The North Texas Division (NTD) of HCA wanted to develop a comprehensive intern/residency program for Labor and Delivery nurses. The purpose of the residency is multi-faceted:  to ensure that new L&D nurses are educated using the newest information from EBP; to ensure that all of the L&D interns/residents in the NTD are taught the same material; to build a rapport amongst the residents/staff by providing monthly reflective learning opportunities to the residents to ease their transition into practice; to establish a cohesive curriculum that will decrease the amount of time each educator spends developing individual internships.

Proposed change:

The proposed change involves moving from a facility-specific orientation/internship, to developing a division-wide residency that addresses the complex needs of the new graduate. Instead of simply focusing on the didactic and skills that a new L&D RN will need, our residency will address the socialization needs of the new hire, and ease their transition into practice. In addition, the change to a division-wide residency allows the L&D educators from each facility to collaborate and develop an education plan that will be used by many hospitals.

Implementation, outcomes and evaluation:

The Chief Nursing Officers (CNOs) from the NTD were responsible for presenting the idea of a residency to the NTD. Once the internship/residency was approved, the Human Resources departments at each facility were responsible for posting the positions and screening the applicants. The Nurse Managers at each facility hired the interns/residents. The response to the residency was met with approval and great enthusiasm. Hundreds of applications were received, allowing each facility to choose exceptional candidates. In the future, we will measure overall satisfaction of the residents, as well as retention rates.

Implications for nursing practice:

By developing a comprehensive, cohesive internship/residency, we will enable the L&D nurses in our division to be exposed to the highest quality education possible. Implementing the reflective learning and socialization process will demonstrate to our residents the hospital system’s commitment to their personal and professional development. In developing a uniform residency across all of our division’s hospitals, we will ensure that all nurses will be exposed to the same level of education, which will facilitate sharing of competent employees.

Keywords: Residency, internship, socialization