Late Career Nurse and New Graduate Transition

Nova Scotia

The growing nursing shortage threatens to affect the quality of care in Nova Scotia. A lack of professional development opportunities, the difficulties nurses face transitioning into the workforce, and the absence of effective mechanisms to help nurses find jobs are recognized as major obstacles to the retention and recruitment of nurses.

The Nova Scotia Nurses’ Union (NSNU), the Nova Scotia Department of Health, the district health authorities (DHAs), nursing schools and other organizations partnered to address these issues, building on current initiatives in the province. The resulting project focused on three areas:

  • Development of a centralized service to identify individual employment preferences employee/employer needs and orientation requirements
  • Implementation of an 80/20 staffing model as per the NSNU collective agreement
  • A mentorship program to support the transition of new graduates into the workplace

The 80/20 model allows nurses to spend 80% of their time in direct patient care and 20% in professional development activities. The professional development time was used to support the mentorship program by providing training for mentors, workshops for mentors and mentees, and time for mentors and mentees to meet.

Project Objectives: 
  • Develop and implement a provincial approach to the coordination of new graduate hiring to the district health authorities, the IWK Health Centre and long term care facilities
  • Develop and implement evidence-based principles and guidelines for orientation and transition programs that incorporate individualized needs assessments
  • Develop evidence-based guidelines for the mentorship component of Nova Scotia’s 80/20 Late Career Nurse Strategy
  • Build a mentor pool using the 80/20 Late Career Nurse Strategy
Project Implementation: 

The project took place over a 27 month period. Activities included a provincial inventory of new graduate hiring practices and key informant interviews with the union, employers and human resource consultants. A scan of Nova Scotia and other provinces was conducted to identify best practices in multi-stakeholder approaches to recruiting and hiring nurses within a given labour market. Results from the key informant interviews and the best practice scan were reviewed and recommendations were developed. This lead to the development of orientation tools, a provincial orientation framework and new provincial guidelines for orientation and transition support.

A “Tool Kit” consisting of forms and educational resources was developed for new graduate orientation and transition in Nova Scotia. Participant and facilitator manuals were developed, and five workshops were held with over 75 nurse participants from six DHAs. Twenty nurses from five DHAs participated in the 80/20 nurse mentor initiative, and thus far, ten new graduates are receiving support from nurse mentors during their first year of practice.

The program utilizes nurse mentors participating in the 80/20 professional development model. All mentors receive education and training to enhance their capacity to support new graduates. Designated program leads supported the nurse mentors. Though the majority of 80/20 professional development time was dedicated to mentorship, nurses also had time to participate in other formative activities.

The project also purchased a permanent enhancement to the Health Services Placement Network (HSPnet), a web-based system for coordinating student placements. The enhancement allows students in their graduating year to search employment opportunities in the NS DHAs, and to upload documents to their student profile and to employer sites when applying for jobs. The tool was launched with a small pilot group in July, 2010, and then fully implemented for the spring 2011 graduating classes.

Project Outcomes: 
  • Province-wide implementation of the NS HSPnet employment placement enhancement (beginning with the spring 2011 graduating classes in all NS Nursing Schools)
  • A province-wide “Tool Kit” for new graduate orientation and transition disseminated to nurse leaders through the provincial nursing network
  • Development of mentorship and 80/20 nurse mentor program workshops, tools and materials for ongoing mentorship training
  • Increased mentorship capacity – to date, 75 nurses have participated in education and training to support new graduates
  • Evaluation findings contributed to the national body of evidence-based research on mentorship and 80/20 projects. Findings will be used to assess the business case for the NS 80/20 Late Career Nurse Strategy