CommonSpirit's plan to curb turnover among new nurses

Nurses who entered the field during the COVID-19 pandemic faced unique challenges as they stepped into a time of unprecedented turbulence in modern healthcare. 

Pre-pandemic, turnover among nurses in their first year on the job was already relatively high. Studies have shown new grad turnover rates as high as 30 percent during the first year of practice, and as high as 57 percent in the second year. The effects of COVID-19 may have complicated that.

"New grads came in, and because of the pandemic, during a really hard time, and said 'this just isn't for me,' and so the turnover of the new grads was very rapid — within the first few months — much more rapidly than it was previous to COVID-19," said Kathy Sanford, DBA, RN, chief nursing officer at Chicago-based CommonSpirit Health. 

Novices entering the field at the height of the pandemic missed out on the normal level of support they would have received otherwise, Dr. Sanford told Becker's

"It's anecdotal, but I've been told that they felt unsupported," she said.

"We had to have all hands on deck taking care of patients," Dr. Sanford said, adding that front-line nurse managers were tied up most of the time taking patient loads. That meant "the normal support that a new grad would get during times when we didn't have a pandemic wasn't there." 

Some nursing students also had in-person clinical time disrupted as many health systems restricted operations to essential functions early in the pandemic, another factor complicating the transition from student to nurse. An April 2021 survey from the International Council of Nurses found 73 percent of National Nurses Associations reported the pandemic disrupted undergraduate students' education. 

The effects of the pandemic brought renewed attention to the importance of a new nurse's first year transitioning from student to expert. To boost support and ensure new hires have a more unified experience, CommonSpirit is launching a systemwide, one-year residency program. 

"The residency program we're putting in has both the preceptors that are on the units teaching nurses how to be nurses and take care of patients, but it also has a didactic portion and a support portion, coaching and mentoring — a little bit different than other residencies in the past," Dr. Sanford said. 

"New nurses need help learning how to do things other than taking care of patients," she said, which is what the didactic portion of the program will focus on.

The program will include classes that cover: "Where do you go if you feel like you're being bullied? What is your personality, and how do you get along with people with different personalities? Where do you go if you have a great idea [about] how we can do things better? And finally, your own well-being. How are you as a nurse going to take care of your own physical, mental and spiritual well-being?" Dr. Sanford said. 

The didactic portion of the program will be completed through an online learning platform, while work with preceptors will be both virtual and in-person. 

"Most residency programs are just teaching you how to take care of multiple patients and work on the unit and get the jobs done. This one is, I think, a bit more holistic," Dr. Sanford said.

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