Council Nurtures New Grads and Newly Hired Nurses

Approximately 17% of newly licensed nurses leave their first RN jobs within the first year and 31% by the second year, according to a 10-year longitudinal study conducted by the Robert Wood Johnson Foundation. Nursing leaders at Cleveland Clinic South Pointe Hospital addressed the high turnover rate by forming a New Grad/New Hire (NGNH) Council in the summer of 2016.

Structuring the council to have an impact

South Pointe’s NGNH Council was created as part of an enterprise-wide effort to retain nurses at Cleveland Clinic. In January 2016, Erica Shields, BSN, MBA, RN, NE-BC, director of nursing for Emergency Services at South Pointe, joined the Nursing Institute’s Retention Committee. An analysis of nurses who left the organization identified new graduate nurses in the first year of their career as a significant group experiencing high turnover. In response, Shields and Roman Saini, MSN, RN, nurse manager of the ICU at South Pointe, launched the NGNH Council to provide support for new graduates, and newly hired nurses within their first two years of employment at the hospital.

The NGNH Council got off to a slow start until Jen Horn, MS, BSN, RN, a clinical nurse who joined the hospital’s Emergency Department in fall 2017, took over as chair of the council. “She was very energetic and wanted to be involved and engaged in a project at South Pointe,” recalls Shields. In March 2018, the council and its meetings were restructured, with Horn at the helm and two co-chairs, Lauren Kulasa, BSN, RN, clinical nurse in the ICU, and Molly Jackson, BSN, RN, clinical nurse in the Emergency Department. Together, they help plan and promote the meetings.

Sharing stories and gaining knowledge

One of the first things Horn and her co-chairs did was create a mission statement for the NGNH Council, which they place at the bottom of all emails promoting meetings and events. The statement reads:

“The New Grad/New Hire Council at South Pointe is a group composed of new graduates and newly hired RNs. We meet together monthly to support each other and learn about our hospital. We participate in social events outside of work to build lasting bonds with our peers.”

Meetings are held once a month on a Tuesday at 7:45 a.m. when many council members are finishing a night shift. To add structure, the meetings feature a set agenda: They begin with a “high/low/plateau” activity, followed by a speaker presentation and then announcements on upcoming events.

During the high/low/plateau portion of the meeting, each attendee shares the high point of their last month, the low point and a plateau — or something they are still working on. “People share both personal and professional thoughts as a way to get to know each other,” says Horn. “People really treat the council as a safe place to ask questions, tell stories or reflect on what’s going on in their lives.”

Speakers present on a variety of topics. “Many presentations are similar to things they have heard in orientation, but so much is thrown at new nurses during orientation,” says Shields. “Once they’ve worked on a unit for a couple months or so, they may have had certain experiences and have questions.” Topics have included infection prevention, risk management, ethics, Magnet® designation and code lavender crisis intervention for staff who are overwhelmed by stress or a traumatic event at work. “We try to keep it varied because no one thing will appeal to every nurse,” says Horn.

Making meetings a priority for new nurses

The meetings last about 45 minutes and include refreshments. Typically, 10 to 12 nurses attend. The NGNH Council also recently began offering a call-in option for nurses who aren’t working that day. Usually, two to four nurses call in.

Horn and her peers try to boost attendance by sending out reminder emails a couple days in advance and placing fliers on each unit. Nurse managers also encourage staff to attend. “As a director in the ED, I have set a goal for new hires and new grads to get engaged in the department in some way,” says Shields. “The New Grad/New Hire Council is a perfect opportunity to get involved.” She expects new nurses to attend at least half the meetings throughout the year.

Building connections that improve patient care

The council meetings and occasional dinners outside of work have helped nurture new nurses at South Pointe, says Horn. “It can be a rough environment to be a new nurse on a floor with experienced nurses,” she says. “It’s good for people to have a place where they truly know they are in the same company with people who understand where they are coming from and see things from their perspective.”

Shields says the monthly meetings have also provided a place for nurses to build relationships with peers from other units. “Making a connection and having a friend on another floor when they call report or give handoff on the patient really helps bring together the team and build cohesiveness,” she says.

That was evident in a recent incident outside the Emergency Department. A patient from the ICU who had completed imaging tests coded while waiting for an elevator to go back to his room. The caregivers with the patient immediately took him around the corner to the ED for the code blue. “Because of involvement in the NGNH Council, I knew so many people from the ICU who responded, and I had a comfort level with them,” says Horn. “The ED nurses stayed on the periphery and gave them supplies as needed. We knew how to communicate and work together.”

While South Pointe doesn’t yet have numbers to indicate the success of the NGNH Council, Horn says she knows it’s making a difference – with both nurse leaders and new nurses. “The council is a success because of managerial support,” she says. “New grads and new hires have so many things to focus on, and elevating that as a priority has been a really great thing.”