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Increasing Registered Nurse Retention Using Mentors in Critical Care Services
Abstract
Recruiting and training 1 newly hired registered nurse can cost thousands of dollars. With a high percentage of these newly hired nurses leaving their first place of employment within their first year, the financial implications may be enormous. It is imperative that health care facilities invest in recruiting and retention programs that retain high-quality nurses. Mentorship programs in retaining and easing the transition to practice for new graduate nurses, re-entry nurses, and nurses new to a specialty area are critical in nurse retention. Discussion in this study includes the effect of implementing a mentor program into the critical care services area of a 325-bed not-for-profit community hospital in northern Indiana. Based on this study, nurses with a mentor were retained at a 25% higher rate than those not mentored. Implementation of a mentor program reduced the training cost to the facility and increased retention and morale
... Moreover, a preceptor in nursing is a person who is trusted to provide advice to less knowledgeable or less experienced individuals. By contrast, a preceptee is an individual or group of people seeking advice from a more experienced and knowledgeable person (Schroyer et al., 2016;Lavoie-Tremblay et al., 2020;Tiew et al., 2017). Research indicates that exposure to preceptorship programmes can increase nurses' confidence, job satisfaction levels and retention, and positively impact their clinical performance (Antohe et al., 2016). ...
... Nurse mentoring programs provide minimal opportunities for professionals who join new health services, ranging from new graduates to professional nurses who come from other services. The form, duration, organization, and even the impacts of mentoring programs in the literature are very diverse [3]. This review will contribute to determining which nurse mentoring models/processes exist in the clinical context, as well as their impacts and contributions to institutions and to professionals. ...
Introduction:
Mentoring programs minimize stress and anxiety in recent graduates and in newly recruited nurses, guiding their careers and enabling them to retain their skills and correctly care for patients. The objective of this scoping review is to explore and summarize the existing literature on mentoring models and programs in the clinical nursing context.
Methods:
The databases searched include PubMed, Embase, Cochrane Library, Epistemonikos, Cuiden, Scielo, MEDES, OpenGrey, Trove and MedNar. Published and unpublished studies worldwide that included nurse mentoring programs in a clinical context, in public and private systems and primary, secondary and tertiary healthcare settings, and articles published in English, French, Spanish and Portuguese, were included. Nurse students and training specialists were excluded. The papers were screened by two independent reviewers. In cases of discrepancy, a third reviewer made the decision.
Results:
Eleven studies were included. Most of them were conducted in the USA. A wide range of nurse mentoring programs were identified with highly variable characteristics. The duration of the programs and the evaluation systems were different, but the expected results matched.
Conclusions:
Mentoring programs need more in-depth and extensive study. In spite of their differences, they all lead to improvements for nurses, patients and organizations. A gender influence was found in our results, which could be studied in future research.
Introduction. The work of a nurse in conditions of war or conflict imposes unique demands on her emotional state. The aim of the work – to study the level of anxiety in nursing students and to identify ways of its regulation. The main part. The paper analyzed the questionnaires of 19 students in the first year, nine in the second year, 10 in the third year, and 10 in the fourth year of the educational and Scientific Institute of Nursing of TNMU. The results showed that a third of future nurses have a high level of reactive anxiety, and half of them have an average level of personal anxiety. A decrease in anxiety was observed among fourth-year students compared to first-year students, which indicates the development of emotional stability during the learning process. Future nurses have a high level of anxiety associated with a sense of danger or failure in their studies and professional activities. Conclusions. The study confirms the high level of anxiety among nursing students, as well as the effectiveness of the training in reducing this anxiety. Psychological support and the development of anxiety management skills can improve these healthcare workers’ psychological well-being and professional performance.
Background
Trained ICU nurses may perform oesophageal pressure measurements which may help facilitate its implementation in the usual patient care to better assess lung and chest wall mechanics and easily detect patient‐ventilator asynchronies.
Aim and Study Design
We thus conducted a prospective educational study aiming to assess the ability of ICU nurses to perform reliable oesophageal pressure measurements after a short dedicated training program.
Results
All the 11 nurses who completed the program succeeded their practical evaluation (nine (82%) at the first evaluation and two (18%) at their second attempt).
Conclusion
These results show that this training program is feasible and that trained ICU nurses can perform accurate oesophageal pressure measurements in mechanically ventilated patients.
Relevance to Clinical Practice
Such training program may help to implement this technique in routine ICU care.
Програми наставництва використовують у медсестринській практиці як невід’ємну частину навчального плану. Ментор – це професіонал із важливим досвідом і знаннями, який бере на себе відповідальність за скерування, консультування, навчання та допомогу іншим у навчанні компетентностей, удосконаленні їх професійного досвіду та сприянні лідерству. Це цілком характерно в контексті студентства. Фактичні клінічні медсестринські умови є складними та мінливими, що робить їх дуже цікавими кандидатами для вдосконалення в клінічному контексті. Мета роботи – проаналізувати наукові дані, що стосуються моделей наставництва у медсестринстві та адаптації медсестри на робочому місці. Основна частина. У роботі опрацьовано наукові публікації за останнє десятиліття, а також публікації з високим цитуванням, які доступні в мережі «Інтернет», ключовими були слова «менторство», «моделі наставництва», «адаптація медсестри». Існують різні форми і моделі наставництва у медсестринстві. Проте варто зауважити, що для найбільш успішного розвитку програм наставництва варто не лише брати до уваги модель «ментор – підопічний», а й розширити контингент, в якому одне з важливих місць має посісти керівництво, адже саме мотиваційна складова – похвала і фінансова підтримка найефективніше впливає на розвиток працівника у професійній діяльності. Щоб удосконалити програму менторства, потрібно вжити кількох ініціатив, таких, як потреба у навчанні та підтримці, адекватний розподіл робочого навантаження, винагороди і переваги, а також постійна потреба в оцінці програми наставництва, щоб забезпечити та підтримувати її успішність. Риси ментора поділяють на особистісні, соціальні та професійні. Успішне наставництво вимагає навички міжособистісного спілкування, а також створення сприятливих умов для академічної медицини. Висновки. Отримані результати свідчать про необхідність розширення поняття наставництва в роботі молодої медсестри із залученням прикріпленого ментора і спільною роботою колективу відділення для швидшої її адаптації та отримання відчуття задоволення від роботи.
BACKGROUND: Staffing models within nursing units have long been a hot topic of discussion. The COVID-19 pandemic exacerbated this discussion by straining the national nursing environment and workforce. Before the pandemic, the neuroscience intensive care unit (NSICU) primarily used an acuity-adjusted staffing model and aimed for a nurse-to-patient ratio of 1:1.5. During and after the pandemic, the NSICU was forced to primarily use a centralized staffing model because of the increased turnover in the hospital at large and a rise in patient census. METHODS : Unit census data in an NSICU were tracked before, during, and after the pandemic alongside utilization of a centralized staffing model in the hospital at large. RESULTS : During this time, the NSICU saw a statistically significant increase in average nurse-to-patient ratio and incidences of both floating and tripled assignments. The NSICU simultaneously saw a 180% increase in nursing turnover. CONCLUSION : Although we cannot prove that a centralized staffing model is directly responsible for higher nursing turnover, its utilization led to greater incidence of poor staffing—reflected in deviation from the nurse-to-patient ratio goal of the unit. Nurse staffing concerns play a large role in nurse satisfaction in the workforce: staffing shortages have been described both as a precursor to and as a consequence of increased nursing turnover.
Nurse turnover may negatively impact patient outcomes, the nurse shortage, and hospital finances. This evidence-based practice project examined the effect of a formal mentorship program on new graduate nurses' (NGNs) intent to leave a healthcare position. The outcomes suggest that the mentoring intervention used has the potential to impact new graduate nurse retention rate. Small sample size limits evaluating the project, which needs to be replicated with a much larger number of NGN mentees and more experienced nurse mentors.
Background: Mentorship is a vital part of the nursing profession. The evidence suggests that competent mentors aid in facilitating role transitions, improving job satisfaction, enhancing patient care, and decreasing nursing turnover. Advanced practice registered nurses (APRNs) have the skills and knowledge to provide safe, high-quality, patient-centered care; however, they may be lacking in mentorship abilities. Objective: Currently, there is no formal mentorship training in the organization, which may cause variability in the mentoring of new staff. The focus of this project was to create a staff educational intervention to improve the mentoring competency of surgical APRNs. The knowledge gap, lack of mentoring education given to APRNs acting as mentors to novice practitioners, was noted, and this project identified a staff educational intervention on mentorship training that was developed and implemented. Methods: The project practice-focused question asked if a formal APRN mentorship training program geared toward the six elements of mentoring (as measured by the Mentoring Competency Assessment [MCA]) increased the mentoring competency of APRNs serving in a mentorship role. Benner’s theory guided the planning and development of this project, while the MCA was used for the self-reflection survey. Following a pretest survey, participants experienced an educational intervention geared toward mentoring and mentoring competencies. Formal APRN mentorship training program with an educational intervention that addressed the six domains of mentoring competency geared toward increasing the mentoring competency of APRNs who serve in a mentorship role. Results: A total of 18 surgical APRNs ( N = 18) with more than 2 years of experience participated in the staff educational intervention. There was a statistically significant difference in six of the 26 individual items and in the overall pretest mean scores and the posttest mean scores ( z = −3.41, p < .01), indicating that the APRN mentorship training increased the mentoring competency of the APRNs. Conclusion: The results of this quality improvement project demonstrated how an educational intervention geared toward mentoring competencies can increase the knowledge among a group of APRNs. Educating APRNs in mentorship competencies may enhance mentorship abilities and result in positive patient and organizational outcomes. Implications for Nursing: Educating APRNs in mentorship competencies may enhance mentorship abilities and result in positive patient and organizational outcomes
Background:
The nursing essential mission was to satisfy patients' and caregivers' essential health-relating demand, thanks to communicational, interventional, assistance and helping skills through an appropriate approach which best satisfied both patients and their caregivers. To assess any differences in nursing-home care quality perceived levels both by patients and caregivers.
Methods:
A cohort observational study was conducted from November 2022 to January 2023 using an online anonymous questionnaire for both patients and caregivers who received nursing-home care service.
Results:
A total of 677 patients (43.4%) and caregivers (56.6%) were enrolled. Most interviewees benefited from the nursing-home care service less than 12 months (p = 0.014). Quality perceptions did not significantly vary from patients and caregivers (p > 0.05) for all the items proposed, with the exception of the nursing listening skills which was better assessed by caregivers than patients (p = 0.034).
Conclusion:
Patients and caregivers perceived an average quality of nursing-home care, giving particular importance to some nursing skills, such as listening skills. The general quality of nursing care was however satisfying. Findings suggested more incisive action from health-care nurses to improve quality of nursing-home care and both patient and caregiver satisfaction.
Het tekort aan verpleegkundigen is overal groot. Dit heeft gevolgen voor de patiëntveiligheid, de werkdruk en het ziekteverzuim onder verpleegkundigen. Uit onderzoek blijkt dat het inzetten van mentoren een positieve invloed heeft op de werving, het behoud en de professionele ontwikkeling van beginnende verpleegkundigen.
The study reported in this article aimed to explore the trust protégés felt for their mentors and the effects different dimensions of relationships that can influence this trust in mentoring relationships within academic organizations. The questions defined for this research regarded which dimensions of professional relationships actually do influence protégés' trust, which of those underlying dimensions make trust stronger, and the results the trust protégés felt for their mentor produced in terms of the function of mentoring. The interview form used to answer these questions consisted of two parts. The first part included general questions on the characteristics of mentors and protégés and the functions of mentoring. The second part included 24 questions designed specifically to identify the underlying elements of trust in mentoring relationships. The dimensions specifically were competence, consistency, communication, interest taken in the protégé, fairness, and sharing of control. Thirty-two protégés agreed to take part in the structured interviews, and the total time spent on interviews was 35 hours. The study revealed that among the elements necessary for the building of trust in one's professional mentor, sharing of control and fair behavior were dimension of the mentoring relationship that protégés had positive perceptions and experiences of. Another important finding in terms of positive and negative perceptions was that protégés identify their positive perceptions more with the personal efforts of their mentor. Negative perceptions were seen to be related to factors such as faculty and university culture, legal matters and regulations, law and regulations creating rigid university procedures, and mentors' and protégés' personal characteristics.
The transition from nursing student to registered nurse can be exciting, stressful and challenging. It is common for nursing students to feel insecure about their competence and ability to step into working life. The role of the mentor in the final clinical practice is essential, as they guide students in their clinical learning process and professional growth. This study describes the mentor's support in the transition from nursing student to registered nurse. Sixteen nursing students wrote narrative essays about the significance of the clinical mentor in their role change in the transition process from nursing student to registered nurse. The essays were analysed using inductive content analysis. The findings show that the mentor has a significant role. Three main categories emerged in mentor's role: role change support, the mentor's actions and the qualities of the mentor. In future in clinical nursing practice, it is important to allocate resources to the mentor's work and understand its importance for nursing students' transition to nursing.
Despite recent increases in nurse recruitment in Australia, the current nursing workforce is still below the predicted numbers for the future demands. The combination of an ageing workforce, high nursing staff turnover and an inability to attract and retain nurses is eroding the capacity of the health care sector to appropriately respond to the care needs of the community. Currently, the nursing workforce may have as many as four generations working together. Differences in employment needs and values, work ethics, attitudes towards authority, and professional aspirations, contribute to some of the cross-generational problems that emerge and the turnover of nursing staff. Strategies to improve the retention rates of nurses need to focus on building a cohesive workforce by utilising the strengths and skill sets that characterise different generations of nurses, and creating the conditions in which nurses across all generations feel supported and valued. The aim of this article is to explain how effective leadership, teamwork and mentoring can assist efforts to promote generational cohesion and address the decline in the number of nurses in the workforce.
How To Obtain Contact Hours By Reading This Issue
Instructions: 1.1 contact hours will be awarded by Villanova University College of Nursing upon successful completion of this activity. A contact hour is a unit of measurement that denotes 60 minutes of an organized learning activity. This is a learner-based activity. Villanova University College of Nursing does not require submission of your answers to the quiz. A contact hour certificate will be awarded once you register, pay the registration fee, and complete the evaluation form online at https://villanova.gosignmeup.com . In order to obtain contact hours you must: 1. Read the article, “Educational Strategies for Rural New Graduate Registered Nurses,” found on pages 107–110, carefully noting any tables and other illustrative materials that are included to enhance your knowledge and understanding of the content. Be sure to keep track of the amount of time (number of minutes) you spend reading the article and completing the quiz.
2. Read and answer each question on the quiz. After completing all of the questions, compare your answers to those provided within this issue. If you have incorrect answers, return to the article for further study.
3. Go to the Villanova website to register for contact hour credit. You will be asked to provide your name, contact information, and a VISA, MasterCard, or Discover card number for payment of the $20.00 fee. Once you complete the online evaluation, a certificate will be automatically generated.
This activity is valid for continuing education credit until February 28, 2015 .
Contact Hours
This activity is co-provided by Villanova University College of Nursing and SLACK Incorporated.
Villanova University College of Nursing is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center’s Commission on Accreditation.
Objective
Upon completion of this article, the learner will have reviewed concepts and educational strategies for rural new graduate registered nurses.
Disclosure Statement
Neither the planners nor the author have any conflicts of interest to disclose.
Rural health care facilities are geographically remote, tend to be small, and often possess limited resources. Although newly graduated registered nurses are important to the work force of many rural communities, maintaining a formal preceptorship/mentorship program within a rural hospital may prove difficult as a result of limited resources. Unfortunately, the new graduate may become overwhelmed by the many expectations for clinical practice and the facility can experience high turnover rates of new graduate hires. This article explores the unique traits of the rural hospital and the new graduate nurse as well as the pros and cons of a formal preceptorship program within a rural setting. Constructivist learning theory is used to develop practical teaching strategies that can be used by the preceptor and the new graduate. These strategies are inexpensive, yet effective, and are feasible for even the smallest of facilities.
Facilitating the learning of student nurses in the workplace is an integral role of the registered nurse. This article aims to provide an overview of the role and responsibilities of the mentor in supporting pre-registration nursing students in clinical practice. The professional obligations for the mentor to meet the Nursing and Midwifery Council (NMC) standards (NMC, 2008a) will be explored, including the ongoing requirements to keep up to date in mentoring practices. Some of the challenges within the role will be identified, including the importance of recognizing and supporting the failing student. Recent changes to the preparation requirements for sign-off mentors will be discussed. The article concludes by presenting the potential benefits to both the individual and the practice placement provider.
The most difficult time to retain staff nurses can be the first year after hire. Because of the high costs of recruitment and orientation, retention of these new employees is essential. Mentoring is a viable retention tool for the new employee and for existing experienced nurses. Mentoring also provides professional growth benefits that appeal to existing employees and increase their job enjoyment and satisfaction.
An aging work force, predictions of job growth in health care, and an eventual economic recovery suggest that the current reprieve from the national nursing shortage is temporary. New graduate nurses are an important part of the work force and are needed to replace nurses who will retire in the next decade. Organizational leaders can address the forecasted work force demand by proactively investing in programs for workplace development and retention. Recent literature reports an increased focus on understanding the work experience and career support needed for new graduate nurses. Several studies report improvements in job satisfaction and retention after implementation of structured mentoring programs for new graduate nurses. However, despite successful transition programs, turnover for these same nurses after 1 to 3 years of organizational tenure remains high. Studying factors that contribute to retention and supporting careers beyond the first year of practice may have a significant effect on improving retention and will contribute new knowledge to the nursing literature. This study, undertaken at a Midwestern pediatric academic medical center, examined job factors and career development support that lead to retention of nurses with 1 to 3 years of experience. Understanding these issues may guide nursing leaders and staff development educators in investing in focused retention and career development plans during an economic recession.
This review will explore the lived experience of the transition of new nursing graduates in their first year of practice, the implications to nursing and consequences of status quo, and actions required to support new graduates in their transition to practice.
The new graduate eagerly anticipates their first position in the 'real world' but often experience challenges in their first year of practice.
A literature review highlights the historical inaction and the confirmed lived experiences of new graduate nurses.
New graduate transition into the workforce has implications on both an individual and societal level. No longer can one ignore the need to recruit and retain nurses, especially new graduates.
Implemented collaborative and innovative efforts are required to support new graduate nurse transition to practice.
Nurse Managers must question why the disenfranchisement and marginalization of new graduates continues. Persistent inertia impacts recruitment and retention of graduate nurses and patient safety, transforming episodic challenges into chronic systemic issues. This article will contribute to new nursing knowledge by providing a Canadian perspective of demographic trends of the Registered Nurse (RN) and salient actions required to resolve the discourse of new graduate transition into the workplace.