Article Review and Discussion: Determining Best Fit for Newly Licensed Nurses

Highlights

Newly licensed nurses transitioning into clinical practice can experience stress, uncertainty, and lack of confidence. If left unaddressed, these negative perspectives can impact turnover rates within the first year. Prior to the pandemic, nurse turnover was already an existing challenge and amidst numerous disruptions, this has only been exacerbated. The current nursing turnover rates make the case for ensuring effective onboarding is truly a key consideration.

The question becomes how can we prepare new nursing graduates for independent practice as soon as safely possible? Recently published in the Journal for Nurses in Professional Development, Determining the Impact of Best Fit for Newly Licensed Nurses aims to examine the alignment between a nurse’s personality and specialty practice area and how this may impact orientation length, as nurses who are better suited to their job role may adapt more quickly.

During a five-year period, a study of 1,700+ nurses at 13 hospitals were onboarded using a pre-hire behavioral assessment. Candidates with scores of 75 or higher experienced 6.5 fewer days of orientation post-hire, on average.

Reducing orientation time by 6.5 days can:

  • Decrease training expenses
  • Boost staff morale
  • Reduce burden off preceptors
  • Increase nurse independence

According to the 2021 NSI National Health Care Retention & RN Staffing Report, the current RN turnover rate in the U.S. is 18.7%, with 27.3% of all new hired nurses leaving within a year. Additionally, close to half (49.9%) of the exited employees that were included in the report had less than two years of service.

This trend in turnover by tenure is painfully visible to health systems. Healthcare leaders are pressed to ensure newly licensed nurses are set up for success in their transition into a new role — ideally, as safe and as early as possible. This line of thinking may require new approaches to what has historically been a traditional nursing placement model. By improving the culture early on, however, nurses coming in the door feel more confident, supported, and empowered to deliver high-quality patient care, as quickly as possible.

The Unique Opportunity for Job Fit

One potential source of stress during a nurse’s transition from the classroom to clinical practice is the lack of fit between a nurse’s personality and the nurse’s specialty in which they are placed.

As explored in the study, nurses who are better aligned to their job role can adapt more readily to their new environment which can ease the transition, placing focus on patients and reduce the amount of time spent onboarding. Additionally, shorter orientation times can save organization time, money, and vital resources while serving the professional needs of the individual nurse and the patients they care for.

Nurses who are not well suited for their job role might seek other opportunities where they feel more comfortable. Even if a nurse opts to transfer to a different role within the organization, this places the unit/department with a repetitive need to hire and onboard additional nurses to fill gaps. Another possibility of financial stress to the organization, the nurse may choose to leave for another hospital or health system.

One System’s Approach to Job Fit

In this recently published article, a large health system sought to examine if nurses hired into a specialty practice area that best matched their personality would have lower turnover, fewer transfers, and shorter orientation times. During the application and hiring process, the talent acquisition department administered the Relias Assessments behavioral assessment.

The assessment considered personality attributes, such as teamwork, skills, and ability to handle high-stress environments that help determine a candidate’s suitability for a particular role. The results were utilized to match candidates with their “best fit” clinical specialty area, identified as the setting where they were more likely to be successful.

Summary of Findings

This article showed a significant correlation between job fit and orientation length with higher job fit scores being associated with shorter orientation times. Candidates with scores of 75 or higher experienced 6.5 fewer days of orientation post-hire, on average.

While shorter orientation times have an immediate impact on decreased costs, the study recognizes that future research should investigate to ensure the shorter orientation times are associated with equal or improved nurse satisfaction as well as equal or improved patient care.

Additionally, shorter orientation times can promote a sense of independence. This consideration can increase a new nurse’s self-confidence and self-efficacy, which are important factors in a new nurse’s success.

Role of Relias

With this study, the Relias Assessments behavioral assessment helped match a nurse to a desired clinical unit of hire through behavioral attributes. The assessment also includes a personalized coaching and development plan, which helps match the new nurse with an appropriate preceptor, which could keep the orientation focused and on track. Decreasing orientation times with an efficient & effective approach using valid instruments can boost confidence, reduce preceptor burden, and increase autonomy in the newly licensed nurse.

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Vice President Quality, Relias

Felicia Sadler has been a Registered Nurse for over 30 years and is a Certified Professional in Healthcare Quality, a Lean Six Sigma Black Belt in Healthcare, and has served as an examiner for the Tennessee Center for Performance Excellence. She holds a Master of Jurisprudence in Health Law from Loyola Chicago School of Law and a Bachelor of Science in Nursing from South University. Felicia has served as chairperson for ASHRM's Education Strategy Committee, and ASHRM’s Education Development Task Force and assists health care organizations with strategic solutions to impact clinical outcomes and optimize organizational performance.

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