By: Frankye Myers, Chief Nurse Executive
Amid an increasing demand for nursing care, today’s healthcare organizations are facing challenges in sustaining a pipeline of high-performing, experienced nurses. As high percentages of newly licensed registered nurses (RNs) retire, combined with a turnover rate of recent graduates in their first positions, a pressing need for health systems to provide enhanced support for new nurses as they start their careers has been highlighted.
Of first-time nurses, a 2019 article published in the Journal of Nursing Practice Applications & Reviews of Research pointed out, “This role acquisition represents both a time of elevated stress for the new nurse in acquiring experience to match textbook knowledge and a period of increased financial burden on the hospital in orienting new employees.”
Research has clearly shown that nurse residency programs (NRPs) that provide additional education, experience and support are an effective solution to these challenges, resulting in increased retention, job satisfaction, collaboration and confidence in clinical decision making, as well as improved patient care and decreased hiring and training costs. A case study featured in a 2022 Nursing Administration Quarterly article demonstrated that “the cost of implementing a yearlong nurse residency program is offset more than 300% by the reduced turnover.”
At Riverside, we’ve found great success in strengthening our nursing team over the last six years by offering a nurse residency program to aid our newest nurses in the transition from academia to practice. The evidence-based curriculum that we use, developed jointly by VizientTM and the American Association of Colleges of Nursing, fosters leadership, professional development, networking, communication, wellbeing and quality care. New-nurse retention rates of organizations utilizing this NRP are 75.9 percent — roughly 20 percent higher than national benchmarks. Riverside’s retention rate is even higher still, at 81.9 percent.
Since our residency’s inception in 2017, 539 nurses have graduated from the program. In all hospitals across Riverside Health, the NRP is required for full-time and part-time acute-care RNs with less than one year of hospital-setting experience, with new cohorts beginning four times a year. Future goals include plans to offer a transition-to-practice program for licensed practical nurses and obtain program accreditation.
Over a 12-month period, Riverside nurse residents take part in classroom learning, simulation lab practice, case studies, small group discussions and precepted clinical practice. During monthly seminars, they are introduced to interprofessional practice and given the opportunity to interact with leaders from varied disciplines across the health system. Clinical reflections provide an opportunity for peer-to-peer support and camaraderie. Upon completing the program, all nurse residents deliver a poster presentation, while the top 25 percent deliver a podium presentation.
A special highlight of the program is that each resident implements an evidence-based practice initiative (EBPI) within their unit, either independently or by working together. This provides a hands-on opportunity to improve the care of our patients and team members in proven ways not previously applied at Riverside. Our 2023 Nurse Resident graduates alone completed 46 EBPIs.
It’s been exciting to see many of these initiatives over the last six years applied across divisions, hospitals and even our entire health system. For example, our 2023 system-wide implementation of the Purple Flower Project for care for those living with dementia had its origins as an NRP EBPI from Cohort 8 at Riverside Doctors’ Hospital Williamsburg. The NRP is not only supporting, developing and retaining new RNs, but it’s also allowing these front-line team members to successfully lead the charge in identifying and addressing opportunities to improve practice at large.
Post-session surveys and feedback from Riverside’s NRP graduates have been overwhelmingly positive, and many residents have gone on to advance their careers. “Since completing nurse residency, I have obtained my BSN and Clinical Ladder III, and I became certified as a maternal newborn nurse”, says Brittany Snapp, RN, BSN, a graduate of Cohort 7. “The nurse residency program has given me the tools to provide my patients with the best possible care. It has empowered me to become an active team member, serve on many councils and build strong working relationships with people outside of my direct team. Most importantly, the NRP showed me how much nurses can impact current practice through the implementation of evidence-based practice projects”.
As our twentieth cohort of nurse residents begins the program this spring, they are well on their way to becoming equipped to succeed in their roles, invested in the rewarding profession of nursing and poised to confidently care for their patients for many years ahead.