In a letter to the editor from June 2016, Tamara Kear PhD, RN, CNS, CNN, assistant professor of nursing at Villanova University outlined the challenges in recruiting novice nurses to nephrology, and how it adds to dialysis nurse burnout. I asked Kear to expand further on the topic.

NN&I: Do you think there is a lack of novice nurses in nephrology? If so, where are most of the new hires coming from?

Kear: Nephrology nurse practice settings, particularly dialysis units and clinics, face challenges in hiring nurses and staffing units. The topic of understaffing and difficulty in filling vacant positions is a common topic of conversation among nephrology nurses.

Many of today’s new hires come from the pool of nurses with varying years of experience in the acute care setting. It is difficult to attract novice nurses into the nephrology practice settings.

As a nursing professor who teaches senior nursing students, students seek entry-level positions in acute care settings. The attraction is often related to being enticed by well-developed orientation and nurse residency programs.

Further, many novice nurses apply to hospitals where they completed nursing education clinical rotations and/or nurse externship programs during their formal nursing education.

Familiarity with the unit, staff, and nurse manager gained from placement in a clinical setting or healthcare system during the formative educational years may be viewed favorably by the novice nurse. This familiarity has the potential to decrease the anxiety associated with the entry-level position, thus attracting the novice nurse to this setting.

NN&I: What would be the ideal program to mentor novice nurses in nephrology? Who would manage it (dialysis providers, hospitals, etc.)?

Kear: Mentoring novice nephrology nurses must include, but also extend beyond providing a structured orientation program. The health care organization or dialysis provider should be the manager of the mentorship program for the novice nurse in the nephrology setting.

There are models that can be used to develop a supportive environment for novice nurses that incorporate orientation, preceptorship, mentorship, and opportunities to engage the nurse in a practice environment. These models extend beyond a basic orientation to the specialty and practice setting and incorporate professional development concepts and opportunities.

An effective residency program provides the novice nurse “protected” time off of the unit to develop skills, receive support, and gain exposure to the new role as a nurse and the intricacies associated with becoming a nephrology nurse.

NN&I: What would be the benefits of hiring more novice nurses through residency and mentorship programs?

Kear: There are benefits to the nurses, patients, and organizations. The benefit to the nurse will be engagement in an environment that provides support and professional development opportunities. The benefit to patients is the provision of a professional, safe, and support care environment.

It is well known that hiring new staff is costly for healthcare providers. The benefit to the organization has the potential to be financial through a decrease in staff turn-over and increase retention of staff. There may be a decrease in “sick” days from stress or burn-out.

Mentorship programs also allow incumbent nurses the opportunity to guide the learning and engagement of the novice nurse. This is empowering for the experienced nephrology nurse and has the potential to increase morale on the unit.