What Is a Nurse Residency Program?

Entering the nursing profession is rewarding, but it can strain your mental health. Nurse residency programs aid entry-level nurses in this transition. Extra support at the start of your career creates a strong foundation, boosts confidence, and refines skills so you can provide high-quality care.

So, what is a nurse residency program? Explore program benefits, what to expect, and whether a nurse residency program is the right choice for you.

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What Is a Nurse Residency Program?

A nursing residency program combines classroom instruction specific to your nursing specialty with clinical experience under the supervision and guidance of preceptors, coaches, and the program director.

Nursing residency programs seek to improve patient outcomes, job satisfaction, and communication. They can reduce nurse turnover, error, and self-reported stress. These programs benefit nurses who recently graduated from nursing school.

Nursing fellowships differ from nursing residencies. Accredited nurse residency programs last for six months to one year. Nurses start their nursing residency in the transition phase, where they listen to lectures and read case studies about the nursing specialty they wish to enter.

Nurses then start the integration phase, where they gain clinical experience. The program director watches the nurse residents closely to evaluate skills such as patient evaluation, decision-making, clinical judgment, and communication.

Benefits to new nurses:

• Improves clinical judgment
• Builds strong communication skills
• Teaches nurses to use evidence-based practices consistently
• Increases job satisfaction
• Decreases error

Transition Phase

During the first week of a nursing residency program, nurses may be introduced to other new nurses in their cohort, the hospital policies, and the hospital’s records system. For the next 1-3 months, nurses complete self-directed online learning and certifications, such as the Meditech training.

This transitional period can include lectures on topics such as informatics in healthcare, the American Nurses Association code of nursing ethics, and how to handle sharps and needles safely. Nurses may participate in discussion groups or go through preceptor-led training. Shifts during this phase usually last from 8 a.m. to 5 p.m. on weekdays.

Integration Phase

After the transitional phase, nurse residents enter the integration phase or a nursing preceptorship that can last a few weeks to several months, depending on the program. Nurses will work regular shifts ranging from 8-12 hours during the day, night, or a mix of both, as decided by their employer.

Nurses care for patients, practice clinical judgment, and communicate with family members, patients, and the rest of the healthcare team under the supervision of their preceptor and the program director. The program director and the preceptor will provide consistent feedback about the nurse’s performance in decision-making, clinical judgment, and communication throughout the transitional and integration phases. Nurse residents fill out surveys rating their progress throughout the program.

How Do Nurse Residency Programs Work?

More than 600 hospitals and healthcare systems in 47 states participate in the accredited nursing residency program created by the American Association of Colleges of Nursing (AACN) and Vizient. Hawaii, Wyoming, and Utah are the only three states that do not currently take part in the year-long program.

Nurse residency programs do not need nursing accreditation at this time, so nursing residency programs vary in length, content, structure, and outcomes.

Pros and Cons of Nurse Residency Programs

The pros of a nurse residency program include better outcomes for nurses and their patients in the long run because of the valuable experience nurses gain. In the short term, nurse residency programs present factors, such as going to school, that may not be for everyone.

What to Expect in a Nurse Residency Program

Program directors, instructors, preceptors, and coaches make up the staff of the nursing residency program. Program directors evaluate the nurse residents, coordinate the program, and serve as a go-between for the nurse residents and the rest of the healthcare team.

Instructors lead the transitional training. Any healthcare provider teaching the transitional training can be an instructor, including the program director. Preceptors help with the evaluation and instruction of the nurse residents.

A coach is not directly involved in the nursing residency program but adds an extra layer of support for the nurse resident.

Employers and program directors control the number of hours per shift and the number of shifts the nurse residents work. Responsibilities, hours, and shifts of nurse residents will vary depending on the needs of the hospital and their department.

The number of hours per shift can vary from 8-12 hours. Nurse residents can expect to work day shifts, night shifts, or both. Transitional training may have different hours than integration into the clinical setting.

Nursing residency programs look for nurses who:

• Graduated from an accredited program with at least an associate degree in nursing less than a year before they apply (bachelor’s degree preferred)
• Hold a current RN license in the state where they will work
• Hold a current cardiopulmonary resuscitation certification
• Hold a current basic life support certification from the American Heart Association

What to Look for in a Nurse Residency Program

Accredited nursing residency programs meet industry and educational standards because an accrediting body regulates the quality of their content. However, nursing residency programs do not need program accreditation. They vary in program length, instructors, work expectations, and environment.

Unaccredited programs can last as few as six weeks. The Commission on Collegiate Nursing Education (CCNE) and AACN require accredited programs to last at least six months to one year.

The hospital and the unit the nurse resident works for control much of the nurse’s experience, duties, and work environment. Examples of units that offer nurse residency programs include the emergency department, medical-surgical unit, and critical care unit.

Nursing residency programs use program directors and instructors to teach nurse residents during the transitional period. Then, preceptors, coaches, and program directors help nurse residents adjust to clinical experience in the integration phase. New nurses should ensure the length of their preceptorship is written into their contract to guarantee they have enough time for onboarding.

Is a Nurse Residency Program Right for Me?

Nurses considering applying to a nurse residency program should consider whether they care more about their working conditions or skill level and job satisfaction in 5-10 years.

Nursing residency programs present challenges and limitations for new nurses. Still, for many, the knowledge and experience they gain can provide success and satisfaction in their career, making residency worth the effort.

To find accredited nursing residency programs near you, search for schools:

• On the AACN’s Member Directory page
• On the AACN’s list of participating schools by state
• On the CCNE’s Nursing Residency Program Directory

Frequently Asked Questions About Nurse Residency Programs

Do nurse residency programs lead to a full-time job?

Yes, nurse residency programs can lead to a full-time position and have been shown to include higher retention rates, greater job satisfaction, and improved nurse competency. Some positions may require you to work for the hospital for up to 12 months after you complete the residency.

Are nurse residency programs hard to get into?

Yes, nurse residency programs are competitive because you often compete against dozens, if not hundreds, of applicants. Ways to stand out include:

• Prove your passion by expressing your experiences during clinical rotations within your chosen specialty.
• Demonstrate your commitment to the facility by shadowing one of their nurses before applying.
• Show off how well-rounded you are by including related non-nursing experiences.

Are nursing residency programs worth it?

Yes, nurse residency programs are often worth it. They help pace the learning process, offer a community you can rely on, and equip you with answers to questions you might have down the line.

Can you leave a nurse residency early?

No, you cannot leave a nurse residency early to work at that facility. You must complete the program to keep the position you applied for. Some facilities may request monetary compensation for their investment if you leave the nurse residency early. Other facilities may refuse to hire you again.

Page last reviewed on April 25, 2024

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