Nursing Preceptorship Helps Recruit, Retain Nurses After Graduation

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.

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:

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%.

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.”