roche JE., Lamoureux E. & Teehan T. “A Partnership Between Nursing Education and Practice: Using an Empowerment Model to Retain New Nurses.” Journal of Nursing Administration. 2004; 34(1):26-32.


4. Godinez G., Schweiger J., Gruver J. & Ryan P. “Role Transition from Graduate to Staff Nurse: A Qualitative Analysis.” Journal for Nurses in Staff Development. 1999; 15(3):97-110.


5. Owens D, Turjanica MA., Scanion MW., Herbert C. & Facteau L. “New Graduate RN Internship Program: A Collaborative Approach for System-wide Integration.” Journal for Nurses in Staff Development. 1999; 17(3):97-110.


6. Galt RG. “The value of training and orientation programs in large medical organizations.” Journal for Nurses in Staff Development. 2000; 16(4):151-156.


7. Goode, CJ. & Williams CA. “Post-Baccalaureate Nurse Residency Program.” Journal of Nursing Administration. 2004; 34(2):71-77


8. Nelson, D. & Godfrey L. “Using a mentorship program to recruit and retain student nurses” Journal of Nursing Administration. 2004; 34(12):551-53


9. Cadmus E., Dickson GL., Tuella C. & Rice B. “New Jersey Colleagues in Caring: An Integrated Competency-Based Nursing Practice Model.” New Jersey Colleagues in Caring, 2001.


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