Purpose: The purpose of our program is to assist nurses in transitioning from the student nurse role to practicing nurse. The leap from student nurse to practicing nurse can be very difficult. The transition from academia to the practice setting can be overwhelming both to a new nurse as well as the preceptor. As novices begin their career, they are faced with learning how to practice nursing, using critical skills, learning policies, and becoming familiar with new technology and procedures. The first year is recognized as period of extreme stress. Many organizations are revisiting the need for residency programs to bridge the gap between school and practice setting. One solution is a nurse residency program. The pros and cons of residency program need to be evaluated with both short- and long-term results. According to RN Work Project, 17.9% of nurses left within the first year of starting their first job. Organizations are tasked with the evaluation of cost of turnover verses cost of a residency program. Findings from the RN Work Project (a 10-year longitudinal study, completed in 2016), as well as the Louisiana’s 2019 Nursing Workforce Demand Report were reviewed. Historical data for the organization related to retention and turnover were examined. Based on the findings the team embarked on developing a residency program for novice nurses.
Description: A nursing team was formed led by a nurse educator to address the on-boarding of new nurses. A literature review was conducted related to Patricia Benner’s “Novice to Expert Nursing Theory” and the pros and cons of residency programs. The practice transition accreditation program (PTAP) accreditation by the ANCC guideline for nurse residency programs were reviewed and incorporated into the program. This accreditation sets the global standard for residency programs that transition registered nurses into new practice settings.
This program aligns with the mission and values of our organization. The program was designed as a 12-month foundational program offering support, education, and training to assist in the transition to a competent registered nurse. Completion of knowledge exams and confidence surveys are assigned throughout the program. Surveys are re-assigned at various times during the 12 months to evaluate the efficacy of the program and assist with seminar topics. The program involved classroom, simulation, and computer-based training. Sessions are facilitated by professional development director, clinical educators, or subject matter experts. During the 12-month residency, each nurse resident will complete and present an evidence-based project. Residents are encouraged to support quality indicators and other processes that can be improved when choosing topics for the evidence-based practice projects. Projects are presented during the completion ceremony at the end of the program.
Evaluation and outcomes: In 2020-2021, there are approximately 223 nurse residents enrolled in the program, of which 49 will be set to graduate the program in February and 45 in July 2021. This program has resulted in increased nurse retention and nurse satisfaction.