Realistic Job Previews Can Improve Nurse Hiring Process

Many registered nurses find the realities of a new job or organization often don’t meet their expectations.

This mismatch can cause nurses to change jobs sooner than expected, or leave the profession altogether. This results in tremendous costs to employers and creates a high-stakes challenge for nurse recruiters not only to attract quality RNs to their organizations, but to also retain them as long-term employees.

One way to illuminate the pros and cons of a position to prospective employees, and to help reduce RN turnover rates, is by using realistic job previews.

What are realistic job previews?

A realistic job preview typically is conducted after an employer and applicant have made contact and shown an interest in each other, but before the job is offered or the candidate accepts the position.

Mattia Gilmartin, PhD, RN, executive director of Nurses Improving Care for Healthsystem Elders and a faculty member at the NYU Rory Myers College of Nursing in New York City, has conducted research and written on a variety health and management topics, including nurse recruitment and retention. She said realistic job previews are an evidence-based practice that originated under the auspices of human resource management.

“Realistic job previews are essentially a dress rehearsal and look at the fit between a potential employee and an organization,” Gilmartin said. “They’ve been in use since the 1980s. However, they’re not generally used in healthcare, except for some Magnet facilities and hospitals located in competitive labor markets. My goal is that more healthcare organizations would make use of the evidence-based practice of realistic job previews to help retain nurses and reduce turnover rates.”

If done properly, realistic job previews can be a valuable tool in recruiting the right candidates for the job and reducing unnecessary turnover, according to Frederick Morgeson, PhD, a professor of management at Michigan State University, who has conducted research and written extensively on organizational behavior and human resources management.

“It gives applicants realistic information regarding the many aspects of what a job involves and provides details that applicants may not be aware of,” Morgeson said. “Turnover is high in healthcare compared to other industries and it’s more disruptive and problematic, with some acute care hospitals experiencing turnover rates in the range of 25-35%, and long-term care facilities have even higher rates.”

A realistic job preview provides prospective employees with more information about the benefits and challenges of a potential job so they have a better idea what to expect going in, according to Matt Zingoni, PhD, assistant professor of management, healthcare management and human resources at the University of New Orleans.

“Realistic job previews are about managing expectations for anyone, and especially someone who just finished nursing school,” he said. “If a new employee starts a new job and is surprised by the realities of the position, it erodes the relationship between the new employee and the organization.”

Conducting a realistic job preview provides an opportunity for organizations and prospective employees see if they’re a good match, Gilmartin said.

“The main benefits of finding the right fit between employee and employer are job satisfaction, staff retention and cost effectiveness,” Gilmartin said. “Job satisfaction leads to retention, they go hand-in-hand. And retaining staff results in cost savings for the employer.”

Given the challenging nature of the nursing profession with its physical, intellectual and emotional demands, Zingoni said it’s important to bring in people who have held the position under consideration to speak with potential new hires as part of the realistic job preview process.

“Human resources can provide job descriptions for candidates to read. However, only someone who has currently or recently held that job can speak to the true challenges of the position and what the expected learning curve is for the job,” he said. “This is important for entry-level RNs.”

Realistic job previews can reduce turnover

Gilmartin said new nurses especially have high turnover rates as “they start a new job and have one set of expectations. Then they get to work, and everything is completely different from their expectations.”

“We know that realistic job previews work in reducing turnover rates, and they’re relatively inexpensive to carry out,” she said. “You can conduct a realistic job preview in one day, using a mix of different strategies such as conducting soft interview with the front line manager explaining more about the specifics of a position, giving a formal presentation and having the potential new hire shadow another RN on the unit they’re considering working on.”

Morgeson said hospitals need to recognize the cost of turnover to their organizations, existing nursing staff and patients. Those costs include being short staffed when someone leaves, having to find temporary help, and the time and money spent by HR staff and the hiring manager to recruit, hire and train new employees, he said. High turnover can also lead to poorer patient outcomes, he said.

“Turnover is expensive, typically costing approximately the amount of that nurse’s first year salary,” he said. “It’s also contagious. When one staff member leaves, other colleagues tend to leave. It breaks up the social network.”

Use appreciation to increase retention

Realistic job previews with current employees can be a great tool for healthcare organizations to improve nurse retention rates, experts say.

According to Zingoni, using realistic job previews on a yearly basis is a good way for managers to:

  • Check-in with their employees
  • Evaluate their progress
  • Show appreciation

“Realistic job previews can serve as a time to discuss how a job has evolved over the previous year, how it may change going forward and possibilities for future roles,” he said. “Telling an employee we love your skills is motivating.

“Managers can be spread so thin that during annual employee evaluations, the process may be quick and end with sign here on the dotted line,” he said. “This is not motivating for employees. High-quality talent expects more than that, such as a show of appreciation for their work, career path planning and development opportunities for advancement. The key to retaining employees is not only what you do or say, but also how you make them feel.”

Zingoni said while some employees may not be as interested in career advancement, others are very focused on it and not addressing it can cause them to look for work elsewhere.