This essay was written by my student Benjamin Howell-Little as an assignment in his Clinical II junior-level course in the University of Wisconsin-Madison School of Nursing. I am publishing it here with his permission, as I believe this issue is relevant to many nursing students who are considering their options for transition into RN practice after graduation.
BACKGROUND/SIGNIFICANCE:
For the last few months, I've garnered increasing interest in the possibility of a nursing residency program (NRP) as opposed to just “jumping into” RN nursing. Looking towards our options after the end of next year, I think it would be prudent to learn about what exactly we can and can't do off-the-bat (which is information I've found to be lacking in the nursing program thus far, and wish that weren't the case). Much of what I've focused on this rotation for these Evidence-Based Practice (EBP) essays is patient-centered practices. While I think that is vastly important, I also believe every once in awhile we as students and future nurses need to also examine EBP in the context of our own careers, so that we can most proficiently serve our patients. I am an avid believer in the adage that one must first take care of themselves before they can help others.
For those who are not yet familiar with NRPs, I will quickly explain what they are. NRPs are offered by some institutions that employ RNs to provide an extended transition between graduation from nursing school to taking on full responsibility for nursing care. Whereas many institutions offer an orientation period (which often lasts only several months) for new-graduates and nurses with experience alike – to become familiar with the unit and institutional policies – NRPs often are typically only offered to new-graduates and generally consist of an entire extra year of limited responsibility and emphasis on continuing education and transition. Nursing Residents are typically paid the same amount as new-graduate hires, but also train for a longer period under another nurse, as well as attend classes and discussions with peer residents; NRPs are also more competitive to get into, due to limited financial resources and high demand (Goode et al., 2009).
In my initial research I have looked at local Madison-area options for NRPs, as well as a few articles about NRPs online. I intend to integrate the two in this post. Since I can't cover everything you should know here, I suggest actually checking out the references at the end for more information, as they are really interesting articles. I believe we are in the midst of a transition from sending new-graduate nurses straight off to work to recognizing the benefits of NRPs to new-graduate staff retention and quality of care.
INFORMATION/SUGGESTIONS:
According to two studies, NRPs are cost-effective, partly because they improve patient safety, as well as new-graduate job-satisfaction, and subsequently reduce turnover rates (Cappel et al., 2013; Goode et al., 2009). One study found that as many as a fourth of new graduate nurses had worked at two or more institutions by only 6-8 months after graduation (as cited in Goode et al, 2009). This article also notes that because many orientees take full responsibility for patients within 3-6 months of starting, they often experience a dip in self-perception and confidence; whereas after one year, this confidence becomes regained as new-graduates begin to master their position (2009). These studies exemplify how NRPs can not only increase career-satisfaction, but also new-graduate employee retention rates, patient safety and new-graduate competence.
In terms of Madison Wisconsin NRP opportunities, I've looked into programs offered at UWHC, Meriter and the VA. UWHC offers one that must be applied to in the Fall of the year of graduation, and (according to one previous clinical instructor), is quite competitive. Meriter apparently offers NRPs to all new-graduates upon being hired there as an RN, recognizing their need for a transitional experience. The VA has two NRP programs; the one which I checked out is the “Post Baccalaureate Nurse Residency Program,” which offers a year of residency training and is relatively new. This program you must apply for in the Spring of the year of your graduation.
RECOMMENDATION:
My recommendation, based on these studies about the career-satisfaction and smoother transition aspects of NRPs is that all nursing students should consider this potential option for post-graduate work. While they may be competitive to get into, I suspect that increasing awareness of the benefits of NRPs will lead to a greater number of opportunities in the future.
References
Cappel, C. A., Hoak, P. L., & Karo, P. A. (2013). Nurse residency programs: What nurses need to know. Pennsylvania Nurse, 68(4), 22-28. Retrieved May 15, 2014, from CINAHL database (Try this link: http://search.ebscohost.com.ezproxy.library.wisc.edu/login.aspx?direct=true&AuthType=ip,uid&db=rzh&AN=2012449180&site=ehost-live&scope=site).
Goode, C., Lynn, M., Krsek, C., Bednash, G., & Jannetti, A. (2009). Nurse residency programs: an essential requirement for nursing. Nursing Economics, 27(3), 142. Retrieved May 15, 2014, from CINAHL database (Try this link:http://search.ebscohost.com.ezproxy.library.wisc.edu/login.aspx?direct=true&AuthType=ip,uid&db=rzh&AN=2012449180&site=ehost-live&scope=site).
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