SEATTLE—New doctors have received on-the-job training in residency programs for decades. Now, a growing number of new nurses are doing the exact same thing. Nurse residency programs are now rising in popularity and that, in part, is due to hospitals trying to stave off a huge projected nursing shortage over the next 10 to 15 years.
Nurse residency programs were first introduced in the United States approximately 15 years ago, and programs were established in Illinois and Texas. Until now, however, the idea really did not take off. This summer, a comprehensive cancer care center was the first to implement a nurse residency program, and other cancer centers may soon be joining the trend.
Because of an aging workforce, it is expected that there will be a significant nursing shortage over the next two decades. So, some hospitals around the country are establishing special nursing residency programs as a means of retaining new graduates. Nationally, the average turnover rate of first-year nurses is reported to be approximately 27%. One study showed that 35% to 60% of new graduates change employers within the first year of employment (Beecroft P, et al. Nurs Econ. 2007; 21:13-18, 39).
“At 6 months, the nurses get hit hard, and many places lose nurses. Some nurses leave the profession as well as the hospital. So, we wanted to find out how we could better support nurses during this time,” said Martha Kershaw, RN, MS, OCN, who is the nursing staff development instructor at Roswell Park Cancer Institute, Buffalo, New York.
Roswell Park Cancer Institute is one of four healthcare centers collaborating on the first nurse residency program (Western New York Nurse Residency Program) in the Buffalo, New York, area. The program was kicked off on July 29, 2010, with a program on skills reinforcement. Sixteeen new nurses working at Roswell Park Cancer Institute were among 96 nurses signed up for the residency program from the four Buffalo area healthcare centers.
In many respects, a nursing residency program can be especially beneficial for new oncology nurses. It can help address many problems that new nurses are faced with and thus allow them to better focus on oncology treatments. “With oncology nurses, the treatments change every day, and the things that our nurses have to know in addition to what a regular new graduate has to know are amazing. So we are able to focus on the oncology aspects of nursing that they need to know. The residency program helps with the basic nursing skills as well as the basic assessment skills and also help them become a member of the team on their floor,” said Kershaw in an interview with The Oncology Nurse.
The residency program focuses on how to be a member of the hospital team and be active in the hospital as well as the nursing profession. The nursing residency program in the Buffalo area is based on one in Wisconsin, which was started several years ago and has been highly successful. In the program, each new graduate nurse is hired into a “home” unit where that nurse will be based. Each nurse is then connected with a mentor, whose role is not to evaluate the new graduate, but to offer psychosocial and professional support throughout the first year of employment.
Valerie Smith, who is 29 years old, just finished nursing school last May. Eight weeks later, Smith started her nursing residency program. “I think it is a good program. It is nice to be able to learn about things that you are not really confident about,” Smith said in an interview with The Oncology Nurse. “This kind of program lets you know that everyone has the same fears. It really helps to talk to other nurses about how their first year is going.”
In the Western New York Nurse Residency Program, all new graduate nurses have the opportunity to participate in approximately 6 hours of interactive professional education sessions each month. The sessions are offered off-unit and allow new graduates to review their knowledge and skills in an encouraging and productive learning environment. The goals of the program are to help nurses develop clinical competence and to help expand their critical-thinking skills.
Studies suggest that new nurses often feel that they have grasped the requirements of their job and how to be an effective member of a nursing team. However, many new nurses may need assistance in managing competing priorities on their unit, unexpected and abrupt changes in patients’ conditions, and other teamwork challenges.
“New nurses need support the first year,” Kershaw said. “They have a preceptor, an experienced nurse who teaches them their role as a nurse and evaluates them to make sure they are competent to be on the floor. Our program provides education events each month, and the mentors help nurses when they have a bad day or help answer the questions they are too embarrassed to ask.”