A high demand for experienced nurses and staggering turnover rates among new graduate nurses has resulted in a need for change. Studies show that a high percentage of new nurses resign from their first place of employment within the first year due to inexperience, inadequate training and an overwhelming work environment. To combat this issue there has been the development of residency programs. A residency program is a 12 month course that will train and educate new graduate nurses by assigning mentors. The mentors will be senior nurses who are experienced in various areas of the clinical setting in which the new nurse will be employed. The program will consist of on the job training throughout the course of the year- long orientation, assisting the new nurse with transitioning from student to professional. There is a shortage in nurses per unit in acute care settings and the patient to nurse ratio is causing a variety of issues including a decrease in patient satisfaction (Jones 2007). With an increase in patient ratio per nurse there is an increased chance of medical errors, mortality rates and length of stay for patients. Studies have shown that a residency program can decrease the turnover rate among new graduate nurses.

New graduate nurses are faced with stressful and challenging work environments as they transition from student nurse to practicing professional nurse. Some of the stress related factors are not having adequate skills resulting in a lack of confidence, uncomfortable working with an interdisciplinary medical staff, short staffing, poor leadership, and support. As a result, many new graduates leave the acute care setting within the first year from poor job satisfaction. This exacerbates short staffing problems, is costly for the acute care hospitals, and affects patient care. Most new graduate nurse's training programs are inadequate to prepare promising new nurses for the complexity of today's patient population and challenging work environments. Evidence based practice research supports the concept of institutionalizing a residency and mentorship program lasting at minimum one year with a designated mentor for up to one-year post preceptor ship to answer ongoing questions and concerns. Research evidence shows that acute care hospitals that have implemented this program have higher retention rates and significant increases in job satisfaction of newly graduated nurses. This proposal will include an implementation plan for acute care hospitals to put into practice a residency and mentorship program for new graduate nurses.

A nurse residency program (NRP) was developed to transition the graduate registered nurse (GRN) into clinical practice beyond the academic role. This quasi-experiment project examined new graduate nurses and how an NRP was implemented to assist them in transitioning from scholarly practice into the clinical practice role. Sixteen recent baccalaureate-prepared nurses participated in the program. Each participant agreed to enter the program as a part of their employment process with the facility. During this time, the graduate was supported by a seasoned mentor assisting them in developing critical thinking, improving communication skills, and applying clinical skills during real patient scenarios. The graduate met monthly with the program cohort for one hour to review evidence-based practices, clinical scenarios, and to participate in the didactic discussion. The topics included addressing the roles of the nurse: fatigue- countermeasures related to shift work, nursing documentation, skin assessment, lab interpretation, respiratory system and equipment review, evidence-based practices, and delegation. A paired sample t-test was used to compare pre- and post-test survey results using a questionnaire established by the project hospital. Data analysis identified NRP impacted participants’ responses to questions related to anticipated growth and development of skills, collaborative clinical care, application of knowledge in evidence-based practices, and expansion of knowledge and comfort levels when working in different areas of the facility.

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

Success. Job satisfaction. Leadership. How are these developed and nurtured in a nursing career? Can mentors make a difference? They can and do, according to this book---edited by two pioneering researchers in the field of nursing mentorship. Here they explore the conceptual and practical aspects of mentorship and what it means in nursing. They are joined by more than a hundred nurses, including nurse leaders such as Beverly Malone, Marla Salmon, and Joyce Fitzpatrick, who contribute stories, essays, and personal reflections on mentorship. Their voices, in addition to the editor's research, suggest that nurses are inventing a new, evolving, and very meaningful paradigm, which reaps mentorship's classic benefits: career success and advancement personal and professional satisfaction, enhanced self-esteem and confidence, preparation for leadership roles and succession, and strengthening of the profession. The book describes the dynamics of both informal mentor relationships and structured mentorship programs, such as those used in schools of nursing to help disadvantaged students. In addition to looking at education, the book describes how mentorship plays a role in the practice setting, in professional organizations, and with peers and groups, and how it promotes international and cross-cultural understanding.

The Future of Nursing explores how nurses' roles, responsibilities, and education should change significantly to meet the increased demand for care that will be created by health care reform and to advance improvements in America's increasingly complex health system. At more than 3 million in number, nurses make up the single largest segment of the health care work force. They also spend the greatest amount of time in delivering patient care as a profession. Nurses therefore have valuable insights and unique abilities to contribute as partners with other health care professionals in improving the quality and safety of care as envisioned in the Affordable Care Act (ACA) enacted this year. Nurses should be fully engaged with other health professionals and assume leadership roles in redesigning care in the United States. To ensure its members are well-prepared, the profession should institute residency training for nurses, increase the percentage of nurses who attain a bachelor's degree to 80 percent by 2020, and double the number who pursue doctorates. Furthermore, regulatory and institutional obstacles-including limits on nurses' scope of practice-should be removed so that the health system can reap the full benefit of nurses' training, skills, and knowledge in patient care. In this book, the Institute of Medicine makes recommendations for an action-oriented blueprint for the future of nursing.