Wednesday, September 24, 2008

Research Abstract with Commentary: Value of Nurse Internships

Abstract: New Graduate Transitioning: Necessary or Nice?

This study investigated the influence of personal factors, orientation, continuing education, and staffing shortage on the satisfaction, intent to leave their job, and intent to leave the profession of a random sample of new graduate nurses from varied facilities and geographic locations. It further examined the influence of personal factors and orientation on turnover rates among new graduate nurses. The findings indicate that orientation programs are essential to the retention and satisfaction of new graduate nurses. Given current economic constraints, this study supports nurse executives' ability to advocate for and receive funding for transition-to-work programs as well as the placement of new graduate nurses in well-staffed units.

Scott, E. S., Engelke, M. K., & Swanson, M. (2008). New graduate transitioning: Necessary or nice? Applied Nursing Research, 21, 75-83.

Commentary by Dana N. Rutledge, RN, PhD, Nursing Research Facilitator

This timely study begins to fill a gap in nursing literature related to what factors can predict new graduate job and career satisfaction as well as actual job turnover. A well developed framework predicts that (a) anticipatory socialization (characteristics of education, experience, and expectations) can predispose or protect the new graduate from reality shock, and (b) organizational socialization (things that happen to the new nurse in the first two years of nursing such as orientation, unit culture, staffing) can enhance or inhibit work adjustment. The outcomes of job and career satisfaction, intent to stay, turnover can be predicted by factors within each of these two categories.

Using already collected data (this is called secondary analysis) from a random sample of North Carolina new graduates (< 2 years from graduation from initial RN program), researchers evaluated how this model worked with 329 nurses. They adequately described the variables they used, and ran multiple analyses to look for relationships in the model. One of the drawbacks of using already collected data is that not all factors the researchers wanted to evaluate were measured, and some that were measured contained “missing” data. However, they were able to draw several important conclusions.

Besides the finding reported in the abstract (above), the following were reported:
· Among new nurses, 54% were dissatisfied with their current job, 55% had already left one job, however, 71% were satisfied with nursing as a career.
· Orientation offered to these nurses ranged from < 1 week to 1 year (huge variability!!). The quality and quantity of orientation were associated with turnover (better/longer predictive of less turnover).
· The strongest predictor of job satisfaction was frequency of staffing shortage on a unit. Nurses reporting weekly shortages were 6 X more likely to be dissatisfied than those with less shortages.

These findings point to the need to give our new graduates the most satisfying orientation possible, and that longer orientation lengths may contribute to job satisfaction, and subsequent retention.

Friday, September 05, 2008

GREY MATTERS: a practical search tool for evidence based medicine

The Canadian Agency for Drugs and Technologies in Health (CADTH) has developed a new, free tool to assist in the process of identifying "gray literature" for evidence based medicine. While this is oriented towards EBM, it does have applicability to Evidence Based Nursing. First off, what exactly is "gray literature"? Gray literature is defined in wikipedia as "... a term used variably by the intelligence community, librarians, and medical and research professionals to refer to a body of materials that cannot be found easily through conventional channels such as publishers, "but which is frequently original and usually recent" in the words of M.C. Debachere". It goes without saying that gray literature usually does not appear in customary databases such as Pubmed and CINAHL. There are several resources for identifying gray literature but none are quite as comprehensive as the newly released tool from the CADTH GREY MATTERS: a practical search tool for evidence based medicine.
To access this tool, scroll down the page to Information Services and follow instructions to download the document.
While most of us would never go through this intensity of research for clinical topics, if you are developing a meta-analysis or systematic review, this could be useful. This tool will help you search for evidence based topics in both the international and US grey literature.

Thursday, September 04, 2008

Taking research posters to the units

The Nursing Research Council at St. Joseph Hospital in Orange, California is activating its plan to take research to the units. Members of the Research Council were charged with finding a current nursing research article which might have special application to their specific unit. Leaders of the Nursing Research Council developed a template poster which summarizes a key article into the following sections:

The Research Question
  • Methods

  • Results

  • Discussion

  • Implications for SJH Nursing Practice

Of special note is the section noting implications for St. Joseph Hospital nursing practice. An effort is made to show how the practice implications may mesh with our hospital's values and with our Watson nursing model. The posters will be placed in a unit's lounge area and are intended to make the salient points of a complex research article more accessible and increase interest in nursing research. This photo shows team members at a working meeting in which they identified an article of interest and then summarized it into this reseach poster template.