Partnership with a Community Hospital Nurse Residency Program: An Innovative Approach to Increase BSN Prepared RNs in a Rural Area

Newly graduated nurses have greater responsibility for patient care at an earlier stage in their careers than ever before.  The acuity level in both urban and rural hospitals has increased dramatically in the past 10 years. The National Council of State Boards of Nursing (2007) found that organizations perceive newly licensed registered nurses (RNs) are deficient in areas such as identifying abnormalities during physical assessment, responding to emergencies and supervising care provided by other personnel.  The UHC/AACN Nurse Residency Program (NRP) was developed, by representatives of the nation’s leading academic medical centers and their affiliated schools of nursing, as a one year post-baccalaureate program designed to ease the transition to practice for new graduate nurses.  The NRP is built on an evidence based curriculum and uses both learning and work experiences to support graduate nurses as they transition in their first year of professional practice. Strengths of the UHC/AACN NRP include group support for the new graduates, practical application of nursing concepts through expanded discussion, enhancement of critical thinking skills and in-depth development of leadership skills. The program is designed to increase job satisfaction and reinforce residents’ commitment to the nursing profession. Arguably all new RN graduates, regardless of their educational preparation, can benefit from the strengths and purpose of this NRP. Fortunately, the developers of the NRP understood that the reality of today’s nursing workforce makes it impossible for many rural/community hospitals to hire only BSN graduates. For community hospitals, who offer the UHC/AACN NRP to new hires with ADN preparation, assistance is provided to tailor the curriculum to support their transition into professional roles.

This College of Nursing is one of a limited number of academic partners of the UHC/AACN NRP that is partnered with a community hospital rather than an academic medical center. When the community hospital implemented the NRP in 2012 it was only offered to BSN prepared new hires. Because the community hospital has only 30% BSN prepared new hires it was not impacting the majority of newly employed RNs.  There was an outpouring of interest from associate degree new hires to have the opportunity to participate in a residency program. After two cohorts of BSN prepared nurse residents had completed the one year program the hospital administration decided to open the program to all new hires, regardless of their educational preparation. As a result, in the first cohort where associate degree nurses were eligible to apply, 41 of the 49 residents were prepared at the associate degree level.  Now, not only was the community hospital providing the residency program for the newly hired BSN prepared graduates of the College, but the door was opened for a partnership with the College’s RN to BSN track. 

 The addition of ADN prepared new hires in the community hospital’s NRP provided a  wonderful opportunity to embark on an innovative partnership that  would address the 2010 Institute of Medicine’s The Future of Nursing: Leading Change, Advancing Health report goal to increase the percentage of nurses holding the BSN degree or higher to 80 percent by 2020. Representatives from the academic partner’s RN to BSN program and the hospital’s NRP met to begin the development of an official partnership that would offer associate degree nurses, who were enrolled in the residency program, incentives to continue their education to obtain their BSN. The objectives from RN to BSN curriculum and the objectives of the Residency Program were reviewed and aligned in order to offer students who successfully complete the one year Nurse Residency Program credit for course assignments/requirements if they enroll in the RN to BSN track at the College of Nursing.