New graduate nurses encounter emotional distress related to complex patient care situations and overwhelming workloads. Unequipped with coping mechanisms, new nurses verbalize difficulty feeling accepted in their assigned units. Self-perceptions of inadequacy and lack of independence contribute to anxiety. Consequently, hospitals are at risk for losing newly graduated nurses within the first year. The cost of losing new nurses is overwhelming to hospital institutions and further contributes to the looming nursing shortage. This article describes the use of a reflective practice exercise in a new registered nurse residency program in a magnet hospital to facilitate reflection and problem solving in the patient care unit. More research is needed to investigate the effectiveness of reflective practice in developing coping skills and retention rate in new graduate nurses.

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Peer reviews in nursing are historically used to gauge performance within an individual's scope of practice or as a tool to evaluate a sentinel or adverse event. Quality of care measures, clinical pertinence, and evaluating standards of care have begun as parallel strategies to replace the former uses in assuring the right care at the right time in the right setting.