Development of an Emergency Nurse Internship to Promote a Healthy Work Environment and Improve Nurse Retention

Abstract

Introduction

Following the COVID-19 pandemic, a community emergency department was facing a staffing crisis with new emergency registered nurse turnover rates as high as 83.3%. There were limited experienced emergency nurses available to train the large number of novice nurses hired to fill vacancies. Based on this, the emergency department needed to restructure the orientation process to better align with evidence-based strategies and available resources.

Methods

The Seven Steps of Evidenced-based Practice were used to identify the best practices for an orientation program specific to the emergency department. Based on the evidence, a 16-week, competency-based, emergency nurse internship was implemented in the 33-bed community emergency department.

Results

The primary outcome of this initiative was new emergency nurse retention, which demonstrated a statistically significant reduction from 81.8% (pre-intervention) to 11.1% (post-intervention) (P < .001). Additionally, there was an improvement in the scores for each of the 6 healthy work environment standards.

Discussion

Based on the outcomes of this initiative, an emergency nurse internship is an effective method to improve emergency nurse competence and retention, contributing to a healthier work environment.