Mentoring Novice Nurses To Decrease RN Turnover

Project Topic:

Mentorship

Hospital, City and State:

Cape Cod Hospital, Hyannis, Massachusetts

Unit:

• Intensive Care Unit

CSI Participants:

• Lindsay Kelly, BSN, RN, CCRN
• Emma Slysz, BSN, RN
• Ashley Gray, BSN, RN
• Coach: Denise McDowell BSN, RN, CCRN

Project Goals/Objectives:

1. Decrease turnover 20% in the first year of mentorship
2. Increase Heathy Work Environment Assessment tool (HWEAT) aggregate score and Oldenburg Burnout Inventory (OLBI) score 20%
3. Increase HWEAT Meaningful Recognition score from 3.32 to 4
4. 100% participation from mentors in relation to the project

Project Outcomes:

1. Decreased turnover by 1 RN
2. Increased HWEAT aggregate score from 3.42 to 4.11(4.0 is excellent)
3. Increased Meaningful Recognition score from 3.23 to 4.17
4. These outcomes resulted in a positive estimated annual fiscal impact of $61,100

Project Overview:

Behind every ICU monitor is a nurse making critical decisions that directly impact patient outcomes. The ICU is a fast-paced, high-acuity environment that requires advanced clinical skills, rapid decision-making and strong teamwork.

The CSI team identified a significant influx of newly hired nurses in the ICU, with approximately 50% entering the unit without prior critical care experience. Overall, 20% of the unit’s nursing staff had less than one year of critical care experience. This shift in experience level created challenges, including increased risk of preceptor burnout, potential disruption to team cohesion, and higher financial and operational costs associated with new nurse turnover.

By utilizing our HWEAT results and identifying that there is a need to support these new nurses as they transition out of preceptorship, the team created a structured mentorship program that would support and improve the confidence of new hires as they transition post orientation. We created a framework in which we adapted our own version of the GROW model to fit our project. We put in interventions during our project kickoff, conducted surveys and educated our ICU staff about our project. Each new nurse was paired up with a mentor as an outlet for guidance as they transitioned out of orientation. We also focused on meaningful recognition to highlight our existing staff by implementing a gratitude board, implementing post huddle and providing ongoing skills training.

The feedback about our project’s interventions has been positive. We were able to spread our project to other units in the hospital and presented to senior leadership to share the impact of our mentorship program. Post-mentorship surveys showed improvement in all areas including pre-shift anxiety after the implementation of our project. Our unit its increased Heathy Work Environment Assessment tool (HWEAT) aggregate score from 3.42 to 4.11. Our Meaningful Recognition score increased from 3.23 to 4.17. Lastly, we hope to sustain this project and spread it to all units in the hospital, and collect further turnover information for all hospital staff. We hope to improve the mentorship framework through the development of a dedicated mentorship committee.