Nursing residency programs are a tool used by hospitals to attract and retain new nursing employees. They were developed to ease the transition of a graduate nurse into the roles expected of a registered nurse in an acute care setting. In 2000, a hospital system in Washington state implemented a residency program for eligible new employees hired into the medical, surgical, and orthopedic units of two hospitals owned and perated by the system. This project evaluates the impact of this residency program in attracting and retaining new nursing employees. The study also explores the value of a registered nurse in the acute care setting and the effectiveness of preceptors in the orientation process. Methods used in this study include Likert Scale surveys that focus on the orientee's perception of preceptror support throughout the orientation process. Data supplied from the Human Resource Department was used in examining the effects of the program on retention rates. The results of the project suggest that residency programs may attract new nurses to health care facilities and bolster their self-confidence in the patient-care setting.

New graduate registered nurse residency programs are being adopted as best practice by many organizations. The purpose of this thesis was to evaluate the effectiveness of two different types of programs implemented at an organization to see which produced the largest amount of retention. One group was hired directly into a nursing unit or area where orientation began. Another group was hired into a practice area and rotated through three different areas prior to being matched to a unit or area and then completing orientation. Dr. Patricia Benner's Novice to Expert Framework was used to guide this study because successful residency programs should expound onto the new graduate registered nurses educational base and should offer a variety of experiences to assist with moving towards the stage of expert nurse. Retention data was collected retrospectively and included 12 months of retention data for the two cohort groups being compared. Comparison of this data showed a 4.5% increase in retention from one to another. Further comparison of this data showed that the difference in length of service at 12 months between these two cohort groups was not statistically significant (p=.285). Further comparisons of independent hospitals and practice areas also showed no statistically significant differences in overall length of service at 12 months.

The purpose of this evidence-based project was to compare one-year outcomes for newly licensed Registered Nurses (NLRNs) in three organizations within the same healthcare system. All three have lower than nationally reported turnover and strategies for NLRN retention. Only one is using a Nurse Residency Program (NRP). NRPs are recognized as an effective strategy to retain newly licensed registered nurses (NLRNs) in their first year of employment (Institute of Medicine [IOM], 2010; The Advisory Board, 2007; Spector, 2007). The Commission on Collegiate Nursing Education (CCNE) (2008) defines an NRP as a series of learning sessions and work experiences that occur continuously over a 12-month period designed to assist NLRNs as they transition into their first professional nursing role. This cross-sectional, descriptive study utilized the Casey-Fink Graduate Nurse Experience Survey and intent to stay questions to collect data on NLRNs at one year post hire. Results indicated no statistically significant differences between the three sites and the subscales of the survey. There was a trend of a more positive score for professional satisfaction with Site A. Turnover was also similar between sites and lower than the reported 10% average, with Site A at 2%, Site B at 5%, and Site C at 4%. There was a statistically significant difference between Site A and C in the intent to stay in their current position, with Site A longer than Site C. The study supports the literature and evidence that a NRP is an effective strategy to decrease first year turnover. Further study is needed related to the effectiveness of the components of the NRP, length of time for mentorship, and the impact of accumulation of cohorts.

The problem of new graduate registered nurse turnover is one that continues to be looming over hospitals throughout the United States. Decreased competency, lack of loyalty to employment providers, and diminished retention rates have prompted studies to determine what can be done. Research in this area has indicated that the use of one-year nurse residency programs can make a positive difference over the use of traditional nurse orientation in the retention of new graduate registered nurses. Implementation of a program like the University Health System Consortium (UHC)/American Association of Colleges of Nursing (AACN) Residency Program instead of the traditional nurse orientation for new graduate nurses, can better prepare nurses to take on the future of health care.

Health care facilities across the United States have implemented innovative approaches such as nurse residency programs to facilitate a successful transition to practice for new nurses. Many nurse residency programs evaluate their effectiveness by assessing critical thinking abilities, retention, return on investment, and job satisfaction. Evaluations are conducted using surveys and focus groups. However, there is a void in the literature that examines the effectiveness of a new nurse residency program from the participants' perspective; particularly asking the resident how the nurse residency program has advanced them to become a more competent professional. The theoretical model framing this investigation is Patricia Benner's novice to expert theory. The purpose of this qualitative case study is to understand participants' perceptions of a nurse residency program, specifically looking at how the program transitioned them from advanced beginner to competent nurse professional. The study sample included eight participants employed in a health care facility located in the southeastern United States. Open-ended research questions were designed to elicit the new nurses' perceptions of the effectiveness of a nurse residency program. Data collection was conducted using interviews and audio recordings. Emerging themes indicated that pre-experiences and expectations, leadership and professional development, stress and coping, supportive cohort, program improvements, and reflection on confidence and competency were fundamental elements for an effective nurse residency program. One recommendation from this study was for pre-residency assessment tools to be given to residents for customization to better facilitate the transition of new nurses to a competent professional.

In this comprehensive resource, nursing staff development expert Jim Hansen, MSN, RN-BC, provides instruction and tools to plan, justify, and structure a nurse residency program that develops and retains new nurses through their first year