Moving Past Reality Shock: A Model for New Graduate Nurse Engagement

New graduate nurse (NGN) burnout (poor engagement) leads to 33% annual turnover, costing organizations $82,000 to $88,000 per nurse. Nurse burnout is also correlated with adverse patient events, contributing to 440,000 deaths per year (the third leading cause of death in the United States). Kramer proposes a process of NGN engagement and burnout in her theory of new nurse socialization, but the theory has limited empirical testing or support. The purpose of the preliminary study was to provide empirical support for Kramer’s theory of new nurse socialization, specifically the existence of NGNs’ values mismatch (relationship between amount of leader empowering behaviors (LEBs) and level of organizational commitment) and phases of socialization (change in the amount of role satisfaction), with a secondary data analysis approach. This study did not support Kramer’s proposition that values mismatch leads to low NGN role satisfaction and the existence of three distinct phases of socialization. In the second study, a new model for NGN engagement is proposed by incorporating propositions from Kramer’s theory with others from Kanter’s Theory of Structural Empowerment, Bandura’s self-efficacy work, and Newman’s Attitude-Engagement Model. Aims of this second study were to examine (a) the effects of personal characteristics (presence of previous healthcare work experience and type of degree completed) and organizational characteristics (amount of LEBs, magnet status, and size of hospital) on self-efficacy (level of self-efficacy), (b) the relationships among self-efficacy (level of self-efficacy), personal goal attainment (level of perceived skill mastery), and affective engagement (level of job satisfaction, amount of affective organizational commitment, and level of job involvement), and (c) the effects of affective engagement (level of job satisfaction, amount of affective organizational commitment, and level of job involvement) and self-efficacy (level of self-efficacy) on behavioral engagement (retention). A secondary data analysis was again completed. Results provide preliminary support the proposed model.