Implementation of a Nurse Residency Program in a Women and Newborn's Specialty Hospital: A Magical Transformation

Purpose for the program: Hospitals across the nation are being challenged to meet the increasingly demanding learning needs of new nurses and support their transition to professional practice. Recommendations from the Institute of Medicine underscore the importance of nurse residency programs to help manage the transition from school to professional practice and help new graduates further develop the skills needed to deliver safe, quality patient care. Literature supports that nurse residency programs facilitate the successful integration of nurses into the work environment, enhance the overall experience, and increase retention. While nurse residency programs historically have been supported in large healthcare systems, they focus primarily on acute care. The purpose of this program was to develop a robust nurse residency program in a community specialty hospital for women and newborns by incorporating elements of exemplary nurse residency programs.

Proposed change:  The goal of the program was to move from independent unit-based hiring to an integrated, structured, hospital-wide Nurse Residency Program. While hiring would continue to be unit/specialty specific, coordination among the units would allow for hiring residents into cohorts to promote teamwork and collaboration and provide the group with much needed emotional support. 

Implementation, outcomes and evaluation:  Implementation of the program included structures and processes of evidence based nursing strategies for effective integration of knowledge, skill development, and retention. For effective integration of knowledge, an emphasis was placed on reflective practice in the form of journaling and round table discussion which facilitated learning and increased feelings of empowerment. Skill development included on-going educational meetings that provided the framework for expanded curriculum to bridge the gap between nursing school and professional practice as well as expanded looping rotations which fostered interprofessional collaboration to enhance the continuity of care. Formal mentoring partnerships positively impacted retention by promoting social integration, sense of belonging, and increased confidence. Finally the celebration of key milestones included a residency graduation which validated success, promoted pride, and renewed energy not only for the residents but for the experienced staff who contributed to their achievements. Outcome measures include increase nurse retention by focusing on a low nurse turnover of less than 5%. Qualitatively, nurse residents reported an enhanced sense of accomplishment and satisfaction. Nurse resident feedback, evaluations of programs and experiences provided essential information for continual evaluation and program improvement.

Implications for nursing practice: The innovative structures and processes of the Nurse Residency Program grants new nurses the essential knowledge, skills, and abilities needed for successful transition to professional practice in the delivery of quality patient care.

Keywords: nurse residency program