Nurse Residency Programs: A Guide for Student Nurses
If you’re currently a nursing student and edging closer to graduation, no doubt you’ve come across the term, Nurse Residency Program, (NRP). These programs sound important, but many budding nurses are not entirely clear on what they actually are, or whom they benefit. This guide aims to clear that up. Below you will find a clear description of NRPs, an outline of their advantages and disadvantages, and whether or not they might make sense for you to pursue.
Nurse Residency Programs—an overview
NRPs are a combination of real life nursing experience or hands-on learning with a preceptor and coursework for new graduate nurse hires. You can think of them as a “souped-up” orientation period. Normally when you get hired as a Graduate Nurse (GN) position —by definition, a graduate of an accredited nursing school, who has taken and passed the NCLEX—you are paired with a preceptor in your hiring department.
You then shadow your preceptor for a designated amount of time, typically 3 months. This gradual trial-by-fire period allows you to expand your skill set while you learn your unit’s and hospital’s particular policies and procedures. Concurrently, you attend your hospital’s orientation program, which can be a week or two in length. Then—you’re on your own!
One of the primary differences in a typical preceptorship and an NRP is the length of time you are considered to be in a learning phase. Participants in an NRP can expect to be enrolled for at least six months, on up to one year. Therefore, these nurse resident GNs have a longer period of acclimation while they transition from being a student to being a working RN.
NRPs follow a set curriculum that differs from hospital to hospital. Generally, these are programs that hospitals purchase from outside vendors; they are then customized to each facility’s needs. The overall goal of NRPs is twofold—first, to mold confident and competent new staff, and second, to retain those staff long-term.
The pros
One of the biggest advantages to participating in a residency program is the opportunity to practice clinical skills in a learning environment. In this way, you can almost think of NRPs as an extension of clinical hours from nursing school.
What’s more, the development of clinical judgement in a unit-specific context is something that simply cannot be learned in nursing school. This type of learning happens during traditional orientation and preceptorship for GNs—the advantage of enrolling in an NRP is that the learning period is extended by many months and supplemented with classroom learning as well. New nurses are nurtured along, with more time allowed for concepts to solidify.
Being able to hone in critical thinking skills, practice competencies in real time, and increase exposure to what life is really like as a nurse are dramatically improved within the scope of an NRP. GNs who participate in residency programs therefore hit the ground running when they graduate into full-time practice. This increased level of professional confidence then in turn decreases the rate of burnout new nurses can sometimes feel when placed in traditional “sink or swim” preceptorships.
It’s not just new nurses who benefit from this heightened confidence. Patient care is improved as a direct result. Residency program graduates have a familiarity within their units that their GN counterparts do not possess. In addition, the supplemental coursework they complete deepens their unit-specific knowledge base. Simply put, NRP grads know more about their patients, and have the hands-on skills to back up that knowledge.
The Cons
Hospitals that offer NRPs to new hires are making a significant investment in them. This is advantageous for the employer in the sense that nurses who participate are more likely to be retained, thereby decreasing costly staff turnover rates. But the hospitals recoup some of this investment by passing the cost on to GNs.
One way they do this is by paying NRP participants a lower wage. The program in and of itself is positioned as a means of compensation. Upon completion of the program, GNs will then see their salary increase.
Another potential drawback to NRPs is the stipulation of signing a contract. Most hospitals will require nurse residents to commit to working a certain length of time within their institution in exchange for enrollment in the NRP. For this reason, new graduates are cautioned to perform their due diligence when it comes to assessing whether or not this particular institution will be a good match for them in the long run.
The takeaway
In general, most in the field consider NRPs to be a valuable asset to new nurses. Too often, new graduates are turned loose on their units without the necessary training and real-world experiences under their belt. This can add to the anxiety that new nurses feel as they start their nursing journey; it also perpetuates a sense of Imposter Syndrome, which can be isolating if left unchecked. In turn, anxious nurses who feel unprepared can then feel too intimated to ask for help. This sets them up to be victims of lateral violence, an experience better known as “nurses eating their young.”
If a new grad has the opportunity to learn as they go, experience the vast and varied world of bedside patient care in real time under the wing of a seasoned nurse, everyone wins. The hospital, the patients, the preceptor, and most especially—the GN. Nurse retention is a hot topic now. New nurses who set themselves up for success at every turn before they enter the oft-times chaotic and overwhelming world of nursing as it exists today are making a wise investment in their future.