As a new graduate nurse, selecting where you choose to practice can be daunting but also empowering. However, the initial elation can quickly turn to disappointment if you don’t choose wisely. Exploring whether an organization’s and unit’s culture, values, and practice environment are aligned with your own personal values and needs will help you identify a supportive employment setting that will set you up for success.

Leaders will carefully interview you to ensure you’re the right fit for the organization. You also should invest the time and effort to carefully consider whether the organization is the right fit for you. Interview preparation includes asking questions about the organization’s culture to determine what systems the organization has in place to help you successfully transition from school into clinical practice.

A framework that supports nurses

A positive practice environment can decrease nurse burnout, improve nurse satisfaction, and have an overall positive impact on nursing retention. The American Nurses Credentialing Center Pathway to Excellence^® framework outlines the essential elements—shared decision-making, leadership, safety, quality, well-being, and professional development—of a positive practice environment that supports nurses’ success throughout their careers.

Ask the right questions

Moving from the classroom to the practice setting is a challenging transition for every new nurse. In addition to typical anxiety, the stress that accompanies long work hours, rising patient acuity, and understaffing, many nurses report feeling unsupported by their colleagues and direct supervisors.

Recent graduates are at risk for burnout, which frequently leads to turnover. Research by Kovner and colleagues indicates that as many as one-third of all new nurses leave an organization within the first 2 years. And according to the 2019 NSI National Health Care Retention & RN Staffing Report, overall nurse turnover rose in 2019, with first-year turnover continuing to outpace all other tenure categories. Nurse turnover can have a significant negative impact on employees, employers, and patients, so you want to choose an organization that’s taken steps to improve nurse retention. The Pathway to Excellence Interview Tool includes questions you can ask to ascertain whether an organization has a supportive culture and one that will cultivate your professional growth as a new graduate nurse. (See Are you asking the right questions?*)

In addition to asking the right questions, observe the interactions around you and how the interview is conducted. Are frontline staff invited to participate in your interview? Having them involved in the hiring process will allow you to engage with your potential colleagues and also demonstrates how the organization empowers frontline nurses to have a voice. Does the hospital have a fellowship or RN residency program? Having such a program demonstrates the organization‘s commitment and investment in new graduate nurses’ professional growth and development and the value it places on successful transitions into the clinical setting.

Find your professional home

Nurses in Pathway to Excellence environments excel because they experience, among other things, job satisfaction, opportunities for professional growth and development, and meaningful recognition of their contributions. You get to choose where to start your practice as a new graduate nurse, so choose wisely. Arrive at interviews prepared with questions that will help you determine whether an organization will provide the support you’ll need to succeed. Invest in yourself and take the time now to find the ideal practice environment so you can join with other engaged, collaborative, and committed nurses who have found their professional home.

The authors work at the American Nurses Credentialing Center (ANCC) in Silver Spring, Maryland. Jennifer Hargreaves is a senior analyst, and Christine Pabico is the director of ANCC Pathway to Excellence.

*Please see PDF of this article to view Are you asking the right questions?

References

2019 NSI National Health Care Retention & RN Staffing Report. NSI Nursing Solutions, Inc. March 2019. nsinursingsolutions.com/Documents/Library/NSI_National_Health_Care_Retention_Report.pdf

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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.

McCright M, Blair M, Applegate B, Griggs P, Backus M, Pabico C. Addressing workplace violence with the Pathway to Excellence^® framework. Nurs Manage. 2019;50(8):10-3.

Twibell R, St. Pierre J, Johnson D, et al. Tripping over the welcome mat: Why new nurses don’t stay and what the evidence says we can do about it. Am Nurse J. 2012:7(6). myamericannurse.com/tripping-over-the-welcome-mat-why-new-nurses-dont-stay-and-what-the-evidence-says-we-can-do-about-it

Wieck KL, Dols J, Landrum P. Retention priorities for the intergenerational nurse workforce. Nurs Forum. 2010; 45(1):7-17.