PhD, MS, MSN, RN, APRN-BC, CCRN, CDCES, CNE
Congratulations as you are looking into a nurse residency program and are probably in nursing school or just graduated. Well done on your progress so far!
Nursing school is difficult, but so worth it. In your first semester, you more than likely felt unsettled and nervous to begin as a novice nursing student and you grew to become an expert nursing student after each semester and exam.
Once a nursing student graduates and successfully passes the National Certification Licensure Exam (NCLEX), you will go from being an expert nursing student back to the level of a novice new nurse. Those familiar feelings of anxiety and lack of confidence flood back as you step into your new role as a “real” nurse, otherwise known as a Registered Nurse.
The transition can be difficult and due to this fact, nurse residency programs are available to help new graduate nurses succeed.
Nurse residency programs are being offered by more and more hospitals for several reasons.
Having additional support and training for a newly graduated nurse is attractive to new nurses in a competitive healthcare industry starving for more nursing staff. It has also been shown to produce better outcomes for patients and the transition of the new graduate.
With more training and support from the hospital, the nurse also has a better chance of staying longer at the hospital as an employee.
A nurse residency program is a structured and comprehensive training program designed to support newly graduated nurses as they transition from their academic education to professional clinical practice. These programs are typically offered by healthcare institutions, such as hospitals or medical centers, to provide a supportive environment for new nurses to develop their clinical skills, critical thinking abilities, and confidence in their roles.
In a nurse residency program, the newly graduated nurse often is assigned to a mentor, attends some classroom lectures about the hospital and patient care, and works next to their nurse mentor for several weeks. Each shift, the new graduate helps the regular floor nurse with a patient assignment and gradually works up to taking on more responsibilities of one patient, then two, then three or more depending on the unit’s typical nurse to patient ratio.
Gradually, the new graduate is able to function independently in a full patient assignment but will have the extra support of the nurse-peer mentor if needed.
Because of the added expense and labor needed to offer an intensive training program for new graduates, there are limits to how many positions a facility can offer. You have to apply for a residency and in addition to the regular hiring application, there may be added essay questions to answer.
Any additional work experience in the medical field, or a foreign language or volunteer service you have should absolutely be included in your resume to help you stand out. Some nursing students even volunteer for a medical mission between nursing school and their first job to get unique clinical experience, which can be a stand-out feature on your application.
A nurse residency has many benefits and consists of additional training, support, and time to adjust to your new role. Most residency programs have the same core components which include the following:
New nurses receive an orientation to the healthcare facility, its policies, procedures, and the specific unit in which they will be working.
A general orientation is typical for any new employee, but more time is often given to a new graduate nurse. All newly hired nurse employees are then oriented to their assigned unit and often allowed several shifts to shadow an existing peer nurse.
In the past, this was the ideal scenario but occasionally in the post-covid world of busy hospitals and too few nursing staff, an experienced nurse may “hit the floor” with very little orientation. Newly graduated nurses are often given more shifts to shadow, which can help decrease their anxiety and increase their self-confidence.
The program involves hands-on clinical training under the guidance of experienced preceptors or mentors. New nurses gain exposure to various patient populations and medical conditions.
Nurse Residency programs often include formal education components, such as seminars, workshops, and classes, all aimed at enhancing clinical knowledge, communication skills, and professional development.
Often, the new graduate nurse will attend “class” offered by the hospital education department for several days, or even half of a shift, and will then work on the floor after class to complete a shift. This similar educational format is frequently available for nurses who want to complete a critical care nursing course before they can work in a specialized critical care unit.
New nurses are assigned experienced mentors or preceptors who provide guidance, feedback, and support throughout the transition period. This mentorship helps build confidence and facilitates the learning process.
You will have experienced a variety of nursing styles by shadowing nurses during nursing school. Many times, your nursing school’s clinical shift may have been shorter, and you missed the initial or end-of-shift reports, but now as a new Registered Nurse, you will be able to shadow the full shift experience with your mentor and learn the skills of note taking and reporting to other nurses.
Be willing to learn from your mentor, even if you would not choose to be best friends with your new mentor outside of work. Intelligent people are willing to learn from others to improve their skills.
Nurse Residency programs focus on developing critical thinking and problem-solving skills that are crucial for making sound clinical decisions in real-world healthcare scenarios.
The real test outside of nursing school is the application of all that you learned to help patients heal and not just to pass an exam. You will improve in your clinical judgment with each shift you work under the guidance of your mentor, and you will then need to make decisions because YOU are the nurse!
Nurses interact with other healthcare professionals, such as physicians, pharmacists, and therapists, and you will begin to make phone calls and meetings to discuss patient information and care plans.
Emphasis is placed on teaching new nurses how to integrate the latest evidence-based practices into their patient care approaches.
You learned many of the standard guidelines in nursing school, but there is so much more. Unfortunately, nursing schools have been forced to adjust and shrink their curriculum to help students graduate to successfully pass the NCLEX.
Even if it felt like it, you did not learn everything there is to know. The things you really learned in nursing school is how to learn, and there is so much more to learn about medicine, nursing research, and clinical guidelines for a plethora of disorders.
Nurse Residency programs often include discussions about ethical dilemmas, cultural competence, and other aspects of professional nursing practice that you only read about in nursing school.
You will begin to learn about the educational requirements of practicing nurses by your facility. Nursing is a life-long educational profession.
As new nurses progress through the residency program, they are given increasing levels of responsibility and autonomy in patient care under supervision.
Although you may be in a hurry to have a full assignment like the “experienced nurses,” you will look back on this time during your residency and long for the luxury of time when you only had limited patients!
Regular evaluations and feedback sessions are conducted to assess the progress of new nurses and identify areas for improvement.
Be humble as you receive feedback to improve. It is important to remember that your skills are still young and that you are still a novice and becoming an expert takes time.
There are very few disadvantages of a residency program compared to all the extra benefits of additional training, but the following are a few disadvantages:
One disadvantage may be a decreased salary during the nurse residency program. Many hospitals will only increase your salary after you have completed the training period.
It is important to remember that while you are attending classes and taking on less work, they are not able to assign you a full patient load, which costs your facility more money. It is a fair trade for the additional support and training you will receive.
Another disadvantage is the time commitment to complete the training program; however, this can become an advantage because you are getting work hours.
There may also be limited units that offer the residency program and specialty units may not offer the program at all. Many times, there are new graduate nurses who want to work directly in a critical care unit or women’s health, but only a medical-surgical nurse unit is available for the residency program.
Remember that your nursing career is a marathon and not a sprint. You have time to learn and strengthen your basic skills of time management and prioritization before you move into a specialty unit.
Occasionally, there is a personality conflict between the new graduate nurse and the assigned mentor.
You may have already had that experience during nursing school, and it definitely wasn’t fun. If a new nurse and their assigned mentor do not have a compatible working style or communication approach, it could hinder the learning process.
Generally, you do not get to choose your mentor as the mentor also has to be willing and qualified. You have the choice of either quitting (not recommended) or learning despite differences and finding the good in your preceptor.
You do not have to agree on everything, but you do have to work together, and learning how to work as professionals despite personality differences is a very real skill.
The last disadvantage of a nurse residency program is the sheer competition to be accepted. Due to the added expense and labor needed to offer an intensive training program for new graduates, there are limits to how many positions a facility can offer.
The main concept to remember about a nurse residency program is that it was created to help you succeed in the bumpy transition from nursing student to becoming a practicing competent and compassionate nurse.
Success in a nurse residency program as a new graduate nurse requires dedication, hard work, and a proactive approach to learning and professional growth. The following are some tips to help you succeed in a nurse residency program:
Approach the program with a positive attitude and a willingness to learn. Be open to new experiences, even if they take you out of your comfort zone.
Establish both short-term and long-term goals for your professional development. It is important to have clear objectives that will help you stay focused and motivated throughout the program.
Be aware of which skills you would like to work on and share those with your mentor. If your mentor knows what you would like to work on specifically then they can look for opportunities or collaborate with other nurses on the unit who may have a patient who needs that nursing intervention done.
Nurse Residency programs can be demanding, so staying organized is key. Keep track of your assignments, schedules, and deadlines to avoid unnecessary stress.
One of the crucial skills for a newly graduated nurse is to learn how to organize your shift and patient care. You have seen the “nurse cheat sheets” during your clinical shifts that nurses create to keep them organized.
It is now your chance to develop your own style on how you will keep shorthand notes and reminders for yourself. Nurses are generally happy to share their tips and tricks.
Do not wait for others to assign tasks to you. Take the initiative by volunteering for opportunities to learn and participate in various aspects of patient care.
Be willing to answer call lights and be a team player. Nursing is a team sport, and we need help from each other on a busy unit.
Do not hesitate to ask questions when you are unsure about something. Asking for clarification or guidance shows your commitment to learning and delivering safe patient care.
A dangerous nurse moves forward and does not know what they are doing. Be aware of the right time to ask questions and be certain that it is not in the middle of your nurse’s emergency actions. Typically, at the end of a shift is a good review time.
Regularly reflect on your experiences and identify areas where you have made progress and areas that need improvement. This self-awareness will guide your professional growth.
Put your ego aside and be willing to accept constructive criticism.
Develop your critical thinking skills by actively analyzing situations, making clinical decisions, and considering the rationale behind your actions. Nurse residency programs are designed to challenge you.
Embrace these challenges as opportunities for growth rather than obstacles to overcome.
An important “soft skill” in any profession is how well you can get along with others you work with on a daily basis. Develop positive relationships with your preceptors, mentors, colleagues, and other healthcare professionals.
Networking can provide valuable insights and support throughout your career. One of the best rewards of being a nurse is the rich relationships that you will develop throughout your career.
Stay updated with the latest evidence-based practices and clinical guidelines. This will help you provide the best possible care for your patients.
You will discover that you need to look up information on every shift. The medical profession is always changing with emerging research and evidence.
Nurse Residency programs can be intense, so prioritize self-care to manage stress. Find healthy ways to relax and recharge outside of work.
You figured out how to manage stress in nursing school, and now you will need to identify how to manage stress as a working nurse.
Utilize the resources provided by the residency program, including educational materials, workshops, and seminars. These resources are designed to help you succeed.
If you are facing challenges or struggling with aspects of the program, do not hesitate to communicate your needs to your preceptors, mentors, and managers. They are there to support you.
Remember, success in a nurse residency program is not just about acquiring clinical skills. It is also about developing your professional identity, communication skills, and critical thinking abilities. Approach the program as a valuable opportunity to lay a strong foundation for your nursing career.
The goal of a nurse residency program is to help new nurses transition smoothly into the challenging and dynamic healthcare environment, ultimately improving patient outcomes and reducing turnover rates among newly graduated nurses.
These programs typically last for a specified period, often ranging from several months to a year, depending on the institution and the specific program design. If you choose to apply for and accept a position in a nurse residency program, you should now understand what to expect and what to do for your success.
Good luck, and enjoy the journey!
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