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Report From a National Survey Of Health Service Facilities for the National Review of Nursing Education 20015. New Graduate Registered Nurses5.1 New Graduate Registered Nurse Programs 5.1 New Graduate Registered Nurse ProgramsInstitutions were then asked questions about new registered nurse employees. These related to aspects such as the provision of a new graduate program and their satisfaction with the skills and knowledge of these graduates. Table 23 - Category of organisation providing graduate program for new RNs (n = 432)
A total of 162 organisations provide new RN graduates with a structured graduate program (Table 23). Sixty-four percent of respondents from the public category provide such a program. Lowest is the charitable category (12.2%). Similar proportions of institutions in the private category (both for-profit and non-profit) provide new graduate programs, but at 50% of the level of the public institutions. Despite the numbers of institutions which do provide new graduate programs, there is a considerable number of respondents who do not (62.5%). Table 24 indicates the responses to a question about the number of years the new graduate transition program had been provided. The first graduates from university programs in many states entered the workforce in late 1987 or early 1988. Table 24 - Number of years graduate program has been provided for new graduate RNs
The mean number of years new graduate programs have been provided is greatest in the public category than for all others. When median values are considered the public category of institution has provided a graduate transition program for more years than the other categories with the private categories (for-profit and not-for-profit) close behind at 5 years. 5.2 Satisfaction With New Graduate Registered Nurses5.2.1.Satisfaction with Knowledge LevelsInstitutions were asked using a four point Likert scale to indicate their overall satisfaction with the knowledge levels of new RN graduates. The scale ranged from never satisfied (1) to occasionally satisfied (2), usually satisfied (3) and always satisfied (4). Table 25 - Overall satisfaction with knowledge levels of new RNs
There is little difference in the satisfaction with knowledge levels of new graduate registered nurses between the categories of institutions. The mean ranges from 2.6 to 2.9 (on a Likert scale of 1 - 4) and the standard deviation is small. The median is 3.0 for all categories indicating they are usually satisfied with the knowledge levels of new graduate registered nurses. 5.2.2 Satisfaction With SkillsOrganisations were asked about levels of satisfaction with new graduate RNs undertaking specific activities at two specified time intervals; within 3 months of commencing employment, and from 3-12 months after commencing employment. Possible answers for each activity were 'never satisfied' (1), 'occasionally satisfied' (2), 'usually satisfied' (3), and 'always satisfied' (4). Examples of activities are 'administering IV medications' and 'complex wound dressings'. Appendix I shows amalgamated answers for below 3 months and 3-12 months for new registered nurses undertaking all specified activities. Minimum and maximum ratings, the standard deviation and the mean are shown for each item. The results are divided into four categories again: public institutions; private for-profit; charitable; and private non-profit. 'Not stated' responses are not included. At three months for all skills the mean score for satisfaction with new RN skills is between (2) 'occasionally satisfied' and (3) 'usually satisfied' for all categories of institution. At 3 - 12 months all hospitals in all categories indicated an improvement for all skills. The mean score rises in most instances to 'usually satisfied' (3) to 'always satisfied' (4) because the mean score is greater than 3.00. Of note in the charitable category is that the minimum score remained '1' 'never satisfied' for all skills whereas for most skills in the remaining three categories of institution, the minimum score was '2' with four exceptions in the private-for-profit category. In all categories at three months, time management skills have the lowest mean score indicating the least satisfaction while equally, for all categories of institutions, hygiene skills had the highest mean score (matched by simple dressings in the charitable category). At 3-12 months time management continues to have the lowest mean score for all categories except the charitable institutions where IV medications have a slightly lower mean in terms of satisfaction. Further research should be undertaken to clarify this result. 5.3 Retention Of New Graduate Registered NursesSeveral questions were asked to ascertain the retention rates of newly graduated registered and enrolled nurses and midwives. Respondents were asked to provide data on the number of staff in these categories employed in 1999, 2000 and 2001 and the number retained at the time of the survey (October 2001). Responses for enrolled nurses and midwives were too small to be representative. These data have not been included. Figures 8 - 10 provide data on the number of registered nurses employed into the new graduate programs who were still employed at the time of the survey. Figure 8 - Number of new RNs employed in 1999 who now remain employed by category of institution
Figure 9 - Number of new RNs employed in 2000 who now remain employed by category of institution Figure 10 - Number of new RNs employed in 2001 who now remain employed by category of institution
Figures 8, 9 and 10 indicate that across all categories of institution, not all new registered nurses are retained following completion of a new graduate program. This is not surprising and does not necessarily reflect a loss of new registered nurses to the profession and health system (although it may), but merely a loss to the initial employer who has invested in their training. Many new graduate registered nurses (if not most or all) apply to participate in the new graduate programs provided by health facilities in order to facilitate their transition to the role of employee registered nurse. The majority of these programs are one year in duration. Following completion of this year they are free to take up employment in any institution of their choice. It should be noted that in Figure 10, the public category has lost more new graduates through the year than did the other three. 5.4 SummaryTable 23 indicates that there are twice as many institutions in the public category providing new graduate programs compared to the next most frequent source, the private for-profit category. As Table 24 indicates, the public category of organisation has also been providing these programs for a longer period of time. It would appear that the costs of facilitating the transition of new graduates into employee status are borne largely by the public institutions (which in the main are also the major employing institutions) than perhaps other categories of institution. Using the median of 3.00 (Likert scale 1 - 4) all categories of institution are 'usually' satisfied with the knowledge levels of new graduate registered nurses. In terms of satisfaction with specific skills, at three months, time management skills have the lowest mean score but all means are greater than 2.00 (occasionally satisfied = 2 and usually satisfied = 3). At 3 - 12 months time management skills still have the lowest mean score but all skills have higher mean scores for satisfaction overall. Indeed the means in all cases rise to over 3.00 (usually satisfied and always satisfied = 4). The retention rate for new graduate registered nurses is consistent across three time periods (1999 - now, 2000 - now, 2001 - now) for all categories of organisation. |
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