Defense Date


Graduation Date

Fall 12-2020


Immediate Access

Submission Type


Degree Name





School of Nursing

Committee Chair

Joan Such Lockhart

Committee Member

James Schreiber

Committee Member

Rebecca Kronk

Committee Member

Marilyn Oermann

Committee Member

Jane Brannan


resilience, new nurse, turnover, stress, social support, digital intervention, newly licensed nurse


The nursing shortage has been deemed a public health crisis with the turnover rate of newly licensed nurses (NLNs) growing (Robert Wood Johnson Foundation, 2014). One out of five NLNs are leaving the profession due to work dissatisfaction and feelings of inadequacy (National Academy of Medicine, 2017). NLN attrition during the first year of hire has been associated with feelings of overwhelming stress and decreased sense of support which negatively impact patient safety (Spence Laschinger et al., 2016). As seasoned nurses are attempting to retire amidst a nursing shortage (American Association of Colleges of Nursing, 2018), NLNs require more support than ever before. A prospective, randomized control trial evaluated the impact of a six-week digital intervention (text messaging) on NLNs’ self-reported stress, resiliency, sense of support, and intention to leave (ITL) their jobs, organization and profession. Messages to the experimental group (n=10) conveyed emotional, esteem, and networking support; messages to the control group (n=11) were medical facts. Duchscher’s Theory of Transition Shock (2007) served as the study’s conceptual framework. Outcome data were measured using the Perceived Stress Scale (PSS) (Cohen, Kamarck, & Mermelstein, 1983), the Connor-Davidson Resiliency Scale-25 (CD-RISC-25) (Davidson, 2018), the Sense of Support Scale (SSS) (Dolbier & Steinhardt, 2000), and an Intention to Leave Survey (ITL Survey). Participants in the control group (those who received medical facts as the digital intervention) experienced increased sense of social support. At the end of week three, a Bayes Factor (BF) between 0.33 to 0.10 revealed substantial evidence to support there is a difference between the groups. At the end of week six, a BF between 0.03 to 0.01 revealed very strong evidence to support there is a difference between the groups. The impact of a digital intervention (text messaging medical facts) was found to increase this NLN cohort’s sense of support during the first year of hire. Implications from this study encourages nurse educators to use a cost-effective digital intervention (text messaging) to support NLNs’ first year of practice. Future research is needed to explore NLN resilience and turnover.



Additional Citations

Concilio, L., Lockhart, J., Oermann, M. H., Kronk, R., & Schreiber, J. B. (2019). Newly licensed nurse resiliency and interventions to promote resiliency in the first year of hire: an integrative review. Journal of Continuing Education in Nursing, 50(4), 153-161.