Nursing Shortage: Retention, Mentorship, and New Nurses
This paper examines the growing nursing shortage in the United States, projected to reach a deficit of one million nurses by 2020. It argues that the primary driver is not a lack of nursing school enrollment but the high rate at which new graduates leave the profession. The paper details the workplace stressors new nurses face — including overwhelming caseloads, inadequate preparation, and horizontal violence from colleagues — and documents their psychological toll. It then presents preceptorship programs and mentoring relationships as evidence-based solutions, emphasizing that hospital organizations must fund and prioritize these supports to improve retention and address the shortage.
- Introduction: The Scale of the Nursing Shortage: Scope and historical context of the shortage
- Why New Nurses Leave the Profession: Stressors driving new nurse attrition
- Horizontal Violence and Workplace Hostility: Colleague abuse and its psychological impact
- The Gap Between Nursing Education and Clinical Reality: Limits of simulation and classroom preparation
- Preceptorship and Mentoring as Solutions: Evidence-based programs to support new nurses
- Organizational Responsibility and Conclusion: Hospital funding and retention outcomes
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What makes this paper effective
- Grounds its argument in concrete statistics — such as the 28% increase in nurses leaving for non-nursing jobs and the finding that understaffed nursing contributed to 24% of hospital deaths — which gives the problem urgency and credibility.
- Moves logically from problem identification (shortage and turnover) to cause analysis (workplace stressors, horizontal violence) to solution (preceptorship, mentoring, organizational support), creating a clear persuasive arc.
- Balances emotional appeal — vividly describing new nurses' anxiety and disillusionment — with scholarly citation, making the paper both readable and academically grounded.
Key academic technique demonstrated
The paper demonstrates effective synthesis of multiple sources around a single argument. Rather than summarizing each source separately, the author weaves citations from Butler & Hardin-Pierce, Block et al., Roman, and others into a unified narrative, using each source to advance the next logical point. This is a hallmark of undergraduate-level argumentative writing in health and nursing studies.
Structure breakdown
The paper opens with scope and historical context, then shifts to the causes of nurse attrition — first practical stressors, then the more serious issue of horizontal violence. A transitional paragraph on the limits of nursing education sets up the solutions section, which covers preceptorship and mentoring in turn. The conclusion ties organizational responsibility to retention outcomes, completing the problem-cause-solution framework.
Nursing shortages are increasing at an alarming rate. By the year 2020, the deficit of nurses was expected to reach one million and affect 44 states plus the District of Columbia (AACN). Hospitals have been hardest hit because of the shortage of bedside registered nurses. This is not the first time a nursing shortage has occurred. During the 1980s there was a nursing shortage, but for different reasons than the present one. At that time, not enough people were entering nursing, and as enrollments increased, the shortage decreased. Now, however, the nursing shortage is primarily due to nurses leaving their jobs because of disillusionment (Block, Claffey, Korow, & McCaffrey, 2005).
Between 1992 and 2000, the number of registered nurses who changed to non-nursing jobs increased by 28% (Block, Claffey, Korow, & McCaffrey, 2005). According to Butler and Hardin-Pierce (2005), during their first year of work 53% of new nurses will change jobs. In public teaching hospitals the turnover rate is as high as 55%. The result is a critical shortage of bedside nurses. The impact on patient care can hardly be overstated — in 24% of hospital deaths, understaffed nursing was found to be a contributing factor (AACN).
New nursing graduates may start out excited and enthusiastic, but soon they encounter the reality of the workplace. Expectations for caregiving have changed significantly. Length of stays, for example, are dramatically shorter, and only very sick people are in the hospital (Ellerton, 2003). Many new nurses feel under-prepared. They experience great anxiety about making mistakes and possibly harming their patients. Many feel they lack the knowledge to communicate effectively with doctors and with family members, leaving them feeling inadequate for the job.
The reality of the workplace is a shock. In school, students were instilled with high ideals, but the workplace requires them to carry a larger caseload of patients with serious medical problems. The process of learning can take from six months to a year, yet new nurses are under pressure to function effectively in the real world immediately (Cosentino, 2003).
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