What New Graduates Need from Nurse Leaders This Year

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

It is May, and many nursing students are graduating and will be transitioning into practice. The good news is that jobs for new graduates are more plentiful today, even in specialty areas. The other good news is that most health systems are ramping up their residency programs and plan that future onboarding will be more in-person and less virtual.

The not-so-good news is that this is probably one of the most challenging times for new graduates to transition into professional practice. The metaphor I use for this year’s graduates is that it is like going on vacation to a Caribbean island right after a Category 4 or 5 hurricane. Even if your hotel is completely operational, you will see the stress and the fatigue that the storm caused the employees and island residents. There is no way around it. The nursing workforce today is a different workforce than it was pre-Covid. Many nurses are exhausted and suffer from burnout. There are higher levels of disengagement and turnover. Some units have more than half their staff with two years of experience or less, which makes assigning preceptors challenging.

At the same time, these new graduates have spent a good portion of their nursing program in simulation, so their hands-on clinical experience may be limited. Nurse leaders widely report that they see skill gaps. If there was ever a time to put a great deal of time and energy into the onboarding of these new nurses, it is now. According to recent data from the 2021 National Healthcare Staffing and RN retention report, new graduate turnover in the first year is almost 25%, and 42% leave by the end of year two. These young nurses are also far more likely to share their dissatisfaction about work on social media, which impacts future recruitment.

We know from Gallup data that frontline nurse leaders are the recruitment linchpins in their organizations. Nurse leaders at all levels, from charge to manager, can be proactive today in their own settings by taking some or all of the following steps:

Present a realistic picture to new graduates about what to expect in your environment. Be transparent about the issues and challenges you are working on.
Be hands-on with the onboarding of new graduates – do not delegate this to nurse educators or preceptors with no follow-up.
Assess potential skill gaps constructively and positively. Give your new nurses hope by telling them that they are learning and growing.
Select and give positive recognition to preceptors who are supportive and enjoy working with new graduates.
Observe for signs of bullying of new graduates by other staff and a zero-tolerance culture.
Schedule frequent check-ins with new graduates throughout their first year of practice, especially after the conclusion of the residency program
Monitor patient care assignments that are given to new graduates and follow-up to see if they are appropriate.
Help new graduates with their communications with physicians and other departments by observing for signs of disrespect or the new graduate’s lack of confidence.
Be visible on the unit and seek feedback from new graduates about their experiences.
Ensure that the new graduate attends all the orientation and other support classes offered by the agency despite staffing shortages.

Effective onboarding has never been more important. The evidence indicates that decisions to remain with an employer or not are often made in the first 90 days. These new graduates are the future of nursing. They are entering the profession at a challenging time, and we need to ensure that we retain them.

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