Amid the rising nursing shortages, new graduate RNs (NGRNs) and new-to-oncology nurses need on-the-job training as they enter inpatient and outpatient roles. Nurse residency programs are one strategy to address the competency gap. In a clinical session on April 27, 2024, during the 49th Annual ONS Congress®, ONS members Julianne Luttrell, MS, RN, CNL, NPD-BC, and Leah Scaramuzzo, MSN, RN, MEDSURG-BC, AOCN®, described how nurse residency programs have been successfully implemented in urban and rural healthcare settings.
“Initial competency of NGRNs is declining at an alarming rate, slightly exacerbated by the impact of the COVID-19 pandemic as many traditional in-person clinical and classroom experiences have been adapted or abbreviated,” the speakers said. Data suggest a continuing decline in NGRNs’ initial competency, with high first-year turnover, agency use, and overtime as contributing factors.
Nurse residency programs provide curricula that develop nurses who can provide high-quality care to all patients. By bridging the academic–practice gap, the programs support NGRNs in their transition to professional practice and can help reduce turnover. They also prepare nurses to care for patients in specialties that are difficult to fill, helping to address nursing shortages.
Benefits of nurse residency programs include:
- Improved competency and confidence in clinical decision-making
- Increased professional commitment, nurse satisfaction, and teamwork
- Reduced turnover
- Improved practice safety
- Promotion of use of evidence-based practices
- Stronger clinical nursing leadership and critical thinking skills
- Individualized development plans tailored to nurses’ new roles
Nurse residency programs also have a demonstrated effect on quality of care, including:
- Improved quality and safety
- Better patient experience
- Increased caregiver commitment
- Integration of organizational culture and values into nurses’ practice
Luttrell and Scaramuzzo described the Providence Clinical Academy’s RN residency and fellowship program, “a nationally accredited, evidence-based program that places new RNs and transitioning RNs directly into specialty positions through a standard program combined with focused precepting, mentorship; and professional, emotional, and personal support.” The program’s objectives include helping NGRNs bridge the academic–practice gap, develop clinical judgement, and sustain their emotional well-being.
Logan Health, a health system located in rural Montana, instituted a pilot accredited nurse resident program in oncology in 2021, with a focus on outpatient care, Luttrell and Scaramuzzo said. In 2023–2024, they built on the success of the outpatient program and initiated a pilot inpatient nurse resident program in oncology. In their first year, nurse residents complete a core orientation and residency curriculum, and then they complete their fellowship with a clinical practicum, a staff development plan for chemotherapy competency, and the ONS Foundations of Oncology Practice Bundle™.
Nurse residency programs offer a solution to develop NGRNs’ competency as they transition to clinical practice, providing structured orientation and mentorship, reducing turnover, and enhancing quality of nursing care.