As the new school year kicks in, nursing students everywhere are bracing themselves for another round of intense lectures, clinical rotations, hours of reading, skills lab, and study marathons.
Balancing coursework, long clinical hours, and possibly even a job or family responsibilities can make it feel like you barely have time to breathe, let alone think about what you’re eating. But trust me, as a family nurse practitioner who’s been through the grind of nursing school, I can tell you that what you eat can make or break your success. Your nutrition directly impacts your energy, focus, and overall performance, and those late-night snacks can be your best ally or your worst enemy.
The Common Food Challenges in Nursing School
“I don’t have time to eat healthy.” I totally get it -time is a luxury in nursing school. Between rushing from lectures to clinicals, squeezing in study sessions, and trying to maintain some sort of personal life, who has time to worry about healthy snacks? Grabbing something from the vending machine or drive-thru is all too easy. But those quick fixes usually leave you crashing when you need to be at your sharpest—like when you’re finally sitting down to write that care plan at midnight.
“Healthy snacks are expensive.” With student loans, cutting back work hours to study, and just the general costs of living, it’s easy to think that eating healthy is a luxury you can’t afford. But healthy eating doesn’t have to drain your bank account. There are plenty of budget-friendly, nutritious snacks if you know where to look. It’s all about planning ahead, just like you would for your patient care—because, honestly, isn’t that what you’d tell your patients?
“I need caffeine and sugar to keep me going.” I’ve been there—late nights and early mornings are practically a nursing school requirement. Reaching for that extra cup of coffee or energy drink and that sweet snack might seem like the only way to stay awake, but while caffeine and sugar give you a quick boost, they often lead to an energy crash that leaves you more tired. Over time, this cycle can lead to burnout—something no nursing student needs, especially with finals around the corner. Who wants to stay in fight or flight all the time?
When your schedule is jam-packed, the last thing you need is to worry about where your next meal is coming from. That’s why portable snacks are your best friend. Stock up on snacks that are easy to grab and go, like nuts, seeds, and dried fruits that don’t require refrigeration. Freeze-dried snacks like Crispy Green’s Crispy Fruit are lifesavers—they’re lightweight, easy to carry, and packed with natural nutrients, minus the added sugars and preservatives. Just toss a bag in your backpack, and you’re ready to tackle your day.
2. Balance Your Macros
Not all snacks are created equal. A well-balanced snack includes a mix of carbohydrates, protein, and healthy fats to keep you energized and satisfied longer. Try pairing Crispy Green’s freeze-dried fruit with a handful of almonds for a quick snack that covers your bases. Or mix Crispy Green fruit into your yogurt or trail mix for added crunch and flavor. You could add them to a protein smoothie for a tasty, nutritious boost.
3. Hydrate, Hydrate, Hydrate
It’s easy to mistake dehydration for hunger, and can really zap your energy and focus. Keep a water bottle with you at all times—extra points if you infuse it with lemon or cucumber slices for added flavor. Staying hydrated is one of the easiest ways to keep your mind sharp and your body functioning at its best. Besides, you’ll be educating your future patients on the importance of hydration—let’s lead by example.
4. Incorporate Brain-Boosting Foods
Nursing school demands a lot of brainpower. Certain foods can help give you that cognitive edge. Berries, dark chocolate, and nuts are all known for their brain-boosting properties. Keep a small bag of Crispy Green freeze-dried strawberries or a piece of dark chocolate in your pocket for those moments when you need an extra mental boost.
5. Listen to Your Body
It’s easy to ignore hunger when you’re in the middle of a clinical shift or deep into studying, but skipping meals or snacks can backfire, leading to overeating later or an energy dip when needed most. Keep healthy snacks within reach—whether it’s a bag of Crispy Green freeze-dried fruit in your pocket or some trail mix in your backpack—so you’re ready when hunger strikes.
Here’s My Snack Cheat Sheet for Busy Nursing Students
Nuts and Seeds: A mix of almonds, walnuts, and sunflower seeds makes for a satisfying, protein-rich snack.
Freeze-Dried Fruit: Crispy Green’s Crispy Fruit comes in delicious flavors like apple, mango, and pineapple—perfect for a sweet, crunchy snack on the go.
Greek Yogurt: Add a handful of granola and Crispy Green freeze-dried fruit for a tasty and nutritious treat.
Whole-Grain Crackers and Hummus: A savory option packed with protein and fiber to keep you full and focused.
Dark Chocolate: A small piece of dark chocolate satisfies your sweet tooth and has brain-boosting benefits.
Protein Smoothie: Mix some Crispy Green freeze-dried fruit into your protein shake for added flavor and nutrients.
Oatmeal with Crispy Fruit: For a fiber-rich breakfast, start your day with a bowl of oatmeal topped with Crisp Green fruit. Every once in a while, switch it up with bran cereal.
The Bottom Line
As you dive into another demanding academic year, remember that what you eat dramatically affects how well you perform. By planning ahead and choosing healthy and convenient snacks, you can keep your energy up, stay focused, and take on whatever nursing school throws your way. With some forethought and the right choices, you’ll fuel your success—now and in your future nursing career.
Summer is almost over, and with the end of one season comes the start of another—nursing school. For first-year nursing students, the first semester can seem daunting and overwhelming. New classes mean new changes, workloads, and a new beginning for an exciting career.
Some examples of responsibilities nursing students will have within their first year include classes on anatomy and physiology, pharmacology, and other fundamentals of nursing. Your classes can also include hands-on activities and a mix of labs and lectures. Clinicals will test your lab skills and will be the start of nursing basics like administering vitals, giving shots, and conducting full-body assessments.
Some nurses say that their first year of nursing school is the hardest. This isn’t necessarily because of the coursework but the transition into nursing while learning the ins and outs of properly taking care of a patient.
So, take care of yourself as you face this transition in your life. You’re on your way to becoming an actual nurse! As exciting as that sounds, it’s also scary because you never know what’s on the other side of all of the work you’re about to do.
Remember that learning nursing skills can take practice, and it’s easier for you to take time to learn the expertise needed on the job instead of expecting yourself to have it all figured out the first semester.
You’d be surprised at how many resources you have when looking around. Read the materials given to you on orientation day, or stop by your school’s student services to find more (free!) opportunities available to you as a student. You never know what you might find.
Taking the extra 10 minutes to read assignment instructions, the syllabus, or any other material you have can save you from asking additional questions at the end of the day.
Ask questions that feel “dumb.”
Yes, you’ve probably been told that there are no “dumb questions,” but when it comes to a patient’s well-being, it’s worth asking a question someone else might have, too.
If you feel anxious about doing this, practice asking questions to an advisor first, and then build confidence in larger rooms with multiple students.
Your instructors and advisors are there to help you succeed. Even if you think you might have asked a question that doesn’t make sense and embarrassed yourself, at least you know you’ve done it to avoid potentially hurting a future patient.
Strategies to help you stay organized and avoid missing deadlines include getting a calendar you can see daily and writing down upcoming deadlines. Another tip is to fill out a planner with all future assignments’ due dates and exams.
Find what self-care routines work for you.
Carving out time for self-care is as important as time spent learning. We all need breaks now and then, including nursing students who may think that time spent not studying is “wasting” time.
Good grades are essential, but they’re not everything. Designate space to refill your tank with activities away from school that make you feel good. This looks different for everyone, but some examples are exercising, getting enough sleep, or even something small like eating lunch with a friend.
Even though you’ll probably have strong emotions starting the new semester, know that this moment won’t last forever. The struggle of long nights studying will likely include making new connections with aspiring nurses who understand what you’re going through. Hang in there, and remember to be kind to yourself throughout your nursing journey.
Starting your career in nursing can be both exhilarating and overwhelming. You can finally use the skills you’ve developed over many years of school to help people, yet the responsibilities that come with care can be intimidating.
Rather than fretting about your first few months post-graduation, focus on getting off to a good start by nailing your applications. A well-crafted application will help you land a role in a healthcare setting of your choice and ensure you can pick from a range of potential employers.
Putting together a perfect application is critical now, as there are 193,100 projected nursing openings in the nation. This means that you should find a workplace that understands some of the common challenges you may face as a minority and newly qualified nurse.
Navigating the Nursing Shortage
The nursing shortage is at the forefront of most recent graduates’ minds. On the one hand, the high demand for nurses puts you in a powerful position to negotiate your contract and land a role in a city or town that suits your lifestyle. However, the shortage also means you must exercise increased caution when offered a job, as a better opportunity may be waiting.
It’s also worth noting that the staffing shortage may undermine your work experience when you enter the workforce. You may become overworked if you enter a chronically understaffed environment and need more nurses. This can be a serious issue as a recent graduate, as you need to build your network and find mentors in nursing who understand the pressures you may face as a minority in the area.
When interviewing prospective employers, ask them how they respond to the staff shortage in healthcare today. They should be able to answer any questions you have related to:
Compensation: A period of sustained inflation has put pressure on wages. Is the prospective employer offering competitive pay for the area, or are they still offering the same salary?
Workload: What steps does the employer take to manage the workload? How often do employees work overtime? What support exists for nurses who are burnt out?
Mentors: What mentorship program will you enter upon arrival? Are you adequately represented at the leadership/mentorship level?
Turnover: Is the employer experiencing heightened turnover? If so, what are they doing to counteract turnover?
Healthcare organizations should be able to answer these questions clearly if they’re serious about providing a healthy, professionally rewarding workplace. When listening to their responses, please pay attention to the steps they have taken to respond to shortages and consider pivoting away from organizations with high turnover rates, poor representation, and low compensation.
Specialization
Rather than jumping at the first opportunity offered to you as a new graduate, consider seeking employment at a healthcare organization that can help you pursue a specialization. Specializing as a nurse increases your salary potential and enables you to land more rewarding roles. Some of the best specializations in nursing today include:
These specializations command a high salary and are in demand currently. This puts you in a strong position to negotiate compensation and may lead to career opportunities that help you fulfill your professional goals. So, before you sign on the dotted line, find out whether or not your new employer is willing to help advance your nursing career through certifications and development opportunities.
Building an Application
Putting together a well-rounded professional application is crucial for a new graduate. Your first application packet will set you up for life and help you land a role with the salary, benefits, and responsibilities you’re looking for. However, building your first application post-graduation can be difficult if you’re unfamiliar with the process. Get the ball rolling by creating a job application process playbook to follow, which will include:
By utilizing the Minority Nurse job finder, you can filter your search to graduate opportunities and further refine your hunt for a great job.
Gather relevant personal information in a single folder, including your details, resume, cover letter, and transcripts.
Revise your resume to be brief and targeted to the specific opening you’re applying for. Further, refine your resume by summarizing your skills and experiences.
Redesign your resume using tools like Adobe Express to stand out.
Write a cover letter that introduces your skills and reflects your personality. Try to tell a story and focus on why you may see nursing as a vocation.
Create a creative portfolio that highlights your school achievements. This shows that you’re serious about your future and ready to enter the professional world.
Taking these steps will put you head and shoulders above the competition. It will also help you connect with employers ready to support you as a minority nurse. This can get you started on the right foot in your nursing career and help you connect with mentors who understand your challenges.
Conclusion
Crafting your nursing journey with care is crucial as a recent graduate. Rather than leaping into the first offer you receive, take some time to do your research and find an employer that can meet your needs. This will spark a period of career growth that will support you for years to come and help you hit the ground running as you enter the professional world of healthcare.
Exposure to traumatic stress can have a life-altering negative impact on student nurses. Traumatic stress can challenge effective coping, emotional regulation, and the ability to focus, retain, and recall nursing concepts. According to the Substance Abuse and Mental Health Services Administration (SAMHSA, 2014), the “3 E” conceptualization of trauma are Event (single or cumulative), Experience (neglect, abuse, betrayal), and Effects (anxiety, loneliness, depression, feeling unsafe ) are manifested in various ways in people with exposure to trauma.
An individualized student-centered approach is crucial in understanding and adapting teaching pedagogy in nursing education to realize, recognize, respond, and resist re-traumatization (SAMHSA, 2014)in student nurses with a history of traumatic stress.
This article discusses the concept of trauma-informed pedagogy in nursing education and its significance in promoting equity and inclusion. Trauma-informed pedagogy suggests that past experiences can negatively impact health outcomes and learning (Garfin D. R. et al., 2018). As a result, educators must be able to identify signs of trauma and adapt their teaching methods to meet their students’ unique needs. It discusses the impact of trauma on nursing students’ physical and mental health functioning, and it then delves into implementing principles of trauma-informed pedagogy in the classroom.
Background/Significance
Trauma is defined as an event or set of circumstances that an individual experiences as physically or emotionally harmful or threatening, resulting in lasting adverse effects on their functioning and well-being (Bremner, J. D. 2006). College students, despite their excitement to succeed, often experience severe psychological distress, with 70% reporting such distress. Additionally, 35% of students were diagnosed with anxiety, and 29% had depression (American College Health Association, 2022).
Transgender and LGBTQIA students report higher levels of mental health issues than their straight counterparts. Microaggressions are also experienced by underrepresented students, creating a sense of unsafety on campus. Evidence suggests that Colleges should pivot to a learning space that promotes inclusion and equity. Only 40% of college students think colleges are doing enough to support mental health (Veneable, M.A., & Pietrucha, M. E., 2022).
The Universal Design for Learning ( UDL) recognizes that every student has different learning needs, and a one-size-fits-all approach is an ineffective instructional strategy. Similarly, implementing trauma-informed pedagogy principles within the nursing curriculum is a significant step toward meeting every student’s learning needs and experiences, promoting accessibility, equity, and inclusion in nursing education.
How Traumatic Stress Affects the Brain
Traumatic experiences can affect the brain’s development, structure, and function. It is critical to understand normal brain development to distinguish brain abnormalities. The areas of the brain responsible for stress responses are the amygdala, hippocampus, and pre-frontal cortex (Bremner, J. D., 2006). When an individual is exposed to traumatic stress, there is an increase in the level of cortisol and norepinephrine. Repeated exposure to stress increases the level of cortisol and norepinephrine and affects normal brain functioning and stress regulation, resulting in pathophysiological change(Bremner, J. D. 2006).
Students who are affected by traumatic stress may have difficulty learning concepts, focusing, and retaining information, resulting in course failures and higher attrition rates compared to their peers who have not experienced trauma. Traumatic experiences can cause anxiety and depression in some students. Past and current data suggest that trauma-informed care is critical for the promotion of equity in people with a history of trauma (Han et al., 2021).
Students’ sense of safety is disrupted, and the cumulative effects are difficulty adjusting to college experience, low grades, and high attrition rates. According to (Corello J., 2018), educators should adopt trauma-informed teaching and be compassionate and consistent in the learning environment. Despite the impact traumatic experience has on the brain, there is hope and possibility for students to be successful.
Implications for Nurse Educators
In the Four “Rs in the Trauma-informed approach to teaching student nurses(SMASHA, 2014), the nurse educator must convey empathy, possibilities, and hope to student nurses and focus on “what happened to you, instead of what is wrong with you’. Implementing trauma-informed principles is an issue of equity and inclusion and must be viewed through the lens of disability.
Realization
Research suggests that 66%-85% of youth report exposure to traumatic events by the time they enter college (Read et al., 2011). Additionally, approximately three-quarters of college students, 77 %, experienced moderate to severe psychological distress (ACHA, 2022). Understanding that traumatic experiences can affect the development, structure, and function of the brain, the nurse educator must acknowledge that trauma happened and provide a trusting teaching environment that emphasizes hope and transformation.
Realizing that trauma affects the student’s ability to function optimally, the nurse educator must stay involved in world events that may be traumatic to students: for instance, racism, disability, COVID-19, sexism, sexual harassment, and sexual orientation. Modeling emotional intelligence skills, self-reflection, and situational awareness, the nurse educator can convey trust and transparency when discussing and understanding sensitive topics in the classroom.
Recognize
The nursing process is a framework taught in nursing education to provide care for diverse populations. It begins with an assessment. Likewise, the nurse educator must be able to recognize signs of traumatic stress and respond with empathy, kindness, and understanding. Some signs and symptoms are difficulty focusing on a topic, lack of engagement, absenteeism, anxiety, low grades, and difficulty adjusting to the college environment.
It is essential to acknowledge that the traumatic event happened, and an evidence-based action plan is activated to promote healing and agency to enhance academic success. The nurse educator must be knowledgeable about topics or events that may trigger traumatic stress and develop a lesson plan or teaching strategies to avoid triggers—for instance, disparities in healthcare outcomes for minorities. Nurse educators must adopt several strategies to effectively support students’ learning experiences in teaching sensitive topics. To this end, the nurse educator should consider the value of establishing eye contact with students and facilitating opportunities for them to share their lived experiences. The nurse educator must also demonstrate a genuine interest in the student experience. By applying these strategies, nurse educators can foster an environment that supports students’ learning journey and promotes their well-being.
Respond
When a student goes through a traumatic experience, their sense of safety can be severely affected. As a nurse educator, it is essential to demonstrate emotional intelligence while conversing with such students regarding traumatic stress. Using the student’s name and giving them enough time to contemplate and respond is crucial. In addition, the nurse educator should offer their presence to show kindness and compassion, which can provide comfort and support for the student.
As a nurse faculty member, you can support your student’s academic journey by referring them to the Office of Accessibility and Disability. The office provides essential services to students with disabilities, ensuring they have the resources to succeed in their studies. Letting your students know you are available for office hours and phone calls is essential, as this can help them feel more comfortable and supported.
Creating a respectful and inclusive learning environment is crucial to the success of all students. You can do this by promoting a culture of civility and respect in your classroom and being mindful of your students’ diverse needs. If a student is experiencing anxiety or stress, consider extending assignment due dates to help alleviate their concerns.
Finally, it is essential to recognize that some students may have a history of trauma that could impact their ability to learn. To increase the accessibility and inclusion of these students, incorporate multiple teaching modalities that address the cognitive, psychomotor, and affective domains of learning. Doing so can help ensure that all your students can succeed.
Resist re-traumatization
In a nursing education culture that prioritizes diversity, equity, and inclusion, it is essential to recognize that some college students may have experienced trauma. By intentionally incorporating transformative, trauma-informed practices into nursing education, we can foster a sense of human dignity, promote academic growth, and help students thrive. To prevent re-traumatization, faculty and peers must have zero tolerance for discrimination against students. The learning environment must prioritize civility, human caring, compassion, and consistency (Corello, 2018) while avoiding punitive measures and implementing clear policies and procedures. Sensitive topics should be approached with empathy and understanding, and training modules focused on trauma and its effects can help create awareness and build a strong sense of community.
Conclusion
Integrating trauma-informed practices into nursing education requires comprehensive changes across multiple levels, from micro to macro systems. At the micro level, nurse faculty must demonstrate empathy, benevolence, courtesy, and honor towards individuals who have survived trauma. They must also remain watchful in recognizing, validating, and averting re-traumatization for student nurses who have experienced trauma. By nurturing a learning environment that fosters personal development and transformation, faculty and students can collaborate to establish a warm and accommodating community open to everyone.
References:
1. American College Health Association -National College Health. (2022). Assessment III: Undergraduate Student Reference Group Executive Summary Spring 2022. Silver Spring, MD: American College Health Association.
2. Bremer, J. D. (2006). Traumatic stress: effects on the brain. Dialogues in Clinical Neuroscience, 8(4), 445-61.
3. Carello, J. & Thompson, P. (Eds). (2021). Lessons from the pandemic: Trauma-informed approaches to college, crisis, change. Palgrave Macmillan.
4. Garfin, D. R., Thompson, R. R., & Holman, E. A. (2018). Acute stress and subsequent health outcomes: A systematic review. Journal of Psychosomatic Research, 112, 107-113. doi: 10.1016/j.jpsychores.2018.05.017
6. Han, H. R., Miller, H. N., Nkimbeng, M., Budhathoki, C., Mikhael, T., Rivers, E., Gray, J., Trimble, K., Chow, S., Wilson, P. (2021). Trauma-informed interventions: A systematic review. PLoS One, 16(6), e0253209. Doi: 10.1371/journal.pone.0253209
7. Kubala, J. (2020). Of Trauma and Triggers: Pedagogy and Affective Circulations in Feminist Formations, 32(2), 183-206.
8. Read, J. P., Wardell, J. D., Vermont, L. N., Colder, Ouimette, P., & White, J. (2012). Transition and change: Prospective effects of posttraumatic stress on smoking trajectories in the first year of college. Health Psychology, 32(7), 757-767.
9. SAMHSA’s concept of trauma and guidance for a trauma-informed approach. (2014). HHS Publication No. (SMA) 14-4884. Substance Abuse and Mental Health Services Administration, Rockville, MD.
10. Veneable , M. A., & Pietrucha, M,E. (2022). 2022 College Mental Health Report, Best Colleges.
Recent nursing school graduates account for the highest number of registered nurses available for recruitment in U.S. hospitals. Yet, they leave the profession at a higher rate than long-term nurses. Many become stressed when they find themselves unprepared for the realities of clinical practice. Many experience additional stresses if they have relocated to a city without friends, are unfamiliar with the local culture, and need more time to explore their new surroundings.
How a Residency Program Can Help Early Career Nurses
. Since then, despite the hospital’s efforts, nurses have been experiencing the same fatigue phenomenon seen at hospitals nationwide.
As a result, St. Jude invited its nurses to reimagine and reenergize the institution’s Nurse Residency Program (NRP), created in 2012 and focused on inpatient pediatric oncology. During its review, a planning team identified barriers to recruiting and retaining new graduate nurses.
The redesigned program, accredited as a practice transition program by the American Nurses Credentialing Center (ANCC), now onboards each resident into a generic graduate nurse role. This shortens delays in licensure, kickstarts their professional development, and helps the new nurses build friendships within their cohort from day one. Following onboarding, the residents participate in a week of NCLEX study preparations, which has resulted in pass rates well above state and national benchmarks.
Clinical Rotations
To ensure that residents find specialties that appeal to them, St. Jude created clinical rotations similar to those employed in medical school. Residents spend 6 weeks in clinical rotations, spending shifts in 12 to 40 patient care areas: inpatient, outpatient, surgical services, and ICU. These rotations introduce the nurse residents to the continuum of care at St. Jude, build relationships across the organization, and allow residents to see all the potential nursing opportunities.
After the clinical rotations, the new nurses are matched to a home unit using the National Resident Matching Program’s algorithm. The entire St. Jude nursing family meets the new team members on Match Day.
Afterward, nurse residents receive a unit-based orientation and complete a 12-month-long curriculum that brings the cohort together for monthly sessions of didactic lessons, simulation, and various activities to assist with transitioning from novice to competent nurse.
Growth of the Whole Nurse
Traditional simulations have been replaced with immersive experiences. NRP leaders built a curriculum that provides growth for the whole nurse, even outside work. Nurse residents learn patient assessment and emergency response skills while consulting with personal finance and wellness experts.
For many new nurses, the workplace isn’t a problem. Nurses relocating from other cities experience a disconnection from unfamiliar local cultures and social life. With a sizable percentage of out-of-state nurses joining St. Jude, the NRP team organizes regular social outings to tour Memphis’ cultural and entertainment venues. The new nurses also participate in community service projects to “pay it forward” and contribute to positive growth within their new environments.
Program Results
The revised program has successfully onboarded three groups of new nurses, bringing more than 60 nurses to the bedside with 100% retention of every cohort after one year, far exceeding the national retention benchmark. Changes to the hiring process allowed for earlier onboarding of high-quality candidates and an increase in cohort size, filling over 90% of RN vacancies with each cycle and allowing expansion into the surgical and ambulatory nursing divisions.
But the support for its residents continues. After the nurse residents graduate from the program, they transition into a mentor program where they obtain support from a senior nurse to help guide them through their second year of professional practice.
A welcome benefit of the revised NRP is the increased diversity within each cohort, bringing critical multilingual skills and new cultural perspectives to St. Jude.
This highly skilled, diverse, and, importantly, satisfied nursing workforce is vital to the St. Jude mission of providing top-flight clinical care while advancing cures and means of prevention for pediatric catastrophic diseases through research and treatment.
Read the January issue of Minority Nurse focusing on RN-to-BSN and Nurse Residency Programs here.
As in most things, getting off to a good start as a nurse can help ensure a long, successful, and satisfying career. With nursing shortages and nurse burnout still taking a tremendous toll on the profession, hospitals must do all they can to ensure new nurses have the tools to succeed.
Organizations help ensure success for new nurses through nurse residency programs, also called transition to practice or new grad programs. These structured learning experiences can be of great benefit.
readiness for practice improved significantly for nurse residents, as did nurse retention perceptions, indicating that nurse residents were more likely to be retained at the study organization. The 1- and 2-year nurse retention rates during the 3 years of the study showed notable improvement.
In this article, we’ll offer specific suggestions on what to look for in a nurse residency program so that you can find a good fit. But first, let’s look at when you should start investigating those programs.
Start Early
To discover if a nurse residency program is right for you, don’t wait until you pass your licensure exam. “Waiting until they pass their NCLEX many times is too late,” says Sheri Cosme DNP, RN, NPD-BC, director, Practice Transition Accreditation Program (PTAP), Advanced Practice Provider Fellowship Accreditation, American Nurses Credentialing Center (ANCC).
Nursing students should “use the time that they’re in school to start identifying those organizations that they want to work at sooner rather than later,” notes Cosme. Many programs start only two to three cohorts a year, so they have very specific recruitment timelines for when they accept applications from new graduate nurses, she says. “My biggest piece of advice to a new graduate nurse is not to miss that window.”
Cosme says to take advantage of your time at your clinical rotations and interview the facility. “That’s going to give them a good sense of what the organization is all about.”
In addition, Cosme suggests checking social media to learn what nurses say about the organization. Also, reach out to employees. You might also ask to speak to a nurse who has recently completed the program to find out how they balanced class time with working off-shifts, suggests Sara R. Grieshop, MHI, BSN, RN, practice excellence supervisor, American Association of Critical-Care Nurses. “Don’t hesitate to interview the programs as much as they are interviewing you,” notes Grieshop.
Make sure, says Cosme, that the organization has a specific plan in place for the program. For instance, the organization should tell you how much time you will spend with a preceptor or the milestones you need to hit to reach full competence.
What to Look for in a Nurse Residency Program
As you research nurse residency programs, consider the following areas:
Accreditation. Find out if the nurse residency program carries accreditation. As of mid-November 2023, some 250 programs in 831 healthcare sites were part of the ANCC Practice Transition Accreditation Program.
Accreditation helps ensure that programs provide a rich educational experience. “Accreditation validates that the programs are consistently following evidence-based standards that support nurses in their transition to nursing practice,” according to Christine Young, MSN, MBA, RN, NEA-BC, DNP, chief of hospital-based services and chief nursing officer, Akron Children’s Hospital.
Length of time. Cosme says a nurse residency program will run between 6 and 12 months. “A majority of the time, the programming is front-loaded,” she notes so that during the first part of the program, the nurse gets more concentrated professional development and support.
Seek programs that provide at least 6 to 12 months of program support and a preceptorship, which will help you acclimate to your intended specialty with a structured orientation and clinical training at the bedside, suggests Laura Douglas, MSN-Ed, RN, NPD-BC, CCRN-K, manager of the transition to practice programs (nurse residency, fellowship, and respiratory residency) at Memorial Hermann Health System.
While clinical orientation may last only 3 to 6 months, depending on specialty, a residency program supports the new graduate first through orientation, then through the initial phases of independent practice for up to a year, according to Young. Support into the second year is also ideal, she notes.
The nurse residency program should provide opportunities for participant feedback and evaluation, including regularly scheduled formal meetings to examine strengths and areas for growth, as well as provisions for individual self-assessment/self-reflection, according to Karen T. Pardue, PhD, RN, CNE, FNAP, ANEF, associate provost for strategic initiatives and professor, School of Nursing and Population Health, University of New England. Also, the program should dedicate attention to activities and interactions that build a sense of community and provide peer support, heightening the new employee’s sense of connection and belonging, she suggests.
Preceptorship. It would help if you were working with a preceptor, and ideally, one or two preceptors through the orientation phase of your residency program, notes Cosme. You should also check if you will have a mentor. While those two roles intersect, they provide different support, notes Young. The mentor, Young notes, could be a previous nurse resident who remembers what it was like to be a new grad in the specialty area they are working in and is willing to connect with the new nurse regularly to offer support, identify resources, and so on. The preceptor must evaluate the new nurse’s ability to demonstrate competency in practice and provide feedback during orientation.
Specialty experience. Determine if the nurse residency program will provide education in your specialty area, notes Cosme. If you’re unsure which unit is best for you, look for a residency program that allows you to work in various units, notes Grieshop. “This will allow you to broaden your horizons beyond what your clinical hours achieved,” she notes.
Never-Ending Learning
Nurses in a residency program, notes Cosme, should “be a sponge, soak it all up, wring themselves out, and soak up even more because they will be learning in nursing every day. I think the biggest blessing in healthcare is that things are constantly changing. We’re always learning.”
Read the January issue of Minority Nurse focusing on RN-to-BSN and Nurse Residency Programs here.
