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Editor's
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About 5,000 new graduates join the nursing profession in California each year. In rough numbers, about 4,200 are from associate degree programs and 800 graduate from bachelor’s degree programs. The highest percentage of these nurses joins our workforce in June. Within the first year of employment, depending on whose numbers you believe, upward of 80 percent to 90 percent of new graduates will leave their first job. This is not a new phenomenon; high turnover of new graduates has been with us a long time. We should all be embarrassed by this statistic. It will take all of us working together to change it. Both education and practice share responsibility in affecting the new graduate’s first job experience. Things need to change in the work environment that receives new graduates as well as the educational system that prepares them. A significant gap still exists between the structured clinical experiences of the student and the real-life work experiences of a practicing nurse. It still is rare for a student to graduate after accepting a realistic patient care assignment. Faculty also have an important role in developing a student’s expectations and impressions of the workplace. These are not always positive or accurate. Student rotations should be altered to provide a more realistic experience of bedside nursing. In turn, hospitals and more experienced co-workers have unrealistic expectations of new graduates and put them in positions of responsibility far ahead of their time. The growing shortage of nurses is likely to exaggerate this problem. Experienced nurses, tapped as preceptors, are not always prepared to provide the needed structure and support to new nurses, or given the necessary time from their normal work responsibilities. The sink-or-swim attitude still is a common experience. Managers need to ensure that new graduates are not pushed beyond their abilities in the first year of practice. Many nursing experts have suggested that a required, BRN-approved pre-licensure internship before entry into practice would provide a buffer to ensure that new nurses acquire early experience in a supportive and structured manner. While new nurses are increasingly savvy and seek out employment where there are educational resources and preceptor support designed specifically for the new graduate, they may not be able to assess the variables that separate the "adequate" from the "exceptional" new graduate environments. Let’s just say that not all new graduate programs are created equal. Often, the promise of a structured new graduate program is nothing more than a slightly extended orientation period. However, California does have some model programs that have demonstrated excellent outcomes with high new grad retention rates. These are the programs we should showcase and replicate in other settings. To improve new graduate retention, the work environment must improve as well. This remains the most significant challenge facing health care today. Those of us at the bedside are not always the most supportive of new graduates either. As nurses, we should be willing to make the greatest investment of all in new nurses. We have the most to gain from their success and presence at the bedside. While it does require significant investment of resources to provide the necessary support for new graduates, it is money well spent. Responsible employers should not hire new graduates unless they are willing to make the investment in education and support in a professional clinical practice environment with the requisite resources for new graduates. As a profession, we can afford only the best and most supportive experiences for our new colleagues.
What
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