Article Review

Article: Support Programs for New Graduates in Pediatric Nursing

Authors: Patricia Messmer, Jane Bragg and Phoebe Williams

By: Leroy A. Binns Ph.D.

Co-authors Patricia Messmer, a consultant for Nursing Education and Research at Miami Dade College, Jane Bragg the director of Psychiatry and Palliactive Care at Miami Children’s Hospital and Phoebe Williams a professor at University of Kansas School of Nursing have concentrated their efforts in conducting research that endorses support programs for newly minted pediatric nurses.

Such collaboration which is intensive in its breath and scope deploys the contribution of associated scholars in assessing three fundamental issues surrounding work satisfaction and “burnout” factors in relation to retention. They are the percentage of new graduates who remain on the job following two years of employment, the connection or lack thereof between work gratification and exhaustion and the turnover rate subsequent to the creation of support programs for incoming registered nurses.

The article is timely in its quest for support systems as it takes into consideration the need to acquire and sustain nurses during a period of chaos, transition and most significantly a deficiency of said care givers as such will gravely impact the nature of care provided. In fact the trio concedes an inability to address stress related concerns that may be attributed to management issues, insufficient guidance and support and an excess in responsibilities resulting in deterioration amongst patient and unacceptable nurse to patient ratios render patients to an unsafe environment.

They are also in agreement with colleagues who are convinced that continued turnover rates could become a fiscal catastrophe for hospitals. To support this claim mention is made of a turnover rate of 35% to 60% of new nurses within the first year of employment to the tune of $60,000 for each position – a fate that could cost individual medical centers up to $300,000 annually and associated entities the likes of employing institutions an estimate as high as $145,000 per RN.

To bolster the argument for retention reinforcement the writers have reviewed additional literature that references a modified version of Aiken’s revised Nursing Work Index and the Maslach Burnout Inventory. The outcome of a target group of nurses who completed the aforementioned studies reveals a majority of nurses who were pleased with their jobs and therefore intend to stay on assignment. Growth in professionalism ranged from an increase in the amount of time spent with patients and documenting patient care to an improvement in the quality of patient care provided and is a progression accredited to support group programs and reflected in a decrease in turnover rates from 7.6% in 2006 to 5.7% in 2009.

The NWI scale underscores work satisfaction and scores of participants whereas MBI demonstrates stress/burnout and grades of respondents. In the end in light of evidence of stress associated with exchanges with providers, the use of complicated high tech equipment, interactions with families and particularly in the case of pediatric nurses caring for dying children, the studies advocate for effective strategies to enhance job satisfaction and retention of nurses inclusive of learning from experienced instructors and residencies about how best to defuse stress. The tools of favorability are incorporative of but not limited to clinical skill sets and the ability to interface with other medical professionals and families.

In accordance with supporting documentation testament to the previously cited assumption transcends demographics, gender, ethnicity, age and marital status and is more apparent among nurses in pediatric hospitals as opposed to their counterparts in non pediatric facilities. Further nurses both new and seasoned in magnet hospitals perceive a more desirable work atmosphere augmented by programs that increase professional proficiency.

This scholarly presentation fails to address external factors that are likely in part accountable for dissatisfaction among nurses. However it is comprehensive in the wealth of information it provides primarily by way of surveys to conclude there is a correlation between job satisfaction and fatigue that could adversely affect retention. It also recommends a proven supportive environment towards sustainability of the health care facilitators in question.