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TMCNet:  What We Have Learned from a Model Nurse Residency Program: Ideas for Linking Service and Education [Nursing Education Perspectives]

[December 07, 2013]

What We Have Learned from a Model Nurse Residency Program: Ideas for Linking Service and Education [Nursing Education Perspectives]

(Nursing Education Perspectives Via Acquire Media NewsEdge) Despite the preparation they receive during their nursing education, newly graduated RNs often find the work environment challenging. These new nurses benefit from a nurse residency program (NRP) to transition into the role of professional nurse and leader at the bedside.

The NRP in our hospital supplements the nursing orientation we offer. The specific aims of the NYP Nurse Residency Program are to develop critical thinking skills in new RNs; improve their organizational ability and technical skills; encourage the use of outcome data to promote patient safety; and support new graduates in their transition to autonomous practice while strengthening their commitment to lifelong learning. An essential goal is to enhance the commitment of these new RNs to nursing as profession.

A supportive learning environment during the transition phase reduces turnover, with a direct impact on the quality of patient care and the fiscal stability of the institution. Statistics show that the turnover for new graduates is between 35 percent and 55 percent. Since the inception of our NRP, our turnover rate has been less than 2 percent, with each position retained representing a savings of $f00,000 or more. This result, factored in with the benefits of having a stable workforce, presents a compelling case for developing an NRP.

We survey our nurse residents quarterly during their first year of practice. Results indicate that over the last several years, the needs identified in these surveys have changed very little. There continues to be a preoccupation among residents with skill mastery.

Our residents express concern about their ability to recognize a change in the patient's condition and intervening appropriately. They are also concerned about delegation, conflict resolution, and time management, issues that are addressed in monthly meetings where members of the cohort share and discuss their experiences.

We have used the data from the survey to improve the nursing education experience. One issue residents identified was having little experience with electronic documentation during their clinical rotations as students. In collaboration with our academic partners and our information technology department, students doing clinical rotations at our facility now have the ability to document care using the electronic medical record.

It would be impossible for schools of nursing to prepare students for every conceivable situation they will encounter in practice. An effective residency will help new graduates apply what they have been taught to their clinical practice, making the transition into practice a successful one.

One graduate offered this appraisal of our program: "In retrospect, the NYP Nurse Residency Program accomplished something quite vital in today's health care environment. It propagated within us a working sense of the value of cooperation, collaboration, and networking and did so by introducing cohorts to an environment fostering teamwork through relevant projects, empathy, supportive feedback, and respect. All the while, the program reinforced concepts so vital to contemporary clinicians: evidence-based practice, leadership development, and embracing lifelong learning. Most of all, the NYP Nurse Residency Program fostered within us a sense of belonging that can be elusive in large institutions." About the Authors The authors are leadership staff of NewYork-Presbyterian Hospital, New York, New York. Wilhelmina Manzano, MA, RN, NEA-BC, is senior vice president and chief nursing officer. Reynaldo R. Rivera, DNP, RN, NEA-BC, FAAN, is director, Professional Nursing Practice Innovations. Rosemary Sullivan, MA, RN, is director, Nursing Special Programs.

(c) 2013 National League for Nursing, Inc.

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