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

The newly graduated nurse remains at high risk for leaving the nursing profession within the first year of entering the nursing workforce. Evidence based studies have reported that some medical centers report retention rates of only 55% in their first year of employment for the newly graduated nurse. Additional evidence based practice have also reported that 31% of these nurses intend to leave the nursing profession in the first three months of employment. This continues to enhance the nursing shortage issue that places the current nursing workforce at risk for burnout which can cause errors that lead to an increase risk for patient safety. Hospitals that have adopted the nurse residency program have reported retention rates of 89% in the first year of employment (Hillman and Foster, 2011). The information provided in this paper will review the evidence based articles that have researched the success of nurse residency programs for the newly graduated nurses. Along with the success of these programs this article will propose a similar plan to implement an equally successful plan to be initiated into nurse residency programs. The goal of this type of program is to reduce the rate of turnover among the newly graduated nurse by providing them a working unit that enhances their education after graduating their nursing programs. The cost of a unit in this nature will also be reviewed along with reports of retention rates for medical centers that have implemented a program similar in nature.

New graduate nurses make up 10% of an organization's nursing staff (Hopkins & Bromley, 2016). New graduates are faced with the challenge of transitioning to practice from the classroom setting. Nurse residency programs are designed to provide new graduate nurses with a resource in their first year of practice. An integrative review of literature was conducted to analyze components of nurse residency programs associated with their respective outcomes. The implementation of a nurse residency program provides the new graduate nurse with support, education, and clinical skills required of a registered nurse. Proposed analysis of this literature review will be presented. -- Abstract

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.

The organization that served as the study site for this project has two nurse residency programs that compete for resource allocation, space, informational materials, and human resources. The DNP project was conducted to combine the programs to eliminate waste and ensure the combined program met with the Commission on Collegiate Nursing Education standards for accreditation of entry-to-practice nurse residency programs. A literature review was used to evaluate practice themes for a formal residency program, and Benner’s novice to expert theory was chosen to guide the program development. A team of nurse educators and managers met via teleconferencing to review the curricula of both programs and compare these to the best practice literature. The teams met over several weeks and achieved consensus on the structure and process for a single best practice nurse residency program. The project had the potential to provide a developmental framework for advanced practice residency and interprofessional trainee programs. Aligning the two programs assured best evidence-based practice and conservation of resources. The goal was to improve new graduate retention within an extensive federal system. Keywords: new nurse satisfaction, BSN residency program recruitment and retention, baccalaureate nurse satisfaction, new nurse shortage, new nurse satisfaction, nurse turnover

New nurses report feeling unprepared, incompetent, and highly stressed, contributing to first-year turnover rates of 25% in some healthcare organizations. Turnover, combined with a preparation-practice gap, has alerted advocacy organizations and researchers to recommend the development of nurse residency programs. Nurse residency programs are a post-graduate training period where new nurses receive enhanced clinical education in the healthcare setting. While highly variable in structure and attributes, programs usually include educational sessions, clinical immersion, and role socialization opportunities. Evidence supports that new nurses participating in nurse residency programs experience positive outcomes, including increased confidence, competence, and decreased turnover rates. Despite this, only half of the hospitals nationwide have implemented a program with most designed around a single health system mission. This dissertation study aimed to identify the attributes of nurse residency programs influencing the newly licensed registered nurse. An integrative review of the literature and evolutionary concept analysis was completed to examine the state of the science of nurse residency programs. Findings revealed a lack of conceptual and theoretical design and variability among program structures, creating a gap in the literature about the attributes of programs that are most influencing new nurses. Based on the literature's noted gaps, a qualitative description study was conducted. Purposive sampling strategies were used to recruit nurses who recently completed varied program models across the United States. New nurses reported the attributes of programs and described how those positively and negatively influenced the transition to practice experience. The overarching themes revealed that new nurses need a cadre of highly supportive individuals across the clinical and educational continuum who espouse astute interpersonal and communication skills. New nurses desire engaging activities with intra and interprofessional team members for clinical skill application, knowledge advancement, and role socialization. New nurses need the structure of meetings at times and in a sequence conducive to learning; and for preceptorship experiences to be facilitated by trained preceptors, on a unit, and of a length that supports confidence for autonomous practice. Future research will include the development and testing of an evaluation tool based on the findings from this study.

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.