My dad was recently recognized for his 25th 'workiversary', meaning he has been at the same job for 25 years! Guess what? He has no plans on leaving until it is time for retirement and I swear that guy will be working until he is 80, just because he can. Kudos to him, but I would say employees of 25 years (and up) are more the exception than the rule. I'm not saying that I wouldn't stay at the same job for 25 years or more, but that would require it being a pretty awesome job. It would have to be one in which I was continually valued, engaged, challenged, and supported...where I was given the tools to be successful and provided with the opportunity to be innovative in the work that I was doing and grow as a professional. It by no means would happen in a job where I felt anything less. Notice here that I didn't say I needed a lot more money, tons of recognition, or extra time off and crazy benefits. Yeah, all those things are nice, and I would take them if you were handing them out, but I want to feel good about the work that I am doing...that I am a valued team member, that my experience and expertise are appreciated, that the work I am doing is contributing to the greater good of the organization or profession and that I was worth the investment to grow and develop.
Employee engagement is a 'hot topic' out there in healthcare right now. Why is employee engagement so important? Research shows that organizations with high levels of employee engagement are more efficient and effective at what they do. Their employees are more productive, have better performance, and it even shows a positive impact on absenteeism, and retention, as well as many other outcomes4 . This is especially important for our new nurses that are coming into the profession. In a research study of over 3000 new graduate nurses, 41% of them reported that if they were free to go into any job, they would want another job. 24% indicated they planned to leave their first job within the first two years of taking it and 37% of the sample intended to begin searching for a new position in one year3. Why do you think that is? I have a few different opinions I would like to share with you …
Reason #1 – Mobility
First, I think it is important to acknowledge the fact that we live in a world where people are more mobile than ever before. The U.S. Department of Labor reported the average person changes jobs 10 to 15 times during his or her career and many workers spend five years or less in each job. The study also showed the younger the worker, the shorter the job duration. (As if that is a big shocker!) Millennials are known for the need to wander the globe. I also don't think you will be surprised to find out that reasons for leaving include things like career advancement, higher pay, and relocation, but also better alignment between personal values and organizational priorities, among many others2 .
Reason #2 – Finding Their Niche
The second reason I think new nurses leave is due to a lack of awareness of what they are getting themselves into. My whole nursing school career I wanted to work in pediatric oncology. I was sure that is what I wanted to do. I mean what could be more meaningful than working with kids with cancer? I was so excited to do this that I took the opportunity to choose a clinical rotation that spent the majority of the clinical hours on a floor dedicated to treating pediatric oncology patients. Perfect, right?! I couldn't have been more wrong. Not that working pediatric oncology wasn't a great experience, it was, and I completely commend those nurses and doctors who do this day in and day out, but what I found was that it wasn't for me. Emotionally, I just could not handle it. Call me what you will, but I found out very quickly that if I was going to last as a nurse I needed to choose a different specialty. I think this is happening all too often with our new graduate nurses. Clinical hours are getting harder and harder to come by depending on your school of nursing, regardless they are not something that is being provided in abundance for a variety of reasons that I won't get into today. The results of this are, however, new graduate nurses picking an area to work in without ever having much, if any, 'real life' experience in that area. Had I never had that opportunity in nursing school to work peds oncology, I would have been lined up to find a job on a unit after graduation and that would have been a terrible fit for me.
Now you may be saying to yourself, "But I am nurse manager on a Medical Surgical unit. That can't possibly be the reason they leave here". What I would say to you is you are probably right. That likely isn't the reason they leave MedSurg. MedSurg though opens a whole new can of worms.
Reason #3 –Exhaustion/Burn-Out
MedSurg or any combination of it is just plain old hard. It is hard to make MedSurg attractive because it is exhausting, which leads to burn-out, and for many they are told they need to work MedSurg before going into a specialty (such as Labor and Delivery, ICU, or ED). While each specialty has their pros and cons, how many other specialties (because I believe MedSurg is a specialty) are you required to care for four to seven (maybe more) acutely ill patients with a large array of diagnosis for 12 hours on a unit that might discharge 12 and admit 14? You know it's true - I am not exaggerating. That happens! All the while you have to assess each patient two to three times during your shift, pass piles of medications, round hourly, document everything short of your own bathroom breaks, and make sure you are making each patient feel like they are having the best hospital experience ever. Now, I am not saying that all of this isn't necessary, I am just saying it is hard and it again is hard to get people to do that for too long before they are just plain old tired, ready for something different, truly experience burn-out or did their 'time' and moved on to what it was they came into nursing to do.
Reason #4 - Support
Finally, I think it comes back to these new nurses not finding what they are looking for in their first year of work. They are looking for a position in which they are engaged, supported, valued, and provided the opportunities to be innovative and contribute to the bigger picture. Some may blame this on the 'new generation', these Millennials that have unrealistic expectations of what work is. Is that really fair though? I mean it is the Baby Boomer generation that raised them to have these beliefs, values, and preferences, correct? Millennials were raised to believe their voice mattered, encouraged to engage and question authority, and to be an individual and independent thinker. Many are naturally outside-the-box thinkers that want to re-innovate the world around them and contribute to the larger picture1. I think I would be hard-pressed to find a leader in any organization that doesn't want these qualities in the employees they are hiring.
So what's the point of all this? New nurses leave for a variety of reasons. Some of these reasons are completely out of our control, but others we have a direct impact on. I encourage you to take a moment and reflect on your current recruitment and retention efforts for new nurses and consider what you can do differently knowing this information. Since you know Millennials are going to change jobs frequently, come to you with little clinical experience, use MedSurg units as a starting point, and expect support what can you start doing, do differently, or continue doing to meet this generation's needs?
Stay tuned for our future blog posts to hear more about working with Millennials!
Nicole Weathers
Program Manager, IONRP
References:
1. Carver, L., & Candela, L. (2008). Attaining organizational commitment across different generations of nurses. Journal of Nursing Management, 16(8), 984-991.
2. Doyle, A. (2018). How often do people change jobs? Retrieved: https://www.thebalance.com/how-often-do-people-change-jobs-2060467
3. Kovner, C.T., Brewer, C.S, Fairchild, S., Poornima, S. Kim, H., Djukic, M. (2007) Newly licensed RN's characteristics, work attitudes, and intention to work. The American Journal of Nursing, 107(9), p58-70.
4. Rayton, B. (2012). Engagement task force: 'Nailing the evidence' workgroup. Retrieved: http://engageforsuccess.org/wp-content/uploads/2015/09/The-Evidence.pdf