Follow up of the Phenotype of a Bone Marrow Transplant Nurse: Survival of the Fittest

Topic Significance & Study Purpose/Background/Rationale There is a need for proficient nursing practice in specialized critical care settings, such as a pediatric Bone Marrow Transplant (BMT) Unit. Nursing tenure has been positively correlated with improving patient outcomes and confidence in giving care, so it is essential that efforts be made to retain pediatric BMT nurses. This study aimed to investigate factors of resilience and how it pertains to the retention of pediatric BMT nurses. Methods, Intervention, & Analysis This study was conducted at Cincinnati Children's Hospital Medical Center (CCHMC) BMT Unit. Researchers collected various data points from 2014 through 2019 to measure BMT nurses' turnover risk. Researchers followed up on multiple data points from 2019, currently measuring the turnover risk. A cohort of 115 nurses completed the Connor Davidson Resilience Scale (CD-RISC) to measure levels of resilience. Within the cohort, a total of 9 senior nurses were interviewed using grounded theory methodology until theoretical saturation was achieved. Findings & Interpretation Researchers looked retrospectively at nursing turnover from 2014-2019. Investigators determined the risk of new nurses leaving was between 22 and 24 months (0.025). Further, follow-up was conducted for data points between 2019-present time, which showed a drastic change in the hazard rate curvature. However, the risk remained relatively unchanged at 22-24 months (0.03). There was no statistical significance found between CD-RISC results and age (p=0.465), gender (p=0.725), working experience (p=0.149), or education (p=0.135). Through a constant comparative process, several themes were identified as positive, negative, and ambiguous contributions to the retention of nurses. Discussion & Implications The risk of nurses leaving after two years decreases significantly. Therefore, we determined that nurses with a commitment to pediatric BMT occur with two years’ experience. Although our initial hypothesis was that senior nurses had greater resilience than less tenured nurses, there was no statistical significance as the effect of resilience is small. However, factors retaining nurses within the pediatric BMT field have proven more complex in our discovery. Multiple themes identified resilience within our limited number of senior nurses, of which those nurses placed significant value and fulfillment working on such a complex and challenging area, often embracing the emotional care of the pediatric BMT population.