Can a one-on-one mentorship program reduce the turnover rate of new graduate nurses in China? A longitudinal study

Abstract

Nursing graduates experience “reality shock” upon entering the workplace as well as face challenges and stress during their transition from nursing student to qualified nurse. The high turnover rate of new graduate nurses not only increases an organization's human resources costs but also results in a shortage of nurses. In particular, a poor experience during the transition from nursing student to qualified nurse can lead to significant turnover. A three-year longitudinal study was conducted to assess the effectiveness of one-on-one mentorship program in reducing the turnover rate of nurses in China. A total of 199 new graduate nurses, recruited in 2013, were considered the control group and received a basic preceptorship, and 239 nurses in 2014 were considered the experimental group, for which a one-on-one mentorship program was implemented. Propensity-score-matching analysis was conducted to adjust the baseline of the two groups, and survival analysis was performed to compare the two groups. The findings showed that the turnover rates for the experimental group were 3.77%, 3.48%, and 8.11% as compared to 14.07%, 9.36%, and 14.19% for the control group at the end of the first three years, respectively. The survival curves of the two groups were significantly different (p < 0.001). The turnover rate for the first year in the experimental group was significantly lower than that for the control group, but the rates in the second and third years were not different. The results indicate that a one-on-one mentorship program is beneficial for the retention of new graduate nurses, particularly during the first year.

Introduction

Nursing graduates experience “reality shock” upon entering the workplace (Kramer et al., 2013) as well as face challenges and stress during their transition from nursing student to qualified nurse (Cho et al., 2012, Hoffart et al., 2011, Teoh et al., 2013). Studies have found that the turnover rate of new graduate nurses in their first year on the job varies from 8% to 69% and from 26.2% to 57% in their second year (Bowles and Candela, 2005, Cho et al., 2012, Mills and Mullins, 2008, Salt et al., 2008, Scott and Smith, 2008, Zhang et al., 2016). The high turnover rate of new graduate nurses not only increases an organization's human resources costs but also leads to nursing shortages, which has been a persistent concern globally (Casey et al., 2004, Hayes et al., 2012, Salt et al., 2008). Therefore, research has focused on the underlying factors and has sought ways to reduce the turnover rate.

In China, the Bachelor of Nursing (BN) degree program usually consists of four or five years of academic and clinical study. Although undergraduate nursing students are required to have a clinical placement for eight to twelve months during the last year of the program, new graduates still have reported having a stressful experience when they first enter the workplace. Notably, the gap between theory and practice can make it difficult for them to adapt to the new environment. The difficulties during the transition period could cause these new nurses to feel overwhelmed, with some as leaving their first jobs or even quitting their nursing career. Because this is a global issue, helping new graduate nurses to manage the transition and retaining them in the profession is an urgent issue for all nursing managers and hospital leaders.