New Graduate Nurses Research Articles

Factors associated with the intention to leave among newly graduated nurses in advanced‐treatment hospitals in Japan

The early resignation of newly graduated nurses (NGNs) will become a concern in Japan as the need for nurses increases. The aim of this study was to conduct an investigation using the Effort-Reward Imbalance (ERI) questionnaire to examine the effect of stressful experiences in the work environment and over-commitment on NGNs' intention to leave and to identify the factors that were associated with their intention to leave, clarifying the appropriate times at which to conduct interventions to prevent NGNs from leaving advanced-treatment hospitals. Anonymous self-administered questionnaires were distributed to all the NGNs (n = 1364) in 14 advanced-treatment university hospitals. Questionnaires with no missing data were returned by 737 NGNs (54%). For the development of the questionnaire, we designed a framework that consisted of the factors that occur during three stages of the NGNs' transition into the workplace. The questions addressed items for individual attributes, employment and organizational characteristics, the Role Model Scale, the ERI questionnaire, two scale items for health status, and the intention to leave. In order to determine the factors that related to the dependent variables, hierarchical multiple linear regression analyses were carried out. We revealed that effort, subjective health status, role models, and effort were important factors that related to the NGNs' intention to leave, as well as their age and city size. Over-commitment and reward were not significant factors. We also found that three subscales of the Job Readiness Scale independently related to the NGNs' intention to leave. These findings can help employers, supervisors, and senior staff of advanced-treatment university hospitals in Japan to improve their work environment in order to benefit NGNs and aid in their retention.

A Longitudinal Study of Factors Associated with Intentions to Leave among Newly Graduated Nurses in Eight Advanced Treatment Hospitals in Japan

This study aimed to examine the factors associated with intentions to leave among newly graduated nurses (NGNs), using a longitudinal design. We distributed self-administered questionnaires (to be returned anonymously) to all the NGNs (n=567) in nine advanced treatment hospitals in Japan on two separate occasions (Time 1 and Time 2, which were approximately 6 months apart). The questionnaire items addressed individual attributes, employment and organizational characteristics, and subjective health, and also included the 22-item Job Content Questionnaire, a scale of intentions to leave, and a novel 21-item job readiness scale. The data from 301 NGNs who had participated in both questionnaire instances was used, and a hierarchical multiple regression analysis was conducted to investigate the factors associated with intentions to leave. The results showed that while psychological distress was a more important predictor of intentions to leave than was cumulative fatigue at Time 1, cumulative fatigue was a more important predictor at Time 2. Among the job stressors, a lack of coworker support consistently led to increased intentions to leave, while a lack of supervisor support had a greater impact on intentions to leave at Time 1. "Being personally suited for nursing work", which was one of the job-readiness subscales, was found to independently and consistently influence intentions to leave. Our study findings revealed the predictors of intentions to leave among NGNs early in their careers in Japan.

Involvement in Promoting the Development of Newly-Graduated Nurses

Involvement in Promoting the Development of Newly-Graduated Nurses

Job stress and intention to quit in newly‐graduated nurses during the first three months of work in Taiwan

To identify job stress and intention to quit in newly-graduated nurses during the first three months of their work at two different levels of hospitals and to understand factors that may influence their retention. Given the current nursing shortage, retention of newly-graduated nurses is crucial. Design. A cross-sectional research design was adopted. Newly-graduated nurses' perceptions of job stress and intention to quit at different time periods during the first three months in addition to related factors were measured using structured questionnaires in two levels of hospitals in central Taiwan. Subjects experienced somewhat stressful conditions (Mean = 2.89, SD 0.62) and 31.5% intended to quit. Job stress was the highest at 0-1 month and the intention to quit was highest at 1-2 months. The intention-to-quit group had significantly higher job stress with regard to roles/interpersonal relationships than the intention-to-stay group [t(144) = 2.65, p = 0.009]. Logistic regressions indicated that higher job stress (odds ratio = 2.26; 95% CI 1.14-4.51), working at a medical centre (odds ratio = 3.61; 95% CI 1.10-10.92) and not having had a clinical practicum in the working hospital (odds ratio = 2.41; 95% CI 1.01-5.77) were significant predictors associated with the intention to quit. Newly-graduated nurses perceived moderate job stress which significantly influenced their intention to quit. Nursing administrators should assist newly-graduated nurses in role adaptation and interpersonal relationships particularly to those who had previously worked only in medical centres and had never done a clinical practicum in the hospital. Our findings provide concrete directions to nursing administrators in developing a stress-alleviation programme to decrease newly-graduate nurses' job stress, to facilitate them successful entry into practice and to decrease their intention to quit.

Increasing Retention of New Graduate Nurses

With the nursing shortage and the high incidence of turnover among new graduate nurses (NGNs) within the first year of employment, there is an increased need to investigate the effectiveness of retention strategies aimed at retraining NGNs. The purpose of this articled was to determine which organizational strategies increase the retention rates of NGNs. A systematic review of the research literature was conducted to examine published studies that focused on a retention strategy implemented to influence NGNs to stay in their place of employment. Data were extracted, and the quality of each study was assessed. Sixteen published studies were included in this review. Of these, 13 did not use true experimental study designs. Based on the studies with the strongest designs, the highest retention rates were associated with retention strategies that used a preceptor program model that focused on the NGN as well as a program length of 3 to 6 months. Evidence for the effectiveness of implementation strategies is limited; however, it is apparent from all the studies reviewed that implementing a retention strategy is effective for increasing retention rates of NGNs.

Nursing Graduates' Perceptions of Their Undergraduate Clinical Placement

Student clinical practice is a significant and essential part of nursing education. Accordingly, clinical placements need to be positive and valuable. The purpose of this study was to describe newly-graduated nurses' perceptions of their student clinical intersession placements and how these placements impacted their functioning as graduate nurses. Inductive semantic analysis of the data revealed four themes: developing nursing skills and knowledge; preparing for future employment; experiencing supportive relationships; and experiencing realities of work-life. Educators must ensure that clinical placements are in an environment that is conducive to learning and promotes the personal and professional development of nursing students. Positive clinical experiences are more likely related to how valued and supported students feel than the physical aspects of a placement; thus, it is imperative educators assess and focus on providing placements that offer a supportive learning environment.

New Graduate Nurses Adaptation to Shift Work: Can We Help?

Shift work's desynchronisation of physiologically determined circadian rhythms has a major effect on the psychobiology of every shift worker. It is also commonly perceived that the effects of shift work contribute to the current New Graduate Nurses (NGNs) attrition rate. NGNs must also adjust to work within the health care system as they adapt to shift work, but do the initial effects of shift work as experienced by NGNs get better with time? This study aimed to describe the adaptation of NGNs to shiftwork. Levels of general health, sleep, fatigue, circadian type, job satisfaction, levels of burnout and the coping processes of 150 final year undergraduate students were investigated in a questionnaire based longitudinal study conducted over their initial twelve months of clinical practice as NGNs. Correlational analysis indicates that whilst shift work initially seriously disturbs sleep and other variables associated with individual and situational differences some adaptation was evident by twelve months. Social dysfunction scores (GHQ28) remained significantly related with variables associated with burnout, job satisfaction, sleep disturbance and life disruption at the twelve month point. The presence of depression on pre-shift work scales was also significantly related to continuing experience of sleep disruption and increased levels of emotional exhaustion throughout the twelve month period. Further investigation is required to establish the effect of shiftwork on outcome measures such as levels of burnout and job satisfaction for NGNs. However, although it is possible that improved preparation for shift work may assist the adaptation of NGNs to shift work during their first year of practice it is clear that attention to the organisation of nursing shift work would also be timely.

Competence of newly‐graduated nurses – a comparison of the perceptions of qualified nurses and students

This paper reports a study that compares opinions of final year nursing students, rating their own competence, with the opinions of experienced nurses on the competence of newly-graduated nurses. The transition of nursing preparation into higher education is regarded as positive, although it has led to differences in opinion about the competence of newly-graduated nurses and their readiness to enter the nursing profession. There are studies showing that newly-graduated nurses perceive themselves as holistically focused, professional practitioners, while other nurses are concerned that newly-graduated nurses do not have necessary skills. A convenience sample of 106 nursing students in the final week of their course and 136 nurses who had experience of supervising nursing students completed a questionnaire. The data were collected in 2002. Own competence, in the form of ability to perform nursing care, was rated by nursing students to be good or strongly developed in most of the investigated areas of nursing care. Experienced nurses also estimated newly-graduated nurses' competence to be good or strongly developed, although to a lesser extent. Nurses qualified within the previous 5 years rated newly-graduated nurses' competence to be higher in comparison with those with less recent education. Further studies are needed to broaden our understanding of why some areas of nursing care, such as ethical awareness, were rated very highly, while others, like informing and teaching of co-workers and planning and prioritizing interventions had the lowest rating.