Robust nurse residency programs can help organizations and nurse leaders retain and support new nurses, who sometimes feel unprepared as they transition to practice. Combatting new-nurse turnover can lead to significant financial savings.
Making the leap from student to professional nurse can be daunting for new graduates as they struggle with limited clinical expertise, underdeveloped clinical judgment, and lack of confidence in applying evidence-based practice (EBP).
New nurses report feeling unprepared and unsupported, which may explain the 31.7% turnover rate among new nurses within their first year of being hired. With registered-nurse (RN) turnover costs ranging from $62,100 to $67,100, that lack of support can have significant financial impact.
Nurse residency programs can smooth the transition
Studies demonstrate that nurse residency programs (NRPs) can help new nurses transition from education to practice. Such programs support career development, enhance job satisfaction, reduce stress, and significantly improve nurse retention rates. Evidence shows that NRPs can contribute positively to a hospital’s financial bottom line. In fact, the American Association of Colleges of Nursing (AACN) has emphasized that structured, transition-to-practice programs such as NRPs have become the global standard for effectively transitioning RNs into new-practice settings.
NRPs provide new nurses with important guidance and training, which enhance new nurses’ skills and raise their perceived levels of confidence. Evidence also shows that NRPs can significantly reduce turnover — nowadays a critical challenge for many healthcare organizations.
Leading programs like the Vizient/AACN NRP, the Versant New Graduate Nurse Residency, and the American Nurses Credentialing Center’s Practice Transition Accreditation Program have delivered impressive results. For example, the Vizient/AACN program boasts a 90.4% retention rate for new graduate nurses after one year, surpassing the national average of 82.5%.
Five best practices for a successful NRP
Nurse leaders play pivotal roles in designing and championing NRPs. They ensure that programs align with organizational goals, support clinical excellence, and foster supportive environments that promote new-nurse confidence, competence, and long-term retention. Nurse leaders can support NRPs in several ways:
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Standardize transition-to-practice programs. Encourage progressive patient care responsibility, allowing nurses to build confidence and competence at a sustainable pace. Make sure to standardize clinical decision support, tailor competency lessons, and perform assessments when and where it is needed most to help prevent dissatisfaction and burnout. Align training with evidence-based clinical practices and national nursing standards. Use competency assessments at key milestones to ensure skill progression and identify areas for improvement.
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Embed a culture of lifelong learning into programs. Foster continuous professional development by providing structured opportunities for ongoing education, certifications, and specialty trainings.
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Consider EBP research opportunities. Encourage participation in EBP research projects to promote critical thinking and innovation in patient care. Offer opportunities for new nurses to collaborate on quality improvement initiatives, to present findings, or to contribute to research publications.
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Support interdisciplinary collaborations. Give new nurses cross-departmental exposures to different specialties to help them explore career paths within the organization. Facilitate team-based learning to promote a collaborative-care model. Offer leadership development opportunities to prepare nurses for future roles in management or specialized practice areas.
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Quantify return on investment. Show positive financial impact as demonstrated by studies: A transition-to-practice (TTP) program that comprised 70 hospitals with 1,032 new graduate RNs achieved an 81.2% retention rate at the hospitals, with a turnover rate of 15.5% for the TTP group and a net cost savings of $7,265 per new graduate RN retained.i
Using technology to enhance an NRP: A case study
AdventHealth, a nonprofit healthcare system headquartered in Florida, operates 51 hospital campuses and hundreds of care sites throughout nine states, with 83,000 caregivers in physician practices, hospitals, outpatient clinics, skilled-nursing facilities, home health agencies, and hospice centers.
To address retention and cost issues, the system wanted to establish an NRP. AdventHealth’s West Florida Division launched a 12-month NRP,ii onboarding more than 500 nurse residents within the first year. The residency program began with a preceptorship, requiring students to partner with experienced nurses on their units for three months and then continued with a nine-month transition to practice.
Initially, the program relied on outdated pen-and-paper methods. It had no standard requirements for content or format and no faculty oversight of EBP projects. To overcome those challenges, The division deployed Ovid® Synthesis, an EBP workflow solution that guides residents through EBP projects. The solution empowers residents to contribute to the culture of EBP by enriching curricula and training, and it facilitates collaborations between mentors and mentees while ensuring standards get met.
After just 10 months of use, the West Florida Division trained more than 600 nurse residents in the use of Ovid Synthesis — a significant accomplishment within a short time frame.
With the right tools and best practices in place, healthcare organizations can establish their own successful NRPs to support retention and cultivate clinical excellence.
Learn how Lippincott® Solutions’ evidence-based practice and professional development solutions can support your nurse residency programs.
