Nurse residency programs: Best practices for helping new nurses succeed

Even though nurse residency programs have been around for a while, it’s still easy to underestimate their importance. Some recent studies of newly licensed RNs suggest the attrition rate at 12 months is around 10%, while others indicate turnover is as high as 15% at one year. With more people than ever having health insurance through the Affordable Care Act, and with an aging population with increasingly complex health needs, we can’t afford to lose so many new nurses each year.

It isn’t just patients that suffer. According to some nursing literature, the cost of hiring and training a new graduate nurse can be anywhere from $60,000 to $96,000. For hospitals, retaining top graduate nurse talent isn’t just an operational priority…it’s a fiscal priority as well.

For some facilities, nurse residency programs have boosted retention rates to 95% at the one-year mark. But not all residency programs are created equal. When transitioning your new nurses, it’s important to keep in mind that the way you develop your program can be the make-or-break factor in new nurse retention, job satisfaction, performance, and better patient outcomes.

The nuts and bolts of a great nurse residency program

It takes time and effort to develop a nurse residency program that produces measurable results. But it’s not impossible to create a program that satisfies the needs of your organization while meeting the needs of newly graduated nurses. Certain best practices help ensure your program’s success as you develop your fledgling workforce.

1. Get everyone onboard. For a nurse residency program to be successful, you need the support of your entire nursing workforce. This includes nursing leadership, clinical nurse educators, and staff nurses. Additionally, hospital administration and human resources should endorse the program, making it easier for you to develop and implement your plans for nursing residency.
2. Line up resources. You can’t develop a nursing residency program if you don’t have the resources to do so. Take stock of your hospital’s financial and human assets, because without both, your program can’t get off the ground. It may be beneficial to appoint a residency planning committee and coordinator to ensure an accurate assessment of available resources.
3. Use best evidence to build your program. Nursing is all about evidence-based practice, and the creation of a nurse residency program should follow those same guidelines. Researching other residency programs and organizational perspectives helps shape decisions and offers insight into which practices work and which don’t. Examination of reliable, measurable evidence should be an ongoing priority of your program, allowing you to modify components of the residency as needed.
4. Implement your program in stages. New nurses develop confidence and skills in stages across time, not all at once. Your program should support nurses as they move from one stage of development to another. This can be achieved through regularly scheduled educational sessions and check-ins with preceptors and clinical nurse educators.
5. Evaluate new nurses and measure outcomes. The only way to truly know if your nurse residency program is successful is by evaluating the performance of your graduate nurses. By reviewing measurable outcomes, such as changes to graduate nurses’ skills, confidence, or attitude toward work, you can determine whether your program has achieved its goals.
6. Sustain your program. Keeping a successful nurse residency program running is challenging, but it can be done. It’s vital to keep all organizational leaders, from administration to nursing management, aware of what’s going on with the program and what your results are. Continued collaboration with organizational stakeholders is key to sustaining your program long-term.