As new generations of nurses enter the workforce, questions abound. What influences a new graduate's job choice? How long do they expect to stay? Why do some of them want to leave? Professors Christine T. Kovner, PhD, RN, FAAN, and Carol S. Brewer, PhD, RN, are spearheading an in-depth study to find answers to some of these critical questions. And thanks to a recent $4.1 million grant, in addition to $1.9 million in earlier funding, from the Robert Wood Johnson Foundation, the research is now funded into 2015.
"There is a lot of information floating around about new graduates," says Kovner, who has been at New York University since 1985. "But, in my opinion, there is no solid, systematic research."
Already, that is changing.
The study, which tracks more than 3,000 nurses from 35 states, touches on a variety of topics including workplace experience, relationships with managers, and violence against nurses. Some early highlights from the first few years of the study include:
- About 66% of newly licensed registered nurses (NLRNs) worked a 12-hour shift
- Poor management was cited as the top professional reason for leaving a first job
- About 62% of NLRNs reported at least one incidence of verbal abuse
- 27.2% of NLRNs who had worked at least 13 months in nursing had already left their first job
- Nearly 60% of NLRNs reported they were satisfied or very satisfied with their jobs
- 41% of NLRNs planned to stay in their first jobs for less than three years
- The median income for NLRNs was $45,000
- The most important work characteristics to new RNs are "the ability to do the job well" and "being rewarded fairly for the work"
It took a great and painstaking effort to get to those results-which are based on a 58% return rate-compiled. In coming up with a universe for the study, Kovner and Brewer looked at the 60 communities used by the Center for Health System Change, a nonpartisan policy research organization located in Washington, D.C. that designs and conducts studies focused on the U.S. healthcare system. They then went to state nursing boards to find newly licensed nurses in those areas.
"Other studies have looked one hospital or one college of nursing," says Kovner. "We wanted to get a national picture."
In short, they felt it was crucial to find a group they could survey several times over a number of years.
"It seemed clear that no one has a data set of a panel of nurses over time and there's a lot you can learn by looking at the same people over time and how they behave," says Kovner, who will survey the original set every two years. "Eventually they won't be new nurses anymore. They'll be nurses."
Adding another wrinkle to the study, the researchers will also survey this year's new graduates to create a comparison.
"I wonder if the people that graduated in '08 are different," Kovner says. "Have nursing schools changed? That will provide some really good information."
The questions that they've used and will continue to use came from three places:
Kovner, a senior fellow at Hartford Institute for Geriatric Nursing at NYU, and Brewer have done several research projects together in the past, but nothing of this magnitude. The results of the survey could be just as groundbreaking.
"The goal is that people will read it and say, 'Wow, it's amazing that the top reason new nurses leave is management at hospital.' That's a problem. That's something a hospital can do something about," Kovner says. "Or that mandatory overtime is tied to someone's intent to leave. Maybe it's something government could do something about."
They also hope that others will use their study as a guide, branching off to conduct other important research. Issues such as hostility against nurses and fairness and equity can become elaborate studies of their own.
But for now, and for the next several years, Kovner and Brewer will continue to learn about the decisions made by new graduates-and perhaps change the world of nursing in the process.
"We're very rigorous researchers," Kovner says. "And this is just a wonderful opportunity."
Editor's note: For more information on the study, visit http://www.rnworkproject.org.