Nursing Preceptorship Helps Recruit, Retain Nurses After Graduation
- Data from a preceptorship-to-hire program appears to improve nurse recruitment and retention.
- Students are admitted into the preceptorship program in the middle of their final semester, before licensure.
- This program style has assisted with hiring and one-year retention rates.
- The program could potentially be recreated in other environments, where nursing programs can partner with area hospitals.
A novel preceptorship-to-hire program between a Florida nursing school and hospital helped fill nursing vacancies, improve retention, reduce turnover, and facilitate the transition from academia to practice, a recent study showed.
The study appeared recently in Nursing Management.
Known as the Excellence in Nursing Preceptorship-to-Hire (P2H), the program involved collaborators at Sarasota Memorial Hospital and the College of Nursing at the University of South Florida-Tampa. The program was designed for bachelor of science in nursing (BSN) students midway through their final semester.
"The nursing students reported a sense of belonging with staff," wrote the researchers. "Although each student was paired with a preceptor, other nurses on the unit often shared their knowledge and skills with the P2H student." The students felt supported by the unit staff and were enculturated into the unit team."
New nurses typically discover that transitioning from school to professional practice is highly stressful. This novel program, researchers said, could help smooth the pipeline from the classroom to the exam room.
What Is a Nursing Preceptor?
Preceptor programs are similar to mentor programs, with preceptorships typically covering a more specific, often shorter period of time.
Nursing preceptors tend to be experienced staff nurses who serve as resources to newly employed or graduated staff nurses. Serving as teachers, coaches, and role models, preceptors help students and new nurses apply the skills they've learned in real-world practice environments, making for a more effective transition between the two phases.
How Is This Preceptor Program Different?
Researchers noted that 25% of newly licensed RNs quit within the first year they were hired. Factors that positively and negatively influence the transition into professional practice include the nurses' expectations, confidence, socialization, and support.
Nursing recruitment and retention is an evergreen problem for healthcare organizations. With the rising number of nurses reaching retirement age, the stage is set for a dramatic transition in nursing where newly graduated nurses replace seasoned professionals.
Transitioning from academia to professional practice is a particularly vulnerable juncture in a nurse's career. The most successful onboarding programs are personalized to support the transition to clinical practice.
These practices require evidence-based strategies to support the development of critical thinking and clinical judgment. Data from this preceptorship pilot study demonstrated how this unique preceptorship model helped improve nurse retention.
The P2H program was designed to begin when students are in their final semester of nursing school. Leveraging the partnership between school and hospital leaders, the program contained four key tenets:
University officials worked to recruit students for the program, while hospital staff identified practice placement settings and registered nurse (RN) preceptors.
As students were evaluated and selected, program leaders finalized placements, preceptors, and shifts.
Orientation period included a clinical experience with assigned preceptors, as well as check-in meetings with university faculty and the hospital coordinator. Meetings involved sharing and evaluating new nurse experiences and roles.
Transition to Practice
Students and unit managers discussed potential employment and future directions based on various criteria, including successful completion of the NCLEX-RN. If eligible, students had the option to work in a paid graduate nurse position until meeting all criteria.
Although the numbers in the study were small, the results were striking. Of the 14 students who began the P2H in school, 12 completed the program and 11 were offered positions at the hospital.
Of the nine who accepted a position, eight were hired on the same unit where their preceptorship occurred. Notably, given the nursing profession's ongoing struggle to retain nurses, the P2H program reported a retention rate of 75%.
How to Re-create an Effective Nurse Preceptor Program
Using the P2H preceptorship model may help recruit and retain qualified nurses. The model also included input from clinical managers and staff in the hiring process, which may help improve the cohesiveness of the team approach.
“The structured approach to the P2H program allowed the clinical managers and staff to have an active role in the hiring decision,” the researchers wrote. “With specialty areas come specialty skills. Staff and managers could provide students with the knowledge and application of those skills and then evaluate the student.”
Re-creating the program at other hospitals requires a collaborative effort between the nursing schools and hospitals. The researchers identified some of the factors necessary for best practices in forming these partnerships.
Best practices included identifying qualified prelicensure nursing students and creating feedback mechanisms. The goal of the feedback is to both garner support and glean information about the program’s implementation and execution.
While the sample size in the pilot program was small, the results support past research demonstrating that preceptorships and mentorship programs can improve nursing recruitment and retention for newly licensed graduates.
The unique aspect of this P2H program — enrolling students before graduation — may help hospitals recruit qualified nurses and prepare them for practice. One of the retention benefits was the determination of fit.
“The student's first choice of placement isn't always the right match,” researchers concluded. “Without the P2H experience, they may have taken a position at the hospital not realizing the physical and mental toll…wasn't sustainable long-term, thus resulting in increased turnover rates and decreased one-year retention rates.”
Hudson, Hilton. (2023). Recruiting and retaining nurses: A critical challenge facing the healthcare industry. Patient Safety & Quality Healthcare
Nursing shortage fact sheet. (n.d.). American Association of Colleges of Nursing
Robinson Leah, et al. (2023). Excellence in nursing preceptorship-to-hire. Nursing Management
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