One Year Post-Baccalaureate Nurse Residency

Helping Baccalaureate Nursing Graduates Transition to Their First Professional Positions & Motivating Them to Stay in the Profession
 

Background & Goal

Even top schools cannot adequately prepare nurses for the challenges of today’s hospitals because of the patient acuity and the complex and increasingly technological hospital environments. Turnover rates among new graduates have ranged up to 50%.

The residency goal is to help baccalaureate program graduates transition from advanced beginner nurses to competent professionals in the clinical environment by providing clinical leadership and formulating an individual development plan for each nurse’s new clinical role.

Program Description

The nurse residency is a one-year transition-into-practice educational program that prepares new baccalaureate nursing graduates for their first professional registered nurse positions in acute care hospitals. It is based on the “Essentials of Baccalaureate Education” so the residency does not repeat education already provided in the baccalaureate degree. The curriculum is evidence-based, drawing on the research that defines the competencies, knowledge and experiences new graduate’s need beyond those obtained in their baccalaureate programs. Students are immersed in clinical work with a clinical preceptor who has attended training based on the national residency curriculum. Residents receive specialty training targeted to their clinical service such as a critical care course, a fetal monitoring course, etc. During the final six months of the program, residents receive content on selecting a mentor and constructing a career plan for their own development. Residents conduct an evidence-based project and present the project in a poster format. 

Evidence of Success

• When the program began in 2002, some UHC hospitals reported retention rates for new graduates as low as 50%. The program has resulted in consistently high retention rates and in 2010, the program reached an aggregate retention rate of 96.1%. 
• Program data from 2010 continues to show positive changes in overall competence and confidence. Resident scores have consistently improved in the organizing and prioritizing scales and the communication and leadership scales. Stress scores decrease significantly by the end of the residency.
• Improved commitment to the nursing profession is observed at the conclusion of the residency program, rated in 2010 by residents at 3.49 on a four-point scale.
• Average cost of replacing a new graduate RN is reported to be more than $80,000. Organizations have been able to document significant return on investment. A 2007 article in Nursing Economics detailed an organization with a 50% turnover rate that achieved a cost savings of $823,680 from implementing the nurse residency. 
• To date in 2011, there are 81 hospitals participating in the residency and 25,000 residents have completed the residency.
• Post baccalaureate nurse residency accreditation standards were developed. CCNE has accredited 5 UHC/ACCN sites in 2010/2011 and three other sites have scheduled on-site evaluations.