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Using a legacy map to support clinical nurses returning to graduate school

Baernholdt, Marianne PhD, MPH, RN, FAAN

doi: 10.1097/01.NUMA.0000558528.44994.4e
Department: Performance Potential

Marianne Baernholdt is a professor at Virginia Commonwealth University School of Nursing in Richmond, Va.

The author has disclosed no financial relationships related to this article.



Supporting a clinical nurse who plans to return to graduate school can be challenging for nurse managers. Although one of the nurse manager's roles is advising and supporting clinical nurses as they strive to grow professionally, your first thought might be one of dread. Thoughts may include how to accommodate the nurse's scheduling requirements with orientation and courses, and whether the nurse will leave the organization after receiving an advanced degree. Both are challenges that nurse managers deal with regularly. However, your next thought should be how to create a win-win situation for the organization and the clinical nurse. This article discusses how nurse managers can use a legacy map to support clinical nurses who plan to pursue a graduate degree and how prioritizing lifelong learning in your organization can increase nurse recruitment and retention.

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The organization

Most likely, you're already dealing with nurse turnover and strategizing with the rest of the leadership team on how to recruit and retain nurses. With 43% of new graduate nurses leaving their first place of employment within 3 years, prioritizing ways to retain new graduate nurses is critical.1 Supporting nurses when they decide to return to graduate school is a good start. Clinical nurses are returning to graduate school in increasing numbers. According to the American Association of Colleges of Nursing, 113,788 students were enrolled in master's degree programs in 2014, whereas 5,290 were enrolled in research-focused doctoral programs and 18,352 were enrolled in practice-focused doctoral programs in nursing.2 By 2017, DNP enrollment increased to more than 25,000.3

Further, support from nurse managers is associated with higher job satisfaction.4 A study of new graduate nurses who were followed from 2006 to 2013 showed that higher job satisfaction and commitment to the organization were associated with lower turnover.5 Supporting clinical nurses who return to school can help improve nurses' job satisfaction and commitment to the organization, which decreases overall turnover.

Although a clinical nurse may leave after obtaining a graduate degree, you can secure long-term recruitment and retention benefits by supporting nurses who wish to return to school. Such support includes collaborating with the clinical nurse on work scheduling. Nurses returning to school report scheduling classes around their work schedules as a significant challenge. Once it's known that you're supportive of clinical nurses returning to school, you'll attract and retain nurses who have similar aspirations. These are often the brightest, most creative, and most productive nurses. To gain from these talented nurses, you can create a contract that states in return for accommodating the clinical nurse's educational program requirements, he or she promises to assist with the organization's continuous professional development initiatives, such as participating in an improvement project, updating a policy, serving as a mentor for new nurses, teaching an in-service, or leading a journal club.

In this way, you can create an environment that supports lifelong learning not only focused on returning to school, but more broadly on continuous education and professional development. In an environment in which clinical nurses are committed to the organization, nurses are more satisfied with their work and, subsequently, patient satisfaction increases.



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Using a legacy map

Some clinical nurses may focus on professional development opportunities outside of a graduate program, whereas others see graduate school as their next goal. As the nurse manager, your first step is to determine what your employees' career goals are. A helpful way to start this process is to create a legacy map—a one-page document that incorporates career planning with meaning and purpose.6

First, the nurse answers two questions: “What do you want to improve in nursing as a result of your efforts?” and “What would you like to be best known for by others?”6 The nurse then continues creating the map with his or her answers/goals on the farthest left of the map. Second, on the farthest right, the nurse lists activities toward his or her legacy. This can include organizational service responsibilities, such as committee work and volunteer work in the community.

Finally, in the middle of the map, the nurse lists what future actions will help him or her reach the legacy goals. This is where the clinical nurse's advanced career aspirations, possible continuous professional development activities, and potential graduate education are listed. The clinical nurse may not achieve this legacy completely or the legacy may change over time, but the process of creating the legacy map and attempting to reach the legacy can produce personal and professional fulfillment. (See Legacy map example.)

The legacy map is created through an interactive process between the clinical nurse and the nurse manager. The premise is that the nurse creates a map that's an honest and accurate representation of what's important to him or her, and the manager provides encouragement and potential support with organizational resources. The dialog between the nurse manager and the clinical nurse around the legacy map also ensures that each component of the map is succinctly defined and measurable. With your guidance, the clinical nurse can use the legacy map to decide which graduate program will best support his or her legacy goals.

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Final thoughts

The dialog between the supportive nurse manager and the clinical nurse that starts with the creation of the legacy map should continue as the clinical nurse decides which graduate program is the right one. Considerations include the type of degree and the logistics involved. Some nurses may want to start with a master's degree, whereas others may choose to enter either a BSN-to-DNP or BSN-to-PhD program.

In addition to the type of program, the clinical nurse also needs to consider the program's reputation and accreditation standing. Further, program location and teaching modality are important considerations. Along with traditional face-to-face education, there are a multitude of online and distance-based programs offering a mix of intermittent on-site work with online education. If this type of program is preferred, there are many more choices that make it easier to combine work and school. However, the clinical nurse needs to consider that high-quality online programs aren't easier or less intensive than traditional format programs. Finally, scheduling flexibility, costs, and advising support should also be considered before choosing a program. Once the clinical nurse has chosen a program, you can offer support as a reference. Being a good reference requires addressing the clinical nurse's strengths and how you'll aid him or her to be successful in graduate school.

Managers who support clinical nurses who are considering returning to graduate school create environments in which lifelong learning is both an individual and organizational responsibility. Your support will benefit the individual nurse's career goals, and thus his or her personal achievement and job enjoyment. For the organization, manager support can boost a nurse's organizational commitment and job satisfaction, which can subsequently help increase recruitment and retention and overall organizational and patient outcomes.

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1. Kovner CT, Brewer CS, Fatehi F, Jun J. What does nurse turnover rate mean and what is the rate. Policy Polit Nurs Pract. 2014;15(3-4):64–71.
2. JONAS Philanthropies. New AACN data confirms enrollment surge in schools of nursing. 2015.
3. American Association of Colleges of Nursing. DNP fact sheet.
4. Hayes LJ, O'Brien-Pallas L, Duffield C, et al Nurse turnover: a literature review—an update. Int J Nurs Stud. 2012;49(7):887–905.
5. Brewer CS, Chao YY, Colder CR, Kovner CT, Chacko TP. A structural equation model of turnover for a longitudinal survey among early career registered nurses. Int J Nurs Stud. 2015;52(11):1735–1745.
6. Hinds PS, Britton DR, Coleman L, et al Creating a career legacy map to help assure meaningful work in nursing. Nurs Outlook. 2015;63(2):211–218.
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