Today’s healthcare atmosphere demands efficient utilize of resources. Research demonstrates that turnover speeds are high for fresh nurse graduates as a consequence of a demanding work environment tied with inadequate support throughout the transition from undergraduate to professional practice. In today’s self-motivated health care environment it is vital to recruit new graduate nurses to healthcare facilities and ensure they have sufficient resources and support to flourish in order to keep them in the profession.Nurse shortage, employers and nurses’ attitudes and graduates expectations, and the environment of the job surroundings among other factors, affect nurses’ retention. Upgrading the place of work for nurses is a noteworthy element of nurse retention. Nurse retention is directly associated to nurse satisfaction in regard to both working conditions and responsibilities. While it is achievable to take a nursing occupation for the money, and pay always numbers in the balance of an excellent work environment, a nurse most frequently stays in a particular job due to caring, conviction, and the faith that their work environment supports them to do what they were trained to do (Duchscher, 2010).
New graduates entering the workplace have great expectations of how their job will be interesting. Reports that new nurse graduates are not sufficiently prepared to enter the workforce are of concern to educators, employers, and other stakeholders. Often, this lack of 'practice readiness' is defined in relation to an inability to 'hit the ground running' and is attributed to a 'gap' between theory and practice and the nature of current work environments.
The study and research have revealed that work processes, changes in technology, and unit design and organization may allow for significant improvements in the use of nurses' moments in time and the safe liberation of care. These enhancements not only optimistically affect patient care, but by increasing authentic care behaviour, they maintain nurses closer to the significant activities that first attracted them into nursing. If the following are not properly implemented it is hard to retain nurses; Investments in nurse safety and health. Having the appropriate lifting and moving gear is important for the avoidance of physical stress. Extensive preparation of new nurses in lifting method is equally significant, as are detailed strategies regarding the number of persons needed to do specific activities. When recruitment is short, nurses still desire to perform essential duties, and back harms are a major basis of lost time for new and experienced nurses. Flexible arrangement plans. These tactics are commonplace in healthcare centers, but require to be constantly revisited in order to discover the right approach for each single facility or system and its workers. Lack of effective mentoring or preceptor programs has been a contributing factor for most nurses leaving. Monitor new nurses cautiously to ensure that they stay on an optimistic track. In addition, providing diversity in the beginning is a key to impressing new nurses and influences their retention. Residency and internship programs offer a way for nurses steadily plunge themselves in the hospital practice, but other kinds of innovative tactics are also being tested. Days, weeks, or months of intermittent, ongoing training or education can positively break off the sometimes grueling era of adjustment during orientation or change work. Regular offs and a variety of understandings can maintain the self-esteem of a young nurse.
When in the hospital environment, the novice nurse is wrapped up in a firmly fixed, distinctively figurative and hierarchical culture that exposes them to major normative traits that have been described as intellectually oppressive, prescriptive and cognitively restrictive. Research has shown that hospital environments move novice graduates away from the idyllic professional practice adopted by nurses in their educational socialization process, and towards a more efficient, productive and achievable-oriented context that focuses institutionally imposed social objectives (Salt, Cummings, & Profetto-McGrath, 2010). Resulting into internal conflict and role ambiguity that it causes have been cited as turning the creative energy of these new nurses into career disillusionment and often causes job dissatisfaction. Existing knowledge suggests that novice graduates encounter moral distress, role performance stress, disillusionment and discouragement during the first months of their introduction to professional nursing practice. These are demanding times for novice nursing graduates, most of them in fact make their initial adjustment to professional practice in the hospital environment.
Cost of retention, recruitment and replacement.
Having effectual support programs for fresh nurses requires a considerable investment in funds and resources, but the price of turnover in the nursing personnel is even more costly. Turnover is extremely financially costly, but even more significant than the financial load is the drain on self-confidence and the unconstructive impact on patient care. Having sustained programs in place for fresh nurses gives the hospice a positive and spirited story to tell nursing students thinking of their first occupation. Investments in the early on stages of service build the organization's person capital and permit nurses to maintain the passion and drive that made them desire to be nurses in the first place. It should be recognized that actual turnover costs might have considerably variances between individual workers, based on the experience and grade of the worker, and on the substitution approach used by the employer (American Association of Colleges of Nursing, 2010). Significant cost investments are seen when savings in transition consequence in a decline in nurse turnover. Organizations have to focus on retaining nurses in their associations and the general profession, as America is in the midst of a nursing scarcity that is expected to deteriorate over the next years.
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Programs hospitals are adopting to increase retention.
Since there is no end in sight for the countries’ nursing shortages, hospitals are putting more focus on retaining their present RN workforce. A complicated process needs in-depth knowledge of the demands and wants of the nursing workforce and a lot of creativity. The management needs to define what exactly motivates nurses to stay, and enjoy their career. Majority of hospitals regularly conduct retention surveys to know what is on nurses’ minds. Some proposed programs found to increase nurse retention are;
Nurse friendly programs help a great deal in identifying and creating an environment that accommodate nurses with their challenges. Changing the work environment to be nurse friendly would improve the hospital's retention of its nurses. This project’s basic aim is to create a nurse friendly environment that is supportive of the highest level of professional nursing practice.
Nurses need to acknowledge and gain support from the administration. The hospital’s director and overall nursing officer need to make an effort of wanting to know the nursing workforce; the chief nurse officer needs to organize lunch with nurses after they have been on practice for three months to ensure that the job meets their expectations. For hospitals that have effectively carried on with the retention programs, the trick seems to be in offering good working conditions and provide opportunities for professional development and accommodating individual lifestyles. It is also important to offer a program for RNs to be able to advance in their career and further their educations (Baggot, Hensinger, Parry, Valdes, & Zaim, 2010).
The stresses of the job can be fueled by obligations external of the workplace. Hospitals should try their best to support nurses on a personal level, which allows a place for creativity for each individual facility to come into play. From concierge services that aid nurses with everyday jobs, to providing day care, to supple scheduling, hospitals should do anything, which allows their nurses to focus on their work and keep them in their jobs for years to come (Lydia, 2008). This is certainly the retention criterion that removes a lot of the burden from nurses, enabling them to focus on the job at hand.
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Mentorship program are also important in preparing and orienting new nurse graduates as they enroll into the work environment. Some other hospital encourage peer group support programs among its new nurse graduates hoping that the new nurse graduates will get encouraged and develop peer networks that can help them cope with the job environment. In fact, most umbrella nursing bodies have instituted compulsory nurse internship program where each new graduate has to undergo two or three months of orientation in four different clinical areas.
To encourage staff retention, organizations need to establish environments in which nurses would want to work. Beside other things, nurses want reliable workplaces that push for quality health care. It is the responsibility of the nurse manager to develop a work environment that encourages professional practice. This is a key piece to retention. It is also significant that nurses be involved in shaping their environment. Nurses want to work in an environment that cultivates high quality to patients and know they have a responsibility in the process. The Nursing Organizations Alliance established principles to guide hospitals and other health care entities in creating a promising working environment.
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While detailed information is lacking on the nature and extent of the shortage, it is speculated to become more vital in the future as the aging of the populace largely increases the demand for nurses. Besides, a couple of factors are integrating to limit the current and future supply of nurses. Enrollments in nursing programs have been going down over the past decade, lessening the pool of new workers to substitute those who are retiring. In addition, several studies have shown reduced levels of job satisfaction among nurses, literally leading to them pursuing other disciplines (Shermont, & Krepcio, 2009). It is important that academic and hospital managements combine efforts and align strategies to prepare nurses for excellence in the present and future practice environment.
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