New graduate RNs in a float pool. An inner-city hospital experience

Nurse managers and nurse educators alike have historically discouraged hiring new graduate RNs into a float pool and have preferred experienced nurses with multiple clinical skills. With a nursing shortage and changing marketplace, we need different strategies for recruitment and retention and ways to improve our clinical practice. A new graduate RN offers a nursing service an opportunity to employ a motivated, ready-to-learn, educationally prepared and intellectually stimulated nurse who happens to have limited clinical experience. The authors present a program for training new graduate RNs to practice nursing in a float pool. The training program focuses on their clinical practice needs and on transitioning them to the RN role. This program resulted in a 96% retention rate. The program offered our medical surgical units a strong clinical support float nurse, our managers a staffing solution in times of need, and the new graduate RN a broad range of clinical experiences making them more valuable members of the healthcare team. This training model is one approach to increasing recruitment and retention and can be replicated in other institutions.     

Developing a cost-effective clinical preceptorship program

We began to explore the development of a Preceptor Program for orientation in order to provide an improved orientation program and to better use the resources available to us for orientation purposes. By creating a Task Force with varied representation, we were able to design a program that is applicable to all nursing units and which allows each unit to tailor orientation to its specific needs. The Preceptor Program has proven to enhance our ability to provide the new staff nurse with a personalized orientation that is both thorough and consistent, while providing existing staff nurses with an opportunity to enhance their professional practice. The improved quality of orientation coupled with significant cost savings has been particularly dramatic in our intensive care units. Though we remain committed to the concept of a Preceptor Program for orientation on all nursing units, we need additional data so that a decision can be made on valid criteria. It is our hope that the extension of our pilot program during 1987 will provide us with the opportunity to fully measure costs and benefits, so that we can move to a house-wide program. In addition to the benefits we originally anticipated, we now believe that a Preceptor Program will be a significant recruitment tool. During the interview process, nurse applicants frequently inquire about the availability of such a program and have been very favorably impressed when we have been able to offer them this approach to orientation. With a projected nationwide nursing shortage and expected increase in staff nurse turnover rates, we believe that a Preceptor Program will become a significant tool for both recruitment and retention of staff nurses.     

Blueprint for proficient practice: an adult medical-surgical nursing orientation program.

Medical-surgical nursing is a specialty that is long overdue for acknowledgment. Our hospital orientation program provides an integration of theory and practical experience using the principles of adult learning. Faculty maintain "facilitator" rather than "instructional" roles and develop supportive and collaborative relationships with the new nurse. Its concise plan and design is intended to have a favorable impact on professional nursing practice and patient care outcomes. In addition, the program has promoted a recruitment advantage in today's arena of educational competitiveness.     

Creation of a stepdown nurse internship program.

Within Christiana Care Health System, an opportunity evolved to develop a nurse recruitment strategy for our stepdown units. Being a large teaching system, there was specific need for nursing education at this entry level. Through collaboration of nursing colleagues, the Stepdown Nurse Internship Program was created. The program encompassed clinical orientation and didactic classes. Of notable significance at the completion of the program were the Basic Knowledge Assessment Test score improvement and the nurse retention rate.     

Introducing student nurses to critical care: shadow a critical care nurse

The lack of student experience in critical care makes it difficult for graduate nurses to anticipate what expectations and demands might confront them in intensive care. Consequently, some new graduates discounted critical care as an opportunity available to them. Our institution believed that critical care had special qualities and if those qualities could be demonstrated to nurses, recruitment would improve. An unexpected benefit from the program was the positive staff nurse response to showcasing their skills and expertise. The success of the program was evidenced by the student evaluations and the hiring of students. To date, seven nursing students out of 20 who attended the program have been hired by the hospital. The long-term impact of the program on retention and recruitment is difficult to predict. The department will track these students, as they do all new hires; however, the initial success warranted continuation of the program. Student response to the program has resulted in plans to expand the "shadow a nurse" concept housewide to showcase the nursing specialities such as rehabilitation, maternal/child health, oncology, orthopedics, chemical dependency, and critical care. Current planning involves designing a program aimed toward high school students, with the goal of encouraging young people to consider nursing as a career.     

Developing a nursing corporate compliance program

This article presents the process that a large urban tertiary care hospital engaged in when developing a corporate compliance program for nursing. The purpose of this article is to demonstrate how nurse executives can successfully implement a comprehensive and practical nursing corporate compliance program. This article describes in detail the 5 steps the hospital took to develop its nursing corporate compliance program and provides examples of tools to guide you in developing a nursing corporate compliance program.     

The impact of a nurse externship program on the transition process from graduate to registered nurse: Part III. recruitment and retention effects.

This is the third and final part of a series of articles that report the findings of a study that investigated the effects of a summer externship program on the transition into a professional role among nurses who participated in a summer nurse externship program at an acute care pediatric hospital. Specifically, this article reports the retention and recruitment benefits of a summer nurse externship program for the institution from 1998 through 2003. A total of 153 externs out of the 193 (79.0%) assumed a registered nurse position at the institution, and 77% remained in that role for 12 months. Overall, the nurse extern program for this institution appeared to be an effective recruitment and retention strategy that is on par with the institution and national data for retention and turnover data.     

Factors influencing career decisions: perspectives of nursing students in three types of programs

The purpose of this study was to describe the effects of motivating factors and characteristics of the nursing profession on students selecting nursing as a career. Students from three types of programs in North Carolina (N = 495) were asked to complete a survey during the first month of their nursing program. Motivating factors influencing the decision to become a nurse were past experience with a loved one or self being ill and/or hospitalized, past health care work experience, and having a family member or friend who was a nurse. Characteristics about the nursing profession influencing career decisions were care and concern for others, job security, and variety of work settings. None of the motivating factors nor characteristics of the nursing profession differed among students from each program type. Data from this survey can be used to developed appropriate recruitment strategies for each program type.     

The Value of Undergraduate Electives for Recruitment in Psychiatric and Mental Health Nursing

The current nursing shortage has focused attention upon the need for the recruitment and retention of nursing students, as well as practitioners, to increase the available supply of nurses. Specialties such as psychiatric nursing which historically have not attracted a large percentage of graduates are at particular risk for nurse shortages. The nursing Literature of the past 15 years has demonstrated that undergraduate electives have served to interest students in particular areas of nursing. The experience of one baccalaureate nursing program which used a grant to institute electives for recruitment into employment and graduate study is described in this article.     

Roles of nurse aides and family members in acute patient care in Taiwan

To improve the nursing care quality in acute care hospitals in Taiwan after the 2003 SARS epidemic, the Taipei City Government Department of Health has allocated about US dollars 6 million for nurse aides' salaries and costs for recruitment, training, and administration of this program. Yet, there have been no corresponding changes in payments for nursing services by the National Health Insurance system in Taiwan such as increasing nurse fees for inpatient services. This article examines the roles of nurse aides and family members in providing acute patient care in Taiwan and discusses issues of nursing care quality as related to nurse staffing in acute care hospitals.     

The impact of utilization review on nursing

At first glance, nursing's role in UR appears to be of strategic significance to the profession. But there are several issues that nurse executives need to consider. First, since UR departments are seldom part of the nursing department, UR nurses are practicing outside the realm of nursing. What responsibility, if any, does the nursing department have to nurses practicing in the hospital, yet not in the nursing department? What can the nursing department do to help UR nurses maintain their identification with the profession and appreciate the strategic importance of their role, with its legal and financial ramifications? Second, UR is changing the established role of the primary care nurse. In your institution UR may already have taken the staff nurses' discharge planning function. It appears that several factors are contributing to this role change. Patient acuity has increased the time needed to administer physical care. The nursing shortage means more patients are assigned to each professional nurse and paraprofessionals are doing more patient care. There is less and less time left for the primary nurse to practice the professional attributes of nursing, primarily discharge planning. This function is shifting to the UR Department. Is discharge planning a function nurse executives wish to relinquish? Finally, we are entering another period of severe nurse shortages, where recruitment and retention of staff are paramount. Actively competing for our staff are the UR departments. Forty professional nurses work in three regional centers of the American Health Network, American Group Insurance Company (Dallas, Texas). In one hospital of 450 beds, nine nurses are employed by the UR department.(ABSTRACT TRUNCATED AT 250 WORDS)     

Job satisfaction and dissatisfaction as described by staff nurses

McNeese-Smith's (1999) study created a clear picture of the factors influencing nurse job satisfaction and dissatisfaction. Excess job dissatisfaction results in nurses resigning their positions, contributing to the nursing shortage. The results of this study could be used to support a research utilization project to educate nursing administration of these factors. Attending to these factors could enhance nurse retention and recruitment, helping to lessen the nursing shortage. Feasibility issues would include the cost and time to educate the nursing administration. Future research should be done to identify the factors of job satisfaction and dissatisfaction in other areas of nursing besides hospital nursing.     

A nurse specialist program in a small hospital

An innovative program in a small hospital can greatly enhance quality of patient care and nurse satisfaction at nominal cost. A custom-designed nurse specialist program was developed successfully by the nursing department at a 49-bed hospital and can easily be adapted to other rural facilities with similar needs.     

Vancouver Island Health Authority (VIHA) in house Perioperative Nursing Program

The Vancouver Island Health Authority (VIHA) in liaison with the University of Victoria (UVIC) offers an introduction to Perioperative Nursing Program to 4th Year undergraduate nursing students. The aim of this program is to help recruit Registered Nurses to the Operating Room. It has been advantageous to the recruitment and retention of nurses graduating from UVIC. Its importance is increased by the fact that a significant quantity of Victoria's perioperative nurses will be retiring in the next few years. Due to the high cost of nursing education and the financial investment that has already been committed by nursing students, the Perioperative nursing program is free to the student as the program can be included, for the successful candidate, as part of the UVIC nursing course. The intention is to encourage participation by reducing the financial burden, stress, and anxiety for the new graduate who intends to specialize. In return, the student is required to work in the VIHA for a minimum of one year, thus supporting the retention efforts of the hospital. For eligible nursing students, this program provides access to extensive perioperative nursing experience. Over the course of 3 months they are exposed to extensive theory in a classroom setting as well as clinical practice through a preceptorship program. The mentoring relationships that develop between perioperative nurses and students lead to meaningful relationships and professional growth for staff. The perioperative focus of the program improves the knowledge and skill set of nursing students. The intent is to increase nursing student's interest in pursuing a career as a perioperative nurse and to help ensure continued growth of the perioperative nursing profession in Victoria.     

Translation to practice: developing an evidence-based practice nurse internship program

Creating a culture of inquiry in which nurses are engaged in the pursuit of the best evidence to support nursing practice ultimately improves patient care and clinical outcomes. So, how do we do that? Implementation of an evidence-based practice nurse internship program has proven to be a key ingredient for success in stimulating critical thinking and subsequent analysis of the evidence behind nursing practice. A pragmatic approach to developing and sustaining an evidence-based practice nurse internship program can be a helpful guide for those who are considering a similar proposition. The recruitment process, education, clinical projects, and lessons learned are detailed in this article as a resource to nursing colleagues in the spirit of professional growth.     

A nurse's story. The journey of a staff nurse

This article describes the professional growth of a nurse who journeyed from being a staff nurse to becoming a coordinator of a national program. The critical turning points that fostered this nurse's development are detailed. The guidance and support of the nursing and hospital administration as well as the mentorship of fellow professionals were key in this developmental process. The communication of this story contributes to the varied tapes-try of professional nursing.     

糖尿病专科护士在提升医院专项护理水平中的作用和地位

目的:探讨糖尿病专科护士在提升医院糖尿病专项护理水平中的作用和地位。方法:在以糖尿病专科护士为核心的护理团队共同努力下,该院成立了院内糖尿病护理小组,定期组织糖尿病专项护理质量检查,开展糖尿病护理会诊,开设糖尿病专科护理门诊,开展护理科研,牵头组建了镇江市糖尿病健康教育者网络。结果:经培训后护理小组成员的理论知识、操作技能考核结果均较培训前明显改善,差异具有统计学意义(P<0.01);该院非内分泌专科糖尿病患者对糖尿病教育总体满意度由培训前的56%上升到培训后的92%;非内分泌专科病区糖尿病专项护理质量检查的均分由基线71分上升为92分;2010年完成院内疑难护理会诊59次、院外护理会诊3次、健康教育门诊328人次;2位糖尿病专科护士申报的护理科研项目均获得了基金资助。结论:糖尿病专科护士是提升医院专项护理水平的重要因素,充分发挥其作用可提高全院糖尿病患者的护理质量。     

Global Oncology Nursing Recruitment and Retention: A SWOT Analysis

ObjectivesThis article documents the current status of global recruitment and retention of oncology nurses. A strengths, weaknesses, opportunities, and threats model was used to identify internal-to-nursing recruitment and retention factors/influences and external opportunities and threats as well as strategies and initiatives to improve the current situation.Data SourcesData sources include published and grey literature from around the world.ConclusionDespite the increasing cancer burden threatening public health worldwide, recruitment and retention of oncology nurses remains challenging. Nursing strengths include action by oncology nursing associations, prelicensure nurse recruitment and preceptorships, and models of hospital shared governance. Nursing weaknesses include nurse bullying, practice models that curtail clinical nurses’ autonomy, and hierarchical and inflexible nursing leadership. External to nursing are opportunities exemplified by international partnerships in oncology care and international oncology conferences for networking and learning. Examples of external threats are a lack of oncology nursing faculty, disrespectful media portrayal of nurses, community misconceptions about cancer curability, and hazards of cancer nursing.Implications for Nursing PracticeGovernments and hospital authorities wishing to successfully address cancer control must strategically plan for the recruitment and retention of an adequate nursing workforce. Opportunities such as government recognition of oncology specialty training, shared governance, continuing specialized education, advanced practice nursing roles and career paths, and participation in national cancer control planning will increase and sustain a critical oncology nursing workforce.     

Transition experiences of nurses as students and new graduate nurses in a collaborative nurse residency program

BackgroundA small Midwestern college of nursing and an affiliate hospital partnered to design a nurse residency program where students are extended pre-hire job offers in a practice area of their choice and are then partnered with a preceptor who they will work with in a clinical immersion experience during the last semester of their nursing program and in their orientation period as new nurses.PurposeThe purpose of this qualitative, phenomenological study was to explore the lived experiences of a cohort of nurses as students and new graduate nurses during transition in this collaborative nurse residency program.MethodA transcendental phenomenological qualitative approach using Meleis' Transition Experience Theory as a theoretical framework is used for this study.ResultsThemes of feeling overwhelmed, supported, and confident were identified. A finding unique to the literature and this nurse residency program model is a theme of overwhelming support.ConclusionsThis information can be used to improve the nurse residency program and its outcomes and also further the advancement of nursing knowledge of the transition experience of new nurses.