Grasp your new grads: Placement program matches nurses with the right job

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Grasp your new grads: Placement program matches nurses with the right job

After reading this article, you will be able to:

  • Discuss the tactics of a new graduate placement program that helped one facility achieve a retention rate between 80% and 90%
  • Describe the placement program’s process for arranging internships for new graduates

From the ICU to pediatrics to the operating room, the choices available to new graduate nurses are exciting and daunting.

Often, new nurses are unsure of their penchant or have a predetermined preference, only to find the unit may not be a good fit. Making sure your new hires are successful at your facility starts with placing them in the right unit.

“The problem in the past was that a new graduate comes into the hospital setting and says something like, ‘I want to work in pediatrics,’ ” says Walter Page Young, RN, BSN, CEN, education specialist of clinical education at St. Joseph’s Hospital in Tampa, FL. “So they interview with the manager in pediatrics, start work, then, after a short time, discover they hate pediatrics. The way the system was built, for your first job, you were stuck for six months before you [could] transfer.”

Most people weren’t willing to wait and often resigned, says Young. “We were losing potentially good nurses because rules and regulations kept them in a spot they disliked,” he says.

That was the reasoning behind a new graduate placement program developed by educators at St. Joseph’s. Since 2003, Young has managed a new graduate program that puts the clinical educators in charge of orienting and placing new graduates in the right hospital unit. This new program has brought a great amount of success to St. Joseph, resulting in high retention rates and a landslide of new graduate applicants.

New graduate nurses: Changing the system

Under St. Joseph’s program, new graduate nurses are hired by the education department and placed in a unit-specific 12-week internship to try out their new role and environment. Lacie McCall, RN, a recent participant of the program, was placed in the pulmonary ICU step-down unit for her internship and has stayed there since starting at St. Joseph’s in June 2008.

“It went very smoothly,” says McCall. “After the two-week general orientation, we met with the educators, and they asked what we were interested in. From that point, we saw what was available, and they tried to place everyone as closely to what they would like as possible.”

The most important aspect of the program is that new graduates are directly under the clinical education realm, rather than a specific unit, upon entering the hospital, allowing for a more thorough, effective orientation period, says Young.

“This program gives us control to make sure the intern gets the best possible orientation. We’re turning out an intern who wants to stay with us,” he says.

Young says he envisioned rotating the new nurses so they could get an idea of each unit, but he quickly discovered that wasn’t going to work. Instead, when arranging internships during the two-week general new-graduate orientation, he considers the new graduates’:

  • Interests
  • Personality
  • Background

“The nurse will tell me, ‘I have an interest in cardiology,’ so I’ll set them up,” says Young. “And then at such a time that the intern decides they either like it or they don’t like it, they let me know.”

Young says he will move the new nurses if they are unhappy, but so far, the matching process has been successful.

“They have the knowledge that they’re not stuck, which gives them a comfort level,” says Young. “But as a ballpark figure, about 90% of nurses stay the first place we put them, even if it’s not what they originally wanted.”

The program is only for full-time, benefited employees. “You can’t do this with a part-time nurse,” he says. “There’s a tremendous amount you have to learn, and it’s not something you can do part-time.”

The large facility also has the luxury of not scheduling its new nurses on the night shift.

“This is a 1,000-bed hospital, and we have some very sick patients. More resources are available to [nurses] on the day shift. And I have better control observing them during the day than at night. I try to see them at least every other day when I make rounds,” says Young.

Aspects to keep in mind

One of the most crucial aspects of the program is that nurses understand it is their responsibility to succeed in the unit, Young says.

“We tell them, ‘We can get you to the unit, but it’s up to you to stay,’ ” he says. At the end of the 12 weeks, the nurse manager gives the nurse a formal interview.

Although the vast majority of the interns are offered unit positions, the internship “doesn’t automatically guarantee a job,” says Young.

“I try very hard not to send an intern to a unit where there isn’t an opening,” he says. “But the nurses need to prove themselves.”

Although St. Joseph’s has allowed Young plenty of opportunity and choice regarding placement of new graduates, he says the program can be easily adapted to smaller hospitals.

“You may not have the choice of many different units and the different unit cultures, but I still think it would be quite beneficial,” says Young.

Evidence of success

The retention rate of new graduates speaks volumes of the program.

“We looked at all new graduates who went through the program and saw how many were still working here after a year, and it’s at 80%–90%,” says Young. “We’re proud of that.”

Additionally, the program has served as a recruitment tool as well as a retention strategy. “We’re getting most of the new graduate nurses in the area,” he says. “We hired 250 new graduate nurses last year. Basically, we scoop up everybody.”

The new-graduate perspective

McCall says she found the program to be a vital part of her success at St. Joseph’s.

“Originally, I wanted to be in the ICU but was put in the ICU step-down, as they felt it was a level of care I’d enjoy,” she says. “It worked out perfectly; I plan on staying there instead of doing the ICU internship.”

McCall says the program emphasized that new graduates need not stay where they are placed, and that accountability is an important component.

“They clarified that when they place you somewhere, if you don’t like where you’re placed, you can come to them. But if you’re not offered a job, they can’t do anything,” she says. “They can get you in the door, but it’s your responsibility to get a job.”

McCall says she found the program to be a great introduction to nursing and to St. Joseph’s. “It helped me take baby steps into a big establishment,” she says. “I’d recommend other facilities institute something similar.”


Adapted from The Staff Educator, November 2008, HCPro, Inc.