Factors contributing to nurse resignation during COVID-19: A qualitative descriptive study.

AIMS: To explore and describe registered nurses' perceptions and experiences of work well-being extending from what inspired them to join the healthcare organization, what created a great day at work for them, through to what may have supported them to stay. DESIGN: Qualitative descriptive study. METHODS: Thirty-nine Australian nurses who resigned in 2021 from two metropolitan healthcare organizations in Victoria were interviewed in 2022, each for 30-60 min. The semi-structured interview transcripts were transcribed verbatim and analysed inductively and thematically. RESULTS: Four themes were constructed for each of the key research questions. Inspiration to join the organizations transpired through organizational reputation, recruitment experiences, right position and right time, fit and feel. A great day at work was created through relationships with colleagues, experiences with managers, adequate resourcing and delivering quality care. Factors contributing to nurses resigning included COVID-19, uncertainty of role, workload and rostering, and finally, not feeling supported, respected and valued. Factors that may have supported the nurses to stay included flexible work patterns and opportunities, improved workplace relationships, workload management and support, and supportive systems and environments. Cutting across these themes were five threads: (1) relationships, (2) communication, (3) a desire to learn and develop, (4) work-life balance and (5) providing quality patient care. CONCLUSIONS: Novel ways of working and supporting individuals, teams and organizations are needed to maintain and sustain nurses. The nurses' inspiration, what created a great day at work, and support needed to stay highlighted the importance of workplace initiatives to build nursing career pathways, provide equitable opportunities for professional development, workload and roster flexibility and implement professional relationship-enhancing actions to foster authentic civility. IMPACT: This study contributes an in-depth exploration of the perceptions and experiences of nurses who resigned from two healthcare organizations and provides a description of (1) what inspired these nurses to initially join the organization, (2) what they perceived created a great day at work for them, (3) the factors contributing to their resignation and (4) what may have supported them to stay. The reasons nurses resign from an organization were identified as complex and multi-factorial, with opportunities for promoting nursing career pathways, addressing equity in opportunities and implementing professional relationship-enhancing actions. These contributions add both context and opportunity to strengthen organizational initiatives to attract, sustain and retain nurses.

Effectiveness of transition programs on new graduate nurses' clinical competence, job satisfaction and perceptions of support: A mixed-methods study.

AIM: To assess the effectiveness of two graduate nurse programs on new graduate nurses' overall competence at 3, 6, 9 and 12 months. Secondary aims were to assess new nurses' job satisfaction at 12 months and explore their experiences of support. BACKGROUND: Most clinical settings have implemented transition programs to help new nurses to adapt to their new environments and expand their competences. To this day, very few studies have assessed the effectiveness of these programs. DESIGN: Longitudinal mixed-methods study. METHODS: The study was conducted at two teaching hospitals in Australia. New nurses were recruited during orientation. Data were collected at baseline (T0; n = 88), 3 (T1; n = 29), 6 (T2; n = 15), 9 (T3; n = 11) and 12 months (T4; n = 9). At each time point, the questionnaire included demographic and the Nurse Competence Scale. At T4, the questionnaire also included the Nurse Satisfaction Scale. Semi-structured interviews were conducted from T1 to T4. This study conforms to the STROBE guidelines. RESULTS: Competence increased significantly at T1, with participants stating that they learned by "getting out" of student mode. At T2, despite no significant difference in competence, participants expressed they were more confident and in control, because they felt supported. Again, at T3, there was no significant increase in competence. Finally, at T4, competence increased significantly, with participants acknowledging that they still had a lot to learn. CONCLUSION: This study supports that 12-month transition programs are necessary for NGNs to expand their competence. One major factor influencing NGNs during their first year was how well they felt supported and encouraged to seek help when they needed it. RELEVANCE: There is a need to understand how new NGNs enrolled in transition programs expand their competences. Their professional development depends on a supportive environment where NGNs feel confident in asking questions or for help.