The nursing shortage is a topical issue in modern health care, affecting nurses’ performance, job satisfaction, and turnover intentions. The major causes of nursing shortage include the aging nursing workforce and low retention rates of new nurse graduates (Cochran, 2017). Therefore, viable options to ameliorate the nursing shortage should be directed toward recruiting recent graduates and their subsequent retention.
One such option is the development of nurse residency programs (NRPs) designed to facilitate nurses’ transition from the academy into practice (Ulep, 2018). Studies show that new nurses often leave the workplace or the profession because they lack support in clinical decision-making, feel overwhelmed by job stress, and are unable to resolve conflicts (Cochran, 2017). NRPs supply nursing graduates with preceptors who aid them during the process of transition into practice and help them address the emerging issues.
The second viable option is the introduction of career development programs. Research shows that nurses regard healthcare organizations as a springboard for their future professional achievements and career advancements (Bernard & Oster, 2018). Therefore, in order to ensure nursing staff retention and meet future workforce needs, organizations have to develop internal career paths. An effective career development program includes educational requirements, lateral and vertical growth opportunities, organizational processes for different career levels, and the required proficiencies (Bernard & Oster, 2018). These components are necessary for nurses to visualize their career paths and prepare for future career advancements.
The third option for recruiting and retaining the nursing workforce is establishing a healthy work environment. This option requires the organization to develop a clear vision and mission and employ highly-prepared nursing leaders who would disseminate them among the nursing staff (Shirey, 2017). In addition, a healthy work environment implies that there should be effective communication between managers and employees because empowering and supportive communication is crucial for nurses’ job satisfaction (Shirey, 2017). Having a supportive organizational culture ensures that higher retention rates by increasing employees’ job satisfaction and commitment to the organization.
The Impact on Costs, Quality, and Access to Healthcare
Evidence shows that NRPs positively affect the cost and quality of care, as well as access to healthcare. The studies identified in Cochran’s (2017) literature review show that the implementation of NRPs led to a significant decrease in the cost of healthcare and an increase in the retention rate. In one case, the nursing turnover was reduced from 36.8% to 6.4%, and the labor costs fell from $19,099 to $5,490, leading to a net savings of $10-$50 per patient day (Cochran, 2017).
In another case of the NRP implementation, retention rates rose from 35-61% to 94-97%, and savings from the reduced turnover rates considerably exceeded the spending on the program (Cochran, 2017). Further, NRPs significantly improved nurses’ critical thinking and communication skills and confidence levels, thus positively affecting the quality of care (Cochran, 2017). Finally, a considerable increase in retention rates after the implementation of NRPs suggests that this option also improves access to care by reducing the nursing shortage.
Career development programs also have a positive impact on costs, quality, and access to healthcare. According to Bernard and Oster (2018), providing nurses with career development opportunities increases their job satisfaction, thus decreasing the cost of healthcare through cost savings associated with recruitment and retention. In addition, such programs improve employees’ organizational commitment and the desire to learn, which leads to better organizational performance and improved patient outcomes (Bernard & Oster, 2018). Implementing career development programs helps healthcare organizations attract and retain new nurses, which positively affects access to care.
Finally, establishing a healthy work environment has a positive influence on the nursing workforce. A healthy work environment has been proven to promote interprofessional collaboration, provide learning opportunities, reduce anxiety levels, and decrease reality shock (Cochran, 2017). In such an environment, communication and decision-making are improved, leading to enhanced quality of care (Shirey, 2017). A healthy work environment decreases nursing turnover rates, thus decreasing the cost of care and improving access to care. However, there is scarce evidence on how organizations can maintain a healthy work environment once it is achieved.
The Best Option
Based on the evidence, it may be suggested that the implementation of NRPs is the best option for recruiting and retaining new nurses, thus resolving the nursing shortage issue. One major reason for this choice is that NRPs aim to recruit and retain new nursing graduates and ensure their successful transition into practice. Targeting recent graduates is especially important in the current situation as the nursing workforce is aging, and about 700,000 employed nurses are expected to retire in the next five years (Ulep, 2018).
In addition, studies show that millennial nurses leave their jobs earlier than previous generations, with 30% of them quitting the job in the first year and 57% of them doing so in the second year (Ulep, 2018). Therefore, recruiting and retaining recent nursing graduates with the help of NRPs seem to be the most viable option under present circumstances.
Furthermore, the implementation of NRPs may indirectly lead to the establishment of a healthy work environment. Studies show that NRPs meet nurses’ need for professional support during their transition from education into practice and promote effective communication and interprofessional collaboration (Cochran, 2017). For NRPs to be effective, they should address all issues encountered by nurses in their practice and last at least 12 months (Cochran, 2017). Such duration and content will ensure that nurses are prepared for successful functioning in the workplace and are not overwhelmed by stress and low self-confidence.
References
Bernard, N., & Oster, C. A. (2018). An evidence-based nursing career framework. Nurse Leader, 16(2), 127–133.
Cochran, C. (2017). Effectiveness and best practice of nurse residency programs: A literature review. MedSurg Nursing, 26(1), 53–57.
Shirey, M. (2017). Leadership practices for healthy work environments. Nursing Management, 48(5), 42–50. Web.
Ulep, K. (2018). The nurse leader’s pivotal role in retaining millennial nurses. The Journal of Nursing Administration, 48(12), 604–608.