The nursing recruitment crisis has generated research into strategies to improve retention of newly qualified nurses. In New Zealand, all DHBs are committed to the Nurse Entry to Practice (NETP) and Nurse Entry to Specialised Practice in Mental Health and Addictions (NESP) programmes to help acclimatise new graduates to the realities of clinical responsibilities. These have had a positive impact on retention rates.
The Advanced Choice of Employment (ACE) scheme was introduced in 2012 to ensure a fair process of recruitment. Using an instrumental case study approach, this study explored the influence that the ACE process has on a new graduates’ decision to accept a place on NESP. The ‘case’ comprised one NESP programme in one DHB. Semi-structured interviews were conducted with 14 participants who had accepted a position on NESP, but did not specify mental health and addictions on their ACE application form. A further interview was conducted with the NESP coordinator to ascertain the employer experience of ACE.
Thematic analysis of the interviews revealed one over-arching theme; ‘ACE is omnipotent’, and three sub-themes; ‘The system’, ‘Nursing as a vocation’ and ‘Professional identity’. The findings revealed that new graduates experience a form of marginalisation as they complete the ACE process. The pressure to secure a position can result in applicants accepting a position in NESP even if they have no interest in a career in mental health. The concept of nursing as a vocational occupation has the potential to ostracise these applicants, but the NESP programme can be successful at socialising new graduates into the mental health profession. ACE has considerable authority in the recruitment process and has created a socio-cultural lag. Education providers and DHBs can help to minimise the effect of this through preparing ACE applicants for the recruitment process.
Key words: New graduate nurses; Advanced Choice of Employment; ACE Nurse Entry to Specialist Practice in Mental Health and Addictions Programme; NESP; mental health nursing; stigma and discrimination; career choice; marginalisation; vocation; socio-cultural lag.