Population growth and aging increase the demand for skilled nurses. Hospitals face the challenge of supplying experienced and qualified caregivers. The cost of training new nurses remains significant. Nursing educators are pivotal in developing the nursing workforce, especially under tightening constraints. This article examines the development of a nursing internship program aimed at attracting and retaining newly graduated nurses and its effect on retention to the institution.
Many challenges confront the nursing profession in the development and retention of its members. Outside allurements such as less stressful jobs and other career opportunities entice nurses away from hospital-based practice. Within the profession, the forces of increasing patient acuity, constraints imposed by a managed care environment, and shortages of nursing personnel conspire to drive nurses away from bedside care. The United States Bureau of Labor Statistics (2000) indicates that the need for nurses will increase 22% between 1998 and 2008. Concurrently, the American Association of Colleges in Nursing's (AACN, 1999) latest annual survey reports a decline in nursing baccalaureate program enrollments by 5.5% in 1998.
The work place environment challenges the newly graduated nurse to perform competently and proficiently in the short period of time provided during orientation. The stresses of these expectations contribute to a high attrition rate for new graduate nurses during the first year of employment. Lack of preparation for the realities of the work place is noted as a contributory factor (Brasler, 1993). In addition, Tradewell (1996) estimated that individuals require approximately 1 year to master a job with successful organizational socialization. Furthermore, it has been estimated that between 35% and 60% of new graduates change their place of employment within the first year (Godinez, Schweiger, Gruver, & Ryan, 1999). To counter these factors, healthcare institutions offer new graduate nurses internship and fellowship programs to assist in the transition to the work environment. Inova Health System (IHS) developed such a program to attract and retain newly graduated nurses.
IHS is a comprehensive network of several acute care hospitals (one of which is a level I trauma center), long-term care facilities, assisted living residences, and outpatient services in the northern Virginia region. With at least five local university-based schools of nursing, IHS wanted to position itself to draw upon and retain newly graduated nurses for its professional work force. This article will describe the process and development of a new graduate nurse internship program to address the needs of IHS's five acute care hospitals and its effect on retention of staff.