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

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 encounter "transition shock" when they enter the workplace, especially in acute care settings such as hospitals. New graduate nurses have a difficult time transitioning into the work environment because they are unprepared by their academic training for the realities they will face and they often don't have the proper support in place to guide them through the transition. This leads to a high attrition rate of up to 30% within the first 18 months of employment which costs hospitals and health care facilities. High nurse turnover of new graduate nurses who aren't prepared for the complexities of clinical practice affect the quality of care provided. Patient outcomes are negatively affected because it often leaves hospitals dealing with a shortage of experienced nurses, which they compensate for by having high patient to nurse ratios. New graduate nurses must develop the necessary critical thinking skills to handle higher acuity patients and difficult situations, develop confidence in their clinical skills, and adapt to peer relationships. One solution to the "transition shock" that new graduate nurses face is the implementation of nurse residency programs. Nurse residency programs are shown to help new graduates have a better transition into the workplace and increase nurse retention. This paper discusses the problem of new graduate nurse turnover, the benefits of nurse residency programs, and the numerous research studies which have been done showing the success of nurse residency programs on new nurse graduate retention and job satisfaction. It also discusses how to implement a nurse residency program and monitor and evaluate its success.

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

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.