By Rose O. Sherman, EdD, RN, NEA-BC, FAAN
A nurse manager recently noted during a webinar that the new graduates they hired in June already seem restless and they are not even finished with their residency program. She observed that “recent graduates come into her health system, complete their residency program and then leave to travel or take other positions. We are in a constant state of onboarding. This can’t be good for them or the profession.”
It is true that many new nurses view their careers differently than previous generations of nurses. They are more restless and want to get ahead in their careers. The work environment has also changed significantly. How would you feel if any of the following had been true in your first six months of practice:
- Your preceptor had only six months more experience than you do.
- Staff on your unit were burned out and angry most of the time about staffing.
- The unit was chronically understaffed, and you were assigned patients you couldn’t manage independently.
- You feel anxious and stressed most of the time and cannot decompress after work.
- You were not feeling much joy in your work, nor were any of your co-workers.
- The families of patients you were trying to help were rude to you.
- You came out of school having done much of your clinical work in simulation.
- You thought you would be part of a close team, but instead, the staff keeps coming and going.
- You have $35,000 in student loan debt that needs to be paid off.
- Your communication skills are weak and you feel psychologically unsafe asking for help.
- You could not afford to rent an apartment anywhere close to your hospital because housing prices are so high.
- Your image of what nursing was going to be like is no place close to what you see every day.
- Your classmates in nursing school are all going to travel and tell you if you are expected to work this hard – you may as well make a lot of money to do it
- Your leader said that nursing is a great profession and things will get better, but you doubt that is true.
I am sure you can add other what-ifs to this pretty extensive list. It is not surprising that professional transitions are incredibly challenging today. I have found while there are common challenges across organizations, there are also challenges to organizations. You won’t know if you don’t ask.
I now encourage residency program coordinators to do STAY interviews with new graduates at the 30, 60, and 90-day points of their transition. The STAY interview questions include the following:
Question 1: What do you look forward to each day when you commute to work?
Question 2: What are you learning here, and what do you want to learn?
Question 3: Why do you stay here?
Question 4: When was the last time you thought about leaving us, and what prompted it?
Question 5: What can I do to make your job better for you?
Several residency program coordinators have told me that they have been able to strengthen the support in their residency program as an outcome of these conversations, which included comments like:
- No one talks to me – I don’t think I am wanted here.
- My preceptor seems mad all the time, and I don’t know how to speak to her.
- I don’t get any feedback.
- I rarely see my manager.
- I have some challenges with the night charge nurse – I don’t know who to talk to or how to work with her.
The point is that we won’t know these things if we don’t ask. If we want to improve our retention, we need to tackle our challenges.
© emergingrnleader.com 2023
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