Settling In: Early Career Registered Nurses/te Noho Mauritau: Nga Tapuhi I Nga Tau Tuatahi O Te Huarahi Mahi

IntroductionRapid changes in the healthcare system are taking place within New Zealand (NZ) and internationally. Discussion about shorter hospital stays and higher patient acuity, increasing use of technology and changing nursing roles, along with a strong focus on doing more with less, permeate the literature (For example Cook, 2009; Laschinger, 2012; Phillips, Kenny, Esterman, & Smith 2014; Wolff, Pesut, & Regan, 2010). Internationally, an emphasis on the retention of new graduates (NGs) has emerged as an important issue as a future nursing shortage is predicted as older nurses enter retirement (Boamah & Laschinger, 2016; Cho, Laschinger, & Wong, 2006; Rush, Adamack, Gordon, Lilly, & Janke, 2013). Within the current NZ nursing workforce only 46% of registered nurses (RNs) are aged under 44 years (Nana, Stokes, Molena, & Dixon, 2013) and it is expected that over half of the workforce will retire by 2035. The forecasted national and international nursing shortage has yet to be realised in NZ due to the effects of the global financial crisis in 2008 (Laschinger, 2012; North, Leung, & Lee, 2014), however workforce planning remains a priority. Due to increased life expectancy, an ageing population will intensify the demand for healthcare. As the largest occupational group in healthcare, nursing capacity will need to expand to help meet this need (Nana et al., 2013). This study, which analyses quantitative data from first and fourth year questionnaires of the Graduate e-cohort Study (GeS), contributes to the discussion surrounding NG employment trends.BackgroundThe 2012/2013 cohort of newly registered nurses in NZ consisted of 1,639 NZ qualified RNs and 1,257 internationally qualified RNs (Nursing Council of New Zealand (NCNZ), 2015a). Since the 1990s NZ has relied heavily on the employment of the latter group of nurses to maintain its nursing workforce. Of the 2012/2013 cohort of NZ qualified RNs, 92% were female with nearly half aged under 25 years (NCNZ, 2015a). This suggests a young mobile workforce that will require time out from the workforce for child-bearing responsibilities at a future date.The degree of support received by NG nurses during their initial orientation to the clinical environment influences not only their satisfaction with nursing as a career choice but also the decision to remain in the professional workforce (Laschinger, 2012). In a survey of RNs in Ontario with less than two years clinical experience working as a RN (n = 342) there was a strong correlation linking positive "structural conditions in the workplace" - including workload, opportunity and empowerment - with job satisfaction and intent to continue practising in their current setting (Laschinger, 2012, p. 478).New graduate nurses that participated in formal transition programmes rated their communication, planning abilities, and leadership skills higher than those that did not participate (Rush, Adamack, Gordon, Janke, & Ghement, 2015). Research also points to the direct correlation between opportunities to undertake continued professional development and job satisfaction and retention (Dyess & Sherman, 2009; Gould, Drey, & Berridge, 2007). An increase in the uptake of postgraduate study by RNs is evident at both an international and a national level (Cotterill-Walker, 2012; Drennan, 2008). In NZ this coincides with the inclusion of a postgraduate paper within many Nurse Entry to Practice (NETP) and Nurse Entry to Specialist Practice (NESP) transition programmes (Haggerty, McEldowney, Wilson, & Holloway, 2009). The availability of Health Workforce NZ funding for postgraduate study has presumably influenced the uptake of postgraduate study (Barnhill, McKillop, & Aspinall, 2012). A retrospective analysis of the 2005 - 2010 NCNZ nursing cohort data demonstrates that RNs who gained a postgraduate qualification within their flrst 5 years of practice are significantly more likely to remain part of the nursing workforce (North, Leung, & Lee, 2014). …