Retaining New Graduates

By Rose O. Sherman, EdD, RN, NEA-BC, FAAN

During a webinar, a nurse manager recently noted that the new graduates they hired in June already seemed restless and just finished their residency program. She observed that “recent graduates enter her health system, complete their residency program, and then want to leave to travel or return to graduate school. We are in a constant state of onboarding. This can’t be good for them or the profession.”

Many new nurses indeed 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 understaffing was a persistent problem.
• You were assigned patients in your first six months of practice that you couldn’t manage independently.
• You often feel anxious and stressed 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 have $37,000 in student loan debt that needs to be paid off.
• You live in a community where rents are high, and you see no future possibility of buying a home.
• Your communication skills are weak, and you feel psychologically unsafe asking for help.
• Your image of what nursing would be like is nowhere close to what you see every day.
• Your leader said that nursing is an excellent profession and things will improve, but you doubt that is true, at least in acute care.

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. While there are common challenges across organizations, there are also unique challenges to organizations. You won’t know what these are if you don’t ask.

I now encourage residency program coordinators and managers to do STAY interviews with new graduates at their transition’s 30, 60, and 90-day points.  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 always seems mad, and I don’t know how to speak to her.
• I don’t get any feedback.
• No one thanks me or tells me I am doing a good job.
• 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 must tackle our challenges.

© emergingrnleader.com 2024

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