Implementation of a Nurse Residency Program in a Women and Newborn's Specialty Hospital: A Magical Transformation

Abstract

Paper Presentation Purpose for the Program Hospitals across the nation are challenged to meet the increasingly demanding educational needs of new nurses and to support their transitions to professional practice. Recommendations from the Institute of Medicine underscore the importance of nurse residency programs to help manage the transition from school to professional practice and help new graduates further develop the skills needed to deliver safe, quality patient care. Researchers have demonstrated that nurse residency programs facilitate the successful integration of nurses into the work environment, enhance their overall experience, and increase retention. Though nurse residency programs historically have been supported in large health care systems, they focus primarily on acute care. The purpose of this program was to develop a robust nurse residency program in a community specialty hospital for women and newborns by incorporating elements of exemplary nurse residency programs. Proposed Change To move from independent unit-based hiring to an integrated, structured, hospital-wide nurse residency program. Though hiring would continue to be unit and specialty specific, coordination among the units would allow for hiring residents into cohorts to promote teamwork and collaboration and provide the group with much needed emotional support. Implementation, Outcomes, and Evaluation Implementation of the program included structures and processes of evidence-based nursing strategies for effective integration of knowledge, skill development, and retention. For effective integration of knowledge, an emphasis was placed on reflective practice in the form of journaling and round table discussion that facilitated learning and increased feelings of empowerment. Skill development included ongoing educational meetings that provided the framework for expanded curriculum to bridge the gap between nursing school and professional practice as well as expanded looping rotations that fostered interprofessional collaboration to enhance the continuity of care. Formal mentoring partnerships positively affected retention by promoting social integration, sense of belonging, and increased confidence. Finally, the celebration of key milestones included a residency graduation that validated success, promoted pride, and renewed energy not only for the residents, but also for the experienced staff who contributed to the residents' achievements. Outcome measures included increased nurse retention by focusing on a low nurse turnover of less than 5%. Qualitatively, nurse residents reported an enhanced sense of accomplishment and satisfaction. Nurse resident feedback, evaluations of programs, and experiences provided essential information for continual evaluation and program improvement. Implications for Nursing Practice The innovative structures and processes of the nurse residency program grant new nurses the essential knowledge, skills, and abilities needed for successful transition to professional practice in the delivery of quality patient care.