Nurse Residency Program: Best Practices for Optimizing Organizational Success

A nurse residency program’s best practice recommendations are presented within this article and are organized around three processes: establishing the program infrastructure, creating a multistaged evidence-based program, and sustaining the program through appropriate evaluation and dissemination of results. These recommendations represent lessons learned and key findings derived from a team of academic and nursing professional development educators after 7 years of residency program implementation at multiple rural and urban hospital sites. Organizations, regardless of size and resources, can use these recommendations to increase the likelihood of building a successful residency program

Effect of Sequence of Simulated and Clinical Practicum Learning Experiences on Clinical Competency of Nursing Students

Two different sequences of blocks of simulated and clinical practicum learning experiences compared the clinical competency development of nursing students using a randomized crossover design. Competency was measured 3 times: after each block of simulated and clinical experiences and after a final simulated experience. No significant differences in competency scores between the 2 groups across the 3 time points were found. Using alternative models of clinical and simulation learning may help address barriers to the delivery of clinical education faced by schools of nursin

Retaining the Next Generation of Nurses: The Wisconsin Nurse Residency Program Provides a Continuum of Support

Because of the high costs associated with new graduate nurse turnover, an academic-service partnership developed a nurse residency program that provides a comprehensive support system that spans 15 months. Now in its fourth year, involving more than 50 urban and rural hospitals of varying sizes and geographic locations, the program provides formalized preceptor training, monthly daylong educational sessions, and mentoring by clinical coaches. Key factors contributing to the success of this program are a dedicated, cohesive planning team of individuals who embrace a common agenda, stakeholder buy-in, appropriate allocation of resources, and clear articulation of measures of success, with associated data collection. Successful elements of the monthly educational sessions are the use of interactive teaching methods, inclusion of content tailored to the unique needs of the nurse residents, and storytelling to facilitate learning from practice. Finally, training to advance the skill development of preceptors, coaches, educators, and facilitators has provided organizations with enduring benefits

Predictors of New Graduate Nurses’ Organizational Commitment During a Nurse Residency Program

Retaining newly graduated nurses is critical for organizations because of the significant cost of turnover. Since commitment to an organization is associated with decreased turnover intent, understanding factors that influence new graduates’ organizational commitment is important. In a sample of nurse residency program participants, predictors of organizational commitment over time were explored. Perceptions of the work environment, particularly job satisfaction and job stress, were found to be most influential. Nurse residency programs provide extended opportunities to model professional role behaviors for new nurses, enhance knowledge development and clinical application, and promote successful integration to the work environment (Bratt, 2009). Despite these benefits, only 21% of new graduates reported having a formal internship or residency program and 6% had no formal orientation (Kovner et al., 2007). In a national survey of registered nurses (RNs) conducted by the Department of Health and Human Services (2010), it was revealed that almost 40% of new graduates plan to leave their current position within 3 years and almost 22% had already changed position or employer. For those new nurses who left their position, most of the reasons (73%) centered on issues related to the characteristics of the workplace, with stressful work environment being cited most frequently, followed by lack of good management and inadequate staffing. Accreditation organizations including the Commission on Collegiate Nursing Education (2008) and the National Council of State Boards of Nursing (2009a) have advocated for the development of transition to practice programs for newly graduated nurses. In addition, the recently released report of the Institute of Medicine (2010) put forth a key recommendation for organizations to provide nurse residency programs for newly licensed nurses. This report also advocates for the need to evaluate the outcomes of these programs, including their influence on patient outcomes and the retention and competency development of new nurses

Perceptions of Professional Practice and Work Environment of New Graduates in a Nurse Residency Program

New nurses continue to face challenging work environments and high expectations for professional competence as they enter practice. Nurse residency programs are gaining prominence as a mechanism to ease new graduates’ transition to practice. This study examined new graduates’ perceptions of their professional practice competence and work environment throughout a yearlong nurse residency program. Employing a repeated measures design, data were collected at baseline, at 6 months, and at 12 months. Results showed that job satisfaction was significantly lowest at 6 months and highest at 12 months. Job stress was found to be lowest at 12 months and organizational commitment was highest at baseline. Of the variables related to professional practice, clinical decision-making was highest at 12 months and quality of nursing performance significantly increased at each measurement point. These data add to the growing evidence supporting the efficacy of nurse residency programs

Interpreting Language in Context in CommandTalk

This paper will focus on how two representations of context are used in CommandTalk to correctly interpret the user's spoken utterances: situational context represents the current state of the simulation, and linguistic context represents the history of the user's linguistic acts

Are Rural and Urban Newly Licensed Nurses Different? A Longitudinal Study of a Nurse Residency Programme

Aim This study aimed to compare rural and urban nurse residency programme participants’ personal and job characteristics and perceptions of decision-making, job satisfaction, job stress, nursing performance and organisational commitment over time. Background Nurse residency programmes are an evolving strategy to foster transition to practice for new nurses. However, there are limited data available for programme outcomes particularly for rural nurses. Method A longitudinal design sampled 382 urban and 86 rural newly licensed hospital nurses during a 12-month nurse residency programme. Data were collected at the start of the programme, at 6 months and the end of the programme. Results At the end of the programme, rural nurses had significantly higher job satisfaction and lower job stress compared with urban nurses. Across all time-periods rural nurses had significantly lower levels of stress caused by the physical work environment and at the end of the programme had less stress related to staffing compared with urban nurses. Perceptions of their organisational commitment and competency to make decisions and perform role elements were similar. Conclusions Differences in these outcomes may be result from unique characteristics of rural vs. urban nursing practice that need further exploration. Implications for nursing management Providing a nurse residency programme in rural and urban hospitals can be a useful recruitment and retention strategy

Answering Wicked Questions: Dealing With Opposing Truths as a Nursing Associate Professor

Nursing associate professors frequently are confronted with increasing responsibilities and fewer resources. These challenges commonly contribute to declines in job satisfaction and may result in departing academe. This article addresses these challenges by providing answers to four common “wicked questions” experienced by nursing associate professors: (a) How do I decline a request from a supervisor to take on additional responsibilities while continuing to support the mission of the school and advance my own scholarly productivity? (b) How do I handle the workload of multiple doctoral students with a variety of content areas that are different from my own and maintain my own level of productivity? (c) How do I handle expectations for more service, and leadership for the school, university, and professional organizations, yet the teaching and research responsibilities have not changed or have increased? and (d) What are some additional tips to being a more productive nursing associate professor