Other Titles

Virtual Session

Abstract

Purpose: This study investigated the impact of the COVID-19 pandemic on stress and intent to leave among new graduate nurses (NGNs) in an accredited nurse residency program. The results informed strategies to increase wellbeing and reduce intent to leave by providing organization-based resources.

Background: Stress among nurses has been studied for decades, but few studies have measured the stress of NGNs associated with a global pandemic. Additionally, retention of NGNs is important to nurse leaders and healthcare organizations because it affects financial stewardship, continuity of care, and patient outcomes. The cost of replacing one nurse is estimated to be over $90,000, which can undermine a return on investment in hiring and onboarding nurses. Retention strategies, including providing resources to counteract stress are important to NGNs to prevent turnover. The system wide NRP earned accreditation with distinction from the American Nurses Credentialing Center Practice Transition Accreditation Program. Findings from a literature review indicate that accreditation: 1) has a positive impact on NRPs including increased retention; increased competence and confidence among NGNs; 2) necessitates program standardization, inclusion of evidence-based models that guide practice, and achievement of outcomes; 3) requires standardized mentor and preceptor programs.

Methods: The study had human subject oversight and used a descriptive, comparative survey design over 3 timeframes (4-, 12-, and 24-months) and across 3 years (2019-2021) to evaluate NGN perceptions of stress and intent to leave. Psychometrically tested instruments were used to measure study variables (stress related to death and dying, conflict with physicians, inadequate preparation to deal with the emotional needs of patients and their families, lack of support, workload, uncertainty concerning treatments, and conflict with other nurses and supervisors), plus an author-developed instrument to measure intent to leave. The instruments were administered by an internet-based survey program. Parametric data were analyzed using descriptive statistics and non-parametric data were analyzed using frequencies and percentages. A linear regression was used to determine the strongest predictors of the intent to leave scale. Conclusions and Implications for

Practice: Findings demonstrated NGNs experienced lower levels of stress pre-pandemic (2019) compared to during the pandemic (2020-2021). The linear regression indicated the strongest predictors of intent to leave were stress related to death and dying, conflict with physicians, lack of support, workload, and uncertainty concerning treatments for the first year of the pandemic (2020). None of the variables were significant predictors of intent to leave for the second year of the pandemic (2021). Nurse leaders must dedicate resources supporting NGNs during unprecedented stressful times to ensure well-being, resilience, and success, thereby reducing intent to leave. Strategies include 1) Organization-based best-health initiatives such as an interactive portal, wellness, and self-care programs; 2) Additional curriculum to address communication with providers, coping with death and dying, and patient treatments; and 3) Intentional rounding by nurse leaders to discuss unit support and workload.

Description

This study investigated the impact of the COVID-19 pandemic on stress and intent to leave among new graduate nurses in an accredited nurse residency program. The results informed strategies to increase wellbeing and reduce intent to leave by providing organization-based resources.

Target Audience: Clinical Leaders and Researchers

Author Details

Kim Reina Failla, PhD, RN, NE-BC, NPD-BC - Caster Nursing Institute, Sharp HealthCare, San Diego, CA, USA

Sigma Membership

Gamma Gamma

Type

Presentation

Format Type

Text-based Document, Video Recording

Study Design/Type

Other

Research Approach

Other

Keywords:

Graduate Nurses, Novice Nurses, Stress and Coping, Turnover, COVID-19, Pandemic

Conference Name

Creating Healthy Work Environments

Conference Host

Sigma Theta Tau International

Conference Location

Austin, Texas, USA and Virtual

Conference Year

2023

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Rights Holder

All rights reserved by the author(s) and/or publisher(s) listed in this item record unless relinquished in whole or part by a rights notation or a Creative Commons License present in this item record.

Review Type

Abstract Review Only: Reviewed by Event Host

Acquisition

Proxy-submission

Date of Issue

2025-10-14

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Additional Files

Slides.pdf (538 kB)

Abstract.pdf (90 kB)

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Fostering Well-being to Combat New Graduate Nurse Stress and Intent to Leave During a Pandemic

Austin, Texas, USA and Virtual

Purpose: This study investigated the impact of the COVID-19 pandemic on stress and intent to leave among new graduate nurses (NGNs) in an accredited nurse residency program. The results informed strategies to increase wellbeing and reduce intent to leave by providing organization-based resources.

Background: Stress among nurses has been studied for decades, but few studies have measured the stress of NGNs associated with a global pandemic. Additionally, retention of NGNs is important to nurse leaders and healthcare organizations because it affects financial stewardship, continuity of care, and patient outcomes. The cost of replacing one nurse is estimated to be over $90,000, which can undermine a return on investment in hiring and onboarding nurses. Retention strategies, including providing resources to counteract stress are important to NGNs to prevent turnover. The system wide NRP earned accreditation with distinction from the American Nurses Credentialing Center Practice Transition Accreditation Program. Findings from a literature review indicate that accreditation: 1) has a positive impact on NRPs including increased retention; increased competence and confidence among NGNs; 2) necessitates program standardization, inclusion of evidence-based models that guide practice, and achievement of outcomes; 3) requires standardized mentor and preceptor programs.

Methods: The study had human subject oversight and used a descriptive, comparative survey design over 3 timeframes (4-, 12-, and 24-months) and across 3 years (2019-2021) to evaluate NGN perceptions of stress and intent to leave. Psychometrically tested instruments were used to measure study variables (stress related to death and dying, conflict with physicians, inadequate preparation to deal with the emotional needs of patients and their families, lack of support, workload, uncertainty concerning treatments, and conflict with other nurses and supervisors), plus an author-developed instrument to measure intent to leave. The instruments were administered by an internet-based survey program. Parametric data were analyzed using descriptive statistics and non-parametric data were analyzed using frequencies and percentages. A linear regression was used to determine the strongest predictors of the intent to leave scale. Conclusions and Implications for

Practice: Findings demonstrated NGNs experienced lower levels of stress pre-pandemic (2019) compared to during the pandemic (2020-2021). The linear regression indicated the strongest predictors of intent to leave were stress related to death and dying, conflict with physicians, lack of support, workload, and uncertainty concerning treatments for the first year of the pandemic (2020). None of the variables were significant predictors of intent to leave for the second year of the pandemic (2021). Nurse leaders must dedicate resources supporting NGNs during unprecedented stressful times to ensure well-being, resilience, and success, thereby reducing intent to leave. Strategies include 1) Organization-based best-health initiatives such as an interactive portal, wellness, and self-care programs; 2) Additional curriculum to address communication with providers, coping with death and dying, and patient treatments; and 3) Intentional rounding by nurse leaders to discuss unit support and workload.