The long-term effect of a nurse residency program, 2005-2012: Analysis of former nurse residents

OBJECTIVE: Research on nurse residency programs (NRPs) typically focuses on retention within the 1-year NRP or perhaps an additional year beyond. Few have evaluated the long-term impact of NRP, and none have adopted a longitudinal approach to follow cohorts over time. This study, conducted in a large urban academic medical center (AMC), examines the effects of the NRPs on former nurse residents (NRs) in 8 cohorts (2005-2012) and compares those who left the institution with those who remain. BACKGROUND: Nurse residency programs have increased from home-grown programs to a standardized 1-year curriculum from national models designed for different types of RNs. Evidence exists that NRPs reduce attrition among new graduates and the Institute of Medicine recommends that all new RNs have access to NRPs. METHODS: Using data from human resources, administrative data, and online survey of former NRs, this is a retrospective, longitudinal study of former NRs in 1 AMC. Nine hundred eighty-seven new graduates completed the NRP from 2005 to 2012; 646 (63.5%) have stayed (stayers) at the institution. A total of 425 stayers responded to survey (65.8%), and 108 surveys were completed by former NRs who had left (leavers) (62.4%). RESULTS: On average, leavers stay for 2.18 years at the institution; stayers typically remained for 4.86 years, suggesting that retention beyond 2 years is dependent on complex set of circumstances beyond the "treatment effect" of the NRP program. Regardless of staying or leaving, respondents hold positive attitudes about the program; achieve high levels of certification, advanced education, and professional accomplishments; and report "transitioning from beginner to competent RN" and "senior staff support" as most valuable aspects of NRP. CONCLUSIONS: Retention among new graduates has improved significantly with the introduction of NRPs at this institution. Former NRPs report favorable assessments of the NRP, regardless of number of years since completion of the program and regardless of whether the individual remains employed in the institution. In addition, former NRs report high levels of professional accomplishments and commitment to nursing. However, without additional research, we cannot definitively tie these outcomes to the NRP.