Nurse Residency Programs: Rolling Out the Welcome Mat

Laura A. Stokowski, RN, MS


July 17, 2015

Ready or Not, You're a Nurse

Once upon a time, nurses were expected to graduate from nurses' training one day, and hit the ground running the next. Known as the "apprenticeship model" in which nursing students received training in exchange for service, these students pretty much staffed the hospitals, so by the time they graduated, there wasn't much left to learn. It was not unusual for a novice nurse to be promoted to a teaching or supervisory position within a year of graduation.

How the situation has changed! It is now widely acknowledged that most new graduate nurses are not ready to assume even the most basic staff nurse role immediately upon graduation or licensure. For many decades, nurses were transitioned from student to staff nurse with formal department orientation programs that ranged in duration from a few weeks to a few months, depending on the setting. Orientation programs typically focus on the hospital or department and its policies, rather than the professional development of the nurse. Novice nurses would cut their teeth on medical/surgical units, from which they transitioned to critical care and other highly specialized areas if they demonstrated the requisite knowledge, skills, and proclivity. They either made it as nurses, or they didn't—a "sink or swim" mentality prevailed.

The problems that surfaced as generation after generation of nurses struggled to adapt to the nursing profession—low retention/high turnover, job dissatisfaction, errors, and burnout—are by no means new, but employers are paying more attention to them. To be fair, a major reason that new graduate nurses today face such a chasm between neophyte and a competent, professional nurse is that hospitalized patients are sicker than ever before, care and treatments are more complex, and patient and family expectations are higher. The work environment is stressful, the shift rotations are punishing, nurses fear for their safety, and incivility abounds. We're not in the 1950s anymore.


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