The semi-direct nursing leadership situation for this project is dealing with a high rate of turnover of nurses in healthcare organizations. High turnover has been realized as a major issue that impacts the quality and stability of healthcare quality being delivered. According to Lin et al. (2019), new nurses have anxiety and stress levels within the first two months after they have completed their orientation. Consequently, many new nurses quit their position as a result of the transition shock. Research conducted by Dwyer et al. (2019) realized that 51.5% of nurses employed recently meet the scientific burnout criteria, with 33.3% of the nurses with less than one and half years of experience reporting quitting their current position. The problem of a high turnover rate has been an issue in healthcare organizations, especially during the early years of experience. In America, the average turnover rate for nurses employed during the first year is 25.3%, and after two years is 47.5% (NSI Nursing Solution, 2020). The aim of this paper is to address the issue of the high turnover rate by proposing the implementation of a receptor program aimed at lowering the turnover rate. The paper will include evidence that supports the change and provide a theory that supports the change and guide implementation. In addition, a timeline for the proposed project will be provided alongside criteria for evaluation of the plan’s effectiveness. Lastly, the paper will reflect on the implications of the change proposal for the nursing profession.
Evidence Supporting Change
According to Vardaman et al. (2020), self-efficacy is correlated with turnover among registered nurses. Nurses who have low self-efficacy tend to have higher chances of quitting nursing. Thus, improving the nurse’s self-efficacy results in increased retention, which in return benefits healthcare organizations financially and enhances the quality and stability of healthcare delivered. A study conducted by Hong & Yoon (2021) shows that healthcare facilities that have put in place preceptor programs have a low turnover rate of nurses. New graduate nurses who take part in preceptor programs have higher levels of job satisfaction and are less likely to quit their positions. The existing researches support the idea of implementing a preceptor program to enhance the retention of nurses and lower the turnover rate.
Change Theory
Lewis’s change theory is the best theory that will be utilized in implementing the change proposed in healthcare organizations. The change theory involves a model of three phases for change which include unfreezing, change, and refreezing (Mitchell, 2013). The unfreezing phase involves communicating the need for change to the nursing staff. This phase also involves highlighting the effect of turnover on the care being delivered. The change phase involves preceptor program implementation, which includes training preceptors, allocating preceptor-preceptee pairs, and, lastly, monitoring the entire change process. The last phase, which is a refreezing phase, involves integrating the preceptor program into the healthcare organization culture and continues ensuring ongoing evaluation and support for the change to be sustainable.
Implementation Timeline
The initial phase of the project for change is unfreezing, which takes the first month. During the first month needs assessment will be conducted alongside the identification of key stakeholders. The project leader will also come up with a communication plan on how the nursing staff will be informed about the program and how it is beneficial for them in the profession.
The next stage is the change phase which will take place from the second month up to the sixth month. This stage will involve recruiting preceptors and selecting them based on their expertise and experience. Also, under this phase, the new graduate nurses are assigned preceptors and are facilitated to consistent meetings and valuations.
The last stage will last from the seventh month to the twelfth month, which is a refreezing phase. Under this phase of change, a system for ongoing support and feedback will be established for the preceptees and the preceptors. In addition, within the period of five months, regular evaluations will be conducted to determine the effectiveness of the preceptor program. Lastly, the preceptor program will be integrated into the procedures and policies of the healthcare organization.
Outcome of Change
The preceptor program’s effectiveness will be determined using the following criteria. First, the nursing turnover rate will decrease to indicate that the program is successful. Second, the nurses will have enhanced job satisfaction as the preceptees and preceptors record improved positive outcomes. Third, the retention rate for new graduate nurses increases when the program is successful. Lastly, the patient outcome will be monitored and evaluated to determine the success of the program, as the improvement in patient satisfaction will be an indicator of the success of the program.
Implication
The preceptor program implementation will have a significant impact on the nursing practice. First, the implementation will contribute to the development and support of new graduate nurses allowing them to smoothly transition into their roles. Consequently, it will improve the quality of care being provided as well as the safety of the patient. Additionally, the preceptor program will contribute to professional growth and increased chances of job satisfaction among the preceptors, something that contributes to a positive working environment and improved performance. Lastly, the success of the program has the possibility of inspiring other initiatives of the same kind in the organization resulting in improved care services and stability of the workforce as a result of increased retention.
References
Dwyer, P. A., Hunter Revell, S. M., Sethares, K. A., & Ayotte, B. J. (2019). The influence of psychological capital, authentic leadership in preceptors, and structural empowerment on new graduate nurse burnout and turnover intent. Applied Nursing Research, 48, 37–44. https://doi.org/10.1016/j.apnr.2019.04.005
Hong, K. J., & Yoon, H. J. (2021). Effect of nurses’ preceptorship experience in educating new graduate nurses and preceptor training courses on clinical teaching behaviour. International Journal of Environmental Research and Public Health, 18(3), 975.
Lin, Y.-E., Tseng, C.-N., Wang, M.-F., Wu, S.-F. V., Jane, S.-W., & Chien, L.-Y. (2020). Anxiety and work stress among newly employed nurses during the first year of a residency programme: A longitudinal study. Journal of Nursing Management. https://doi.org/10.1111/jonm.13114
NSI Nursing Solutions. (2020). 2020 NSI national health care retention & RN staffing report. https://www.nsinursingsolutions.com/Documents/Library/NSI_National_Health_Care_R etention_Report.pdf
Vardaman, J. M., Rogers, B. L., & Marler, L. E. (2020). Retaining nurses in a changing health care environment: The role of job embeddedness and self-efficacy. Health Care Management Review, 45(1), 52–59. https://doi.org/10.1097/HMR.0000000000000202
write