Authors (including presenting author) :
Ng CY(1), Wu KM(1), Leung LM(1)
Affiliation :
(1) Nursing Services Division, United Christian Hospital
Keyword 1: :
Nurse Retention
Keyword 2: :
Young Generation
Introduction :
In 2024–2025, the United Christian Hospital experienced a historically high attrition rate of 20.3% among nurses with less than one year of service. Alarmingly, 7.7% of these dropouts occurred within the first month of reporting for duty as Pre-Registered Nurse Temporary Undergraduate Students (Pre-RN TUNS) or Registered Nurses. This concerning trend necessitates the formulation of policies aimed at creating a more favorable working environment for nurses.
Objectives :
To reduce the attrition rate of Generation Z nurse graduates at United Christian Hospital (UCH) by implementing a tailored pre-employment briefing and personalized career planning.
Methodology :
This evidence-based project with a quasi-experimental design will analyze the attrition rates of two cohorts of nurse graduates at UCH. The 2024 cohort received standard pre-employment procedures. The 2025 cohort comprising general stream registered nurses, will receive a tailored pre-employment briefing addressing Generation Z’s values and expectations, including autonomy, work-life balance, and professional development. They will participate in individual career planning consultations. The primary outcome will be the attrition rate within the first month. The secondary outcome will be measured using the Nurse Workplace Satisfaction Questionnaire (NWSQ).
Result & Outcome :
Primary Outcome:
The dropout rate during the first month of full-time employment between the 2024 cohort (control, n=102) and the 2025 cohort (intervention, n=147).
Result: 2024 Cohort: 3 dropouts; 2025 Cohort: 0 dropouts
Although the p-value (0.068) did not reach statistical significance at the 0.05 level, the result indicates a positive trend suggesting the intervention helped reduce dropouts. Secondary Outcome:
The NWSQ was administered to the 2025 cohort (n=98 respondents). The study compared scores between graduates who received their preferred allocation (intervention effect) and those who did not, across three domains: Clinical Stream matching, Department matching and Unit matching.
Results: In all comparison groups, the mean total satisfaction scores were higher (worse) in the intervention group than the control group. While Clinical Stream matching showed a medium effect size (Cohen’s d = 0.51) for parts of the survey, the differences were not statistically significant (p > 0.05). The lack of statistical significance may be attributed to the "Honeymoon Effect" (Kramer, 1974), where high initial motivation masks emerging problems during the first month. Tailored pre-employment briefing and individualized career planning represent the strategy for retaining Generation Z nurse graduates. The initial result reflects that the dropout rate has dropped after implementing the measures. However, the effectiveness of the measures on job satisfaction may need to be further studied in a longer period.
