Current literature supports the creation and implementation of nurse residency programs to support new graduate nurses as they transition into nursing practice. Additionally, nurse residency programs have been shown to increase nurse satisfaction and retention (Crimlisk et al., 2017; Olson-Sitki et al., 2012). Currently, there are only three nurse residency programs in the state of Alabama. The lack of this important post-licensure resource poses a problem for new graduate nurses who are seeking additional assistance and guidance during the transition to professional practice. This qualitative study examined the decision-making process of hospital leaders in the implementation of the nurse residency program at their facility. This study also explored factors that impacted hospital leaders' decision to implement a nurse residency program. This study found a relationship between the decision to implement a nurse residency program and the desire to increase nursing development in the facilities. The benefits that were identified included building a solid foundation, recruitment and retention, and building relationships. Other factors that influenced the hospital leaders' decision to implement the nurse residency programs were demand and excessive turnover of staff. In addition, multiple barriers such as logistics, manager buy-in, and curriculum development were identified by the hospital leaders as potential barriers to implementation. This study will also be able to help hospital leaders who are struggling with the decision to implement nurse residency programs in their facilities.

A secondary data analysis study was conducted to determine if newly graduated nurses benefited from participation in a 1-year University Health System Consortium/American Association of Colleges of Nursing (UHC/AACN) nurse residency program in a community hospital. The sample included data collected from 121 newly graduated nurses who completed the Casey-Fink Graduate survey at the start of program, 6 months into the program, and again at the end of the year-long program. Data included in the study span 3 years from 2012 to 2015. Participation in a community-based nurse residency provided several benefits to newly graduated nurses. There were statistically significant improvements in participants' level of comfort with communication skills, leadership capacity, ability to organize and prioritize care, and technical skills performance. Most of the participants reported decreased levels of stress and high levels of perceived support. Study participants' professional satisfaction scores did not reach statistical significance but did improve slightly during the program. Turnover of participants in the study site program decreased from 37% prior to program implementation to less than 4% in 2014. Potential cost savings of the nurse residency program for the study site added up to approximately $5 million. The results of this study contribute to the limited number of studies on this topic.

Health care facilities across the United States have implemented innovative approaches such as nurse residency programs to facilitate a successful transition to practice for new nurses. Many nurse residency programs evaluate their effectiveness by assessing critical thinking abilities, retention, return on investment, and job satisfaction. Evaluations are conducted using surveys and focus groups. However, there is a void in the literature that examines the effectiveness of a new nurse residency program from the participants' perspective; particularly asking the resident how the nurse residency program has advanced them to become a more competent professional. The theoretical model framing this investigation is Patricia Benner's novice to expert theory. The purpose of this qualitative case study is to understand participants' perceptions of a nurse residency program, specifically looking at how the program transitioned them from advanced beginner to competent nurse professional. The study sample included eight participants employed in a health care facility located in the southeastern United States. Open-ended research questions were designed to elicit the new nurses' perceptions of the effectiveness of a nurse residency program. Data collection was conducted using interviews and audio recordings. Emerging themes indicated that pre-experiences and expectations, leadership and professional development, stress and coping, supportive cohort, program improvements, and reflection on confidence and competency were fundamental elements for an effective nurse residency program. One recommendation from this study was for pre-residency assessment tools to be given to residents for customization to better facilitate the transition of new nurses to a competent professional.

In this comprehensive resource, nursing staff development expert Jim Hansen, MSN, RN-BC, provides instruction and tools to plan, justify, and structure a nurse residency program that develops and retains new nurses through their first year

New graduate nurses encounter "transition shock" when they enter the workplace, especially in acute care settings such as hospitals. New graduate nurses have a difficult time transitioning into the work environment because they are unprepared by their academic training for the realities they will face and they often don't have the proper support in place to guide them through the transition. This leads to a high attrition rate of up to 30% within the first 18 months of employment which costs hospitals and health care facilities. High nurse turnover of new graduate nurses who aren't prepared for the complexities of clinical practice affect the quality of care provided. Patient outcomes are negatively affected because it often leaves hospitals dealing with a shortage of experienced nurses, which they compensate for by having high patient to nurse ratios. New graduate nurses must develop the necessary critical thinking skills to handle higher acuity patients and difficult situations, develop confidence in their clinical skills, and adapt to peer relationships. One solution to the "transition shock" that new graduate nurses face is the implementation of nurse residency programs. Nurse residency programs are shown to help new graduates have a better transition into the workplace and increase nurse retention. This paper discusses the problem of new graduate nurse turnover, the benefits of nurse residency programs, and the numerous research studies which have been done showing the success of nurse residency programs on new nurse graduate retention and job satisfaction. It also discusses how to implement a nurse residency program and monitor and evaluate its success.