The Attributes of Nurse Residency Programs Influencing the Newly Licensed Registered Nurse

The Attributes of Nurse Residency Programs Influencing the Newly Licensed Registered Nurse
Author: Christina Louise Kiger
Publisher:
Total Pages: 260
Release: 2020
Genre:
ISBN:

New nurses report feeling unprepared, incompetent, and highly stressed, contributing to first-year turnover rates of 25% in some healthcare organizations. Turnover, combined with a preparation-practice gap, has alerted advocacy organizations and researchers to recommend the development of nurse residency programs. Nurse residency programs are a post-graduate training period where new nurses receive enhanced clinical education in the healthcare setting. While highly variable in structure and attributes, programs usually include educational sessions, clinical immersion, and role socialization opportunities. Evidence supports that new nurses participating in nurse residency programs experience positive outcomes, including increased confidence, competence, and decreased turnover rates. Despite this, only half of the hospitals nationwide have implemented a program with most designed around a single health system mission. This dissertation study aimed to identify the attributes of nurse residency programs influencing the newly licensed registered nurse. An integrative review of the literature and evolutionary concept analysis was completed to examine the state of the science of nurse residency programs. Findings revealed a lack of conceptual and theoretical design and variability among program structures, creating a gap in the literature about the attributes of programs that are most influencing new nurses. Based on the literature's noted gaps, a qualitative description study was conducted. Purposive sampling strategies were used to recruit nurses who recently completed varied program models across the United States. New nurses reported the attributes of programs and described how those positively and negatively influenced the transition to practice experience. The overarching themes revealed that new nurses need a cadre of highly supportive individuals across the clinical and educational continuum who espouse astute interpersonal and communication skills. New nurses desire engaging activities with intra and interprofessional team members for clinical skill application, knowledge advancement, and role socialization. New nurses need the structure of meetings at times and in a sequence conducive to learning; and for preceptorship experiences to be facilitated by trained preceptors, on a unit, and of a length that supports confidence for autonomous practice. Future research will include the development and testing of an evaluation tool based on the findings from this study.

Conceptualization of Factors that Have Meaning for Newly Licensed Registered Nurses Completing Nurse Residency Programs in Acute Care Settings

Conceptualization of Factors that Have Meaning for Newly Licensed Registered Nurses Completing Nurse Residency Programs in Acute Care Settings
Author: Beverly Dianne Rowland
Publisher:
Total Pages: 382
Release: 2016
Genre:
ISBN:

Nurse residency programs (NRPs) have been identified as a means to promote transitioning of new nurses into the professional nursing role. Questions have arisen related to which elements within those programs are most meaningful to the development of new nurses. As the nursing shortage drives the need for quick transition and development of nurses to meet workforce needs, nursing must identify what is meaningful to nurses in their transition to practice. The purpose of this multi-site study was to explicate meaning from the experiences of newly licensed registered nurses (NLRNs) who have just completed NRPs. The research question was "What factors have meaning for NLRNs who have experienced transition to practice in nurse residency programs in acute care settings?" Semi-structured interviews were used to collect data from six NLRNs from three different NRPs after completion of their programs. Using interpretative phenomenological analysis, themes and variations within those themes were derived from the descriptive narratives provided from participant interviews. Overarching themes identified were Relationships, Reflection, Active Learning, Resources and Organizational Systems. Findings have implications for practice and education as the nursing profession strives to find ways to transform nurses in an effective and efficient manner.

What are the Essential Components of Nurse Residency Programs that Contribute to Positive Outcomes for Newly Licensed Registered Nurses in Their Transition Into Professional Practice During Their First Year of Practice?

What are the Essential Components of Nurse Residency Programs that Contribute to Positive Outcomes for Newly Licensed Registered Nurses in Their Transition Into Professional Practice During Their First Year of Practice?
Author: Abbey Fritschler
Publisher:
Total Pages: 57
Release: 2013
Genre: Nurses
ISBN:

Nurse residency programs are evidenced based structures and processes that support newly licensed nurses' successful transition from student to professional nurse during the first year of practice. Nurse residency programs are endorsed by the American Association of Colleges of Nursing (AACN), the National League for Nursing (NLN), and the Institute of Medicine (IOM). The purpose of this literature review is to identify the essential components of successful nurse residency programs and associated nurse outcomes post completion. The review identified the five essential program components that lead to positive outcomes of increased retention, competency, and job satisfaction. The five essentials are a nurturing learning environment, supportive leadership, having a mentor or preceptor, peer support systems, and an increase in clinical time for skill mastery. Implications for nursing education and recommendation re presented.

The Future of Nursing

The Future of Nursing
Author: Institute of Medicine
Publisher: National Academies Press
Total Pages: 700
Release: 2011-02-08
Genre: Medical
ISBN: 0309208955

The Future of Nursing explores how nurses' roles, responsibilities, and education should change significantly to meet the increased demand for care that will be created by health care reform and to advance improvements in America's increasingly complex health system. At more than 3 million in number, nurses make up the single largest segment of the health care work force. They also spend the greatest amount of time in delivering patient care as a profession. Nurses therefore have valuable insights and unique abilities to contribute as partners with other health care professionals in improving the quality and safety of care as envisioned in the Affordable Care Act (ACA) enacted this year. Nurses should be fully engaged with other health professionals and assume leadership roles in redesigning care in the United States. To ensure its members are well-prepared, the profession should institute residency training for nurses, increase the percentage of nurses who attain a bachelor's degree to 80 percent by 2020, and double the number who pursue doctorates. Furthermore, regulatory and institutional obstacles-including limits on nurses' scope of practice-should be removed so that the health system can reap the full benefit of nurses' training, skills, and knowledge in patient care. In this book, the Institute of Medicine makes recommendations for an action-oriented blueprint for the future of nursing.

Outcome Comparison of an Evidence-based Nurse Residency Program to Other Orientation Models

Outcome Comparison of an Evidence-based Nurse Residency Program to Other Orientation Models
Author: Debra A. Harrison
Publisher:
Total Pages:
Release: 2012
Genre: Employee retention
ISBN:

The purpose of this evidence-based project was to compare one-year outcomes for newly licensed Registered Nurses (NLRNs) in three organizations within the same healthcare system. All three have lower than nationally reported turnover and strategies for NLRN retention. Only one is using a Nurse Residency Program (NRP). NRPs are recognized as an effective strategy to retain newly licensed registered nurses (NLRNs) in their first year of employment (Institute of Medicine [IOM], 2010; The Advisory Board, 2007; Spector, 2007). The Commission on Collegiate Nursing Education (CCNE) (2008) defines an NRP as a series of learning sessions and work experiences that occur continuously over a 12-month period designed to assist NLRNs as they transition into their first professional nursing role. This cross-sectional, descriptive study utilized the Casey-Fink Graduate Nurse Experience Survey and intent to stay questions to collect data on NLRNs at one year post hire. Results indicated no statistically significant differences between the three sites and the subscales of the survey. There was a trend of a more positive score for professional satisfaction with Site A. Turnover was also similar between sites and lower than the reported 10% average, with Site A at 2%, Site B at 5%, and Site C at 4%. There was a statistically significant difference between Site A and C in the intent to stay in their current position, with Site A longer than Site C. The study supports the literature and evidence that a NRP is an effective strategy to decrease first year turnover. Further study is needed related to the effectiveness of the components of the NRP, length of time for mentorship, and the impact of accumulation of cohorts.

Transforming the Journey for Newly Licensed Registered Nurses: A Community Based Transition-to-Practice Program in Ambulatory Care Settings

Transforming the Journey for Newly Licensed Registered Nurses: A Community Based Transition-to-Practice Program in Ambulatory Care Settings
Author: Cathryn A Halford (DNP)
Publisher:
Total Pages:
Release: 2013
Genre:
ISBN:

Abstract In response to the job shortage for newly licensed registered nurses (RNs), transition to practice and residency programs have been established in many areas of the country including the San Francisco Bay Area. The programs were designed as demonstration projects to assist new graduates by increasing their competence, confidence, and skills, and their employability. Evidence from new graduate programs suggests that the programs provide an important bridge that is necessary for the critical transition from classroom to clinical practice and from newly licensed RN to qualified nursing professional. The University of San Francisco (USF) Transition-To-Practice (nurse residency) program in ambulatory care described in this manuscript was developed and implemented as an innovative and alternative approach to traditional residency programs that has proven successful in increasing the employability of new RN graduates. The program provides a strategy that will enhance newly licensed nurses transition from the academic environment to the professional environment. Transition-to-practice (nurse residency programs) reflect an organizational commitment to support new nurses as they mature into competent professionals. The recent Institute of Medicine report, The Future of Nursing: Leading Change, Advancing Health (2010) predicts that in the near future nursing care will be provided less in traditional hospital settings and will instead occur in the community. Therefore it is important to expand transition programs outside of the acute care setting. Community based programs will prepare new nurses for successful practice in ambulatory care settings who will then be ready for the expected transformation of nuring care into the community. The benefits of transition-to-practice (nurse residency) programs include newly licensed RNs who will gain valuable experience in community settings and improved patient care that is an important investment in the future of healthcare.

Implementing a Nurse Residency Transition to Practice Program at a Veterans Hospital

Implementing a Nurse Residency Transition to Practice Program at a Veterans Hospital
Author: Marcia Lysaght
Publisher:
Total Pages:
Release: 2018
Genre:
ISBN:

Newly licensed registered nurses enter the workforce unprepared to transition to practice and are expected to perform competently in highly complex healthcare settings. Gaps between the student role and practice, result in newly licensed registered nurses feeling ill prepared to transition to practice, leading to high turnover rates. Transition to practice programs assist the newly licensed registered nurse to adapt to the practice setting and develop competence and confidence. Evidence supports the benefits of these program, but there are significant variations in length and pedagogy. A Post Baccalaureate Nurse Residency Program one year in length, modeled after the Commission on Collegiate Nursing Education entry-to-practice nurse residency program, implemented at a large, complex, integrated federal healthcare system. Online surveys to current and former participants of a nurse residency program from 2015 -2017, to assess competence and confidence level, job satisfaction, retention, and assessment of program components and effectiveness. Findings from participants of a 1-year post-baccalaureate nurse residency program revealed significant improvement in competence and confidence scores, increased job satisfaction, and 100 percent remained employed at the medical center one year after program completion. Nurse residency programs have shown to be effective in newly licensed registered nurses transitioning to practice, and positively impacts, job satisfaction, competence, confidence in practice, and retention.

Nurse Residency Program Builder

Nurse Residency Program Builder
Author: Jim Hansen
Publisher: HC Pro, Inc.
Total Pages: 187
Release: 2011-04-26
Genre: Medical
ISBN: 1601468199

In this comprehensive resource, nursing staff development expert Jim Hansen, MSN, RN-BC, provides instruction and tools to plan, justify, and structure a nurse residency program that develops and retains new nurses through their first year

A Retrospective Study of a Nurse Residency Program and Reports of Job Satisfaction, Organizational Commitment, and Turnover

A Retrospective Study of a Nurse Residency Program and Reports of Job Satisfaction, Organizational Commitment, and Turnover
Author: Kenneth Walter Dion
Publisher:
Total Pages: 394
Release: 2011
Genre:
ISBN:

The aging population in the United States and greater access to healthcare due to recent legislative reforms will result in an increased demand for registered nurses. However, meeting this demand will challenge healthcare organizations due to an aging nursing workforce that will be retiring, a lack of new nurses entering the profession due to lack of employment opportunities related to the current macro-economic environment, and the lack of capacity to produce nursing graduates. Furthermore, reported turnover rates of newly graduated registered nurses range from 18 to 60% during the first year of employment. Healthcare organizations implementing structured nurse residency programs have reported success in stemming the tide of new graduate turnover. However, there is a lack of empirical evidence in the nurse residency literature regarding variables that have been shown to decrease turnover of registered nurses. The purpose of this study was to examine the outcome variables of job satisfaction, organizational commitment, and turnover among newly graduated nurse residents in Magnet, Magnet Aspiring, and Non-Magnet Hospital work environments across the US. A descriptive correlational retrospective secondary analysis was completed examining the outcome variables in a sample of 628 newly graduated nurses completing a structured nurse residency program between January 1, 2007 and December 31st, 2009 in general acute care hospitals. The findings from this study demonstrated the difference between job satisfaction at two months, six months, and 12 months among nurse residents in the different work environments. Furthermore, the influence of the residency program on organizational commitment in the context of differing work environments is reported. Moreover, turnover rates following the completion of the nurse residency were found to be lower than the national average for newly graduated nurses. Finally, the relationships between the outcome variables are explicated. The findings of this study will assist in informing healthcare executive's decision making when considering interventions to decrease turnover of newly graduated nurses.