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

Abstract

New graduates are faced with significant challenges associated with transitioning from the role of student nurse to graduate nurse. Acute care environments are driven by complex systems and are technologically advanced. Coupled with extremely high acuity of patients, this setting places many demands on new graduates to develop competency in a relatively short period of time. Many new graduates feel unprepared for the demands of practice and struggle with mastery of clinical skills, time management, development of clinical judgment, and learning to manage a heavier patient care load. This steep learning curve can be overwhelming increasing new graduates' stress level and feelings of incompetence, thereby increasing the potential for turnover.Because the phenomenon of turnover is so costly and impacts quality of care, healthcare organizations have been challenged to design effective programs that offer support for new graduate nurses to ease their transition into practice (Beecroft, Kunzman & Krosek, 2002;Blanzola, Lindeman, & King, 2004; Krugman, Bretschneider, Horn, Krsek, Moutafis & Smith, 2006;Lindsey & Kleiner, 2005;Rosenfeld, Smith, Iervolino & Bowar-Ferres, 2004;Williams, Sims, Burkhead & Ward, 2002). These programs are intended to help new NOT THE PUBLISHED VERSION; this is the author's final, peer-reviewed manuscript. The published version may be accessed by following the link in the citation at the bottom of the page. Nursing, Vol. 40, No. 9 (September 2009): pg. 416-425. DOI. This article is © Slack Incorporated and permission has been granted for this version to appear in e-Publications@Marquette. Slack Incorporated does not grant permission for this article to be further copied/distributed or hosted elsewhere without the express permission from Slack Incorporated. Journal of Continuing Education in 2graduates quickly adapt to fast-paced environments and effectively respond to the challenging, dynamic situations encountered in daily practice.New graduate transitioning programs are particularly important because a large portion of new nurses leave the nursing profession within two years of graduating from nursing school (Kamphuis, 2004;McMahon, 2005). Turnover in the new graduate population is a documented phenomenon with reports indicating that during the first year of practice 30-61% of new graduates change their place of employment (Casey, Fink, Krugman, & Propst, 2004;Godinez, Schweiger, Gruver, & Ryan, 1999). New graduate turnover is very expensive for organizations, which report that a nurse with less than one year of experience who leaves, costs the organization almost $50,000 and can approximate a nurses' annual salary (Beecroft, Kunzman & Kroszek , 2001; WNRP Advisory Team, personal communication, 2005). Turnover costs can be as high as $145,000 (Colosi, 2002). Organizations face financial drains related to costs for advertising, recruitment, and temporary replacements. These costs are underestimated because they do not capture the tremendous consumption of resources required to orient and ...

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

“…The program consists of mentoring and monthly all day professional development sessions provided by nurse experts and skilled facilitators, which was previously described in the literature (Bratt, 2009). These educational sessions are structured around topics designed to enhance new graduates' knowledge of their particular patient population, ability to function as part of a team, a member within the organization, and as a member of the profession.…”

“…This evidence is necessary so that nurses in staff development can be guided by research findings as they institute transition to practice models that best promote competencybuilding in novice practitioners in order to optimize safe, quality care delivery. Therefore, this article describes a portion of the results from a series of investigations surrounding newly graduated nurses' transition to practice experiences from a sample of participants in the Wisconsin Nurse Residency Program (WNRP) (Bratt, 2009;Bratt & Felzer, in press). …”

“…Nurse residency programs (newly licensed nurses' transition to practice programs) are an evolving evidence-based strategy to help new nurses bridge the practice gap, reduce turnover and enhance patient safety and quality of care (Beecroft et al, 2001;Bratt, 2009;Krugman et al, 2006;Romyn et al,2009). Currently the National Council of State Boards of Nursing (NCSBN) is advocating for organizations to adopt a transition to practice regulatory model inclusive of all levels of licensed nurses and recommends that the completion of a transition program become criteria for relicensure after the first year of practice (NCSBN, 2009a).…”

Quiet Lampshade in the Corner? Exploring Fourth Year Nursing Students' Narratives of Transition to Professional Practice

“…While promoters of nurse residency programs/models responded to staff retention through the philosophy of enhanced socialization, accountability, competence, increased collegiality, and transition to professional practice (Anderson, Hair, & Todero, 2012;Meyer, 2009;Clark & Springer, 2012;Diefenbeck, Plowfield, & Herrman, 2006;Fink, Krugman, Casey, & Goode, 2008), it is less clear how these models or programs support senior nursing students' transitions.…”

Concept Maps in Nursing Education: A Historical Literature Review and Research Directions

“…The use of concept maps was studied in critical care (Dobbin, 2001;Hart, 2000), staff development (Phelps et al, 2009;Zimmerman & Pilcher, 2008;), RN education (Speziale, & Jacobson, 2004), continuing education programs for nurse prescribers (Banning, 2006), the operating department (Sewchuk, 2005), graduate student learning (Giddens, 2006), online courses (Conceição & Taylor, 2007;Ertmer & Nour, 2007), new graduate transition programs (Bratt, 2009;St. Cyr & All, 2009;Wilgis & McConnell, 2008), and neonatal intensive care (Zimmerman & Pilcher, 2008).…”