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

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

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.

"New graduate nurse residency programs' primary function is to provide new graduates with clinical experience and bridge the gap between student and competent registered nurse (Walsh, 2018). While the focus of these programs is on teaching new graduates, a gap in practice has been identified when it comes to the education of the nurses that are training these new graduates. The purpose of this program evaluation was to increase preceptor feelings of preparedness for the precepting role, as well as increase preceptor education attendance rates to at least 50% of eligible nurses. This was a program evaluation with a pre-/post-test design that evaluated the impact of preceptor education in 10 registered nurses. Participants submitted surveys to evaluate their feelings of support and preparedness for their educator roles before and after the educational presentation. There was a statistically significant increase in post-education scores (M=11.2, SD=2.15) when compared to pre-education scores (M=6.6, SD=2.8); t(9) = -5.81, p=0.00025597. Furthermore, 100% of respondents had a higher total score on the post-survey than the pre-survey with a mean difference of +4.6 points +/-2.5 (SD), indicating that they felt more supported and prepared to act as preceptors after the education. By offering a preceptor education curriculum that is easily accessible, organizations will see increased attendance rates and therefore higher feelings of support and preparedness from nurse preceptors. These preceptors will then be able to teach and empower new RNs on their journey to practice, offering a smoother and safer transition to professional independence, and decreasing burnout rates and turnover costs to the healthcare organization (Trepanier et al., 2012)"--Abstract.

Newly licensed registered nurses enter the workforce unprepared to transition to practice and are expected to perform competently in highly complex healthcare settings. Gaps between the student role and practice, result in newly licensed registered nurses feeling ill prepared to transition to practice, leading to high turnover rates. Transition to practice programs assist the newly licensed registered nurse to adapt to the practice setting and develop competence and confidence. Evidence supports the benefits of these program, but there are significant variations in length and pedagogy. A Post Baccalaureate Nurse Residency Program one year in length, modeled after the Commission on Collegiate Nursing Education entry-to-practice nurse residency program, implemented at a large, complex, integrated federal healthcare system. Online surveys to current and former participants of a nurse residency program from 2015 -2017, to assess competence and confidence level, job satisfaction, retention, and assessment of program components and effectiveness. Findings from participants of a 1-year post-baccalaureate nurse residency program revealed significant improvement in competence and confidence scores, increased job satisfaction, and 100 percent remained employed at the medical center one year after program completion. Nurse residency programs have shown to be effective in newly licensed registered nurses transitioning to practice, and positively impacts, job satisfaction, competence, confidence in practice, and retention.