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The nursing shortage is considered an international crisis and a significant threat to global health (Ishihara, Ishibashi, Takahashi, & Nakashima, 2014). One is led to consider whether job turnover, particularly among newly licensed RNs (NLRN), is contributing to this problem. The pressure to provide highly competent and quality care, all while transitioning into practice, can lead to stress, burnout, and job turnover in the first years postlicensure (Li, Early, Mahrer, Klaristenfeld, & Gold, 2014). As part of this global NLRN population, the current turnover rate among all RN populations in the United States is 17.2% (Nursing Solutions, Inc., 2016), with reports of up to 40% of NLRNs leaving their job within the first year of employment (Cho, Lee, Mark, & Yun, 2012; Kovner, Brewer, Fate-hi, & Jun, 2014; Nei, Snyder, & Litwiller, 2015; Trepanier, Early, Ulrich, & Cherry, 2012; Ulrich et al., 2010; Unruh & Zhang, 2014). Early job turnover results in significant costs to health care organizations. The average cost of turnover for a bedside RN ranges from $37,000 to $58,000 (Nursing Solutions, Inc., 2016). Inadequate staff-to-patient ratios from increased turnover lead to increased risks to patient safety, decreased quality of care, and increased mortality (Beecroft, Dorey, & Wenten, 2008).
As part of the Institute of Medicine's (IOM, 2011) The Future of Nursing: Leading Change, Advancing Health report, implementation of formal transition to practice residency programs for all NLRNs was recommended to support the competence and confidence development of NLRNs while improving quality of care provided to patients (Commission on Collegiate Nursing Education, 2015). Many positive outcomes have been associated with nurse residency programs, such as reduced turnover rates (Trepanier et al., 2012), increased levels of job satisfaction (Laschinger, 2012), and increased organizational commitment (Chang et al., 2015).
The purpose of this study was to examine factors associated with organizational commitment, and subsequent turnover intent and actual job turnover, among NLRNs who participated in an NLRN residency program. Given limited resources, the study used secondary data from Versant New Graduate Nurse Residency™ (VNGNR™) to test a model of structural empowerment, job satisfaction, autonomy, competence, and group cohesion on organizational commitment and the effects on actual job turnover. The results will inform future research to promote understanding and add to the literature...