The Nurse Residency Program (NRP) at St. Anthony’s Medical Center is a one-year program using evidenced-based principles to facilitate nurse retention, leadership, patient safety, and optimal outcomes while reducing costs associated with orientation and turnover.
The NRP assists the newly-graduated, licensed BSN-prepared nurse to transition from novice to advanced beginner while building relationships throughout the organization. Once candidates are selected through a panel interview process, training begins under direct supervision of an Advanced Clinical Expert (ACE) and nurse preceptors. The ACE’s primary role is to ensure that the resident is progressing through the program by conducting frequent assessments, providing constructive feedback, and coordinating interdisciplinary communication.
Residents are exposed to various units (looping) and observation experiences throughout the medical center. The ACE, along with unit staff and managers, assess each resident’s clinical progression to determine their best fit within the facility. Debriefing sessions with the ACE and program coordinator are scheduled as a means of communication and feedback. Individual orientation release meetings are conducted during the final week of orientation. Bi-monthly, post-orientation meetings are held with a focus on simulation, enhancing critical thinking skills, and succession planning. The goal of the sessions is to enrich the knowledge of the resident so that they can connect experiences while developing professional networks.
- Results reflect significant improvements in bedside applicability and critical thinking. Residents are able to focus on clinical progression and are able to see the big picture of providing care and focusing all efforts on the residency.
- Survey results indicate job satisfaction and retention also improved. The average six month turnover went from 8 to 0 percent post residency implementation (retention rate 100 percent). These results are to be attributed to the structured clinical immersion, mentoring and debriefing, looping, competency validation and support-based NRP. Furthermore, the average yearly turnover went from 37% to 5% (yearly retention of 95%).
- Transfering from one level of care to another has been seamless. The residents are well prepared with the knowledge base and confidence needed to care for the the ever changing patient population.
- Of those hired, 22-25 percent of non-licensed nurses failed NCLEX upon the first attempt. Requiring licensure upon hire eliminated the margin of this percentage.
- The NRP was recognized by the Missouri Hospital Association for its unique structure and excellence and results.
The preceptor provides an experience that creates a diverse and supportive unit-specific orientation. Through the process of looping, preceptors guide the resident’s progressive development by providing constructive feedback regarding interdisciplinary collaboration, cultivation of time management and prioritization skills, and increasing opportunities to execute fundamental nursing skills. The preceptor and resident bonding experiences facilitate the resident’s confidence and competence while providing the resident with an orientation essential in fostering leadership at the bedside.
Future of Nursing
In accordance with the Institutes of Medicine’s (IOM’s) recommendations, St. Anthony’s Nurse Residency Program is results-driven and designed to facilitate the transition from student to professional nurse. Preliminary data supports the effectiveness of the NRP and the positive impact on the future of nursing. At St. Anthony’s, we believe that mapping the future of nursing begins with professional development programs, such as the Nurse Residency Program, to ensure the NGRNs of today will encompass the leadership roles of tomorrow.