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.
One recent study found thatreadiness 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.
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.
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.
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