facilities as they are continuously recruiting and training new nurses. Furthermore, research suggests that the transition to practice is a stressful period, and new graduates who receive support and guidance through nurse-residency programs tend to have higher satisfaction rates, deliver better patient care, and have lower turnover rates. Therefore, the purpose of this project was to evaluate the nurse-residency program in a local, level-two trauma center in rural central Montana that can serve up to 34,000 patients a year.
Methods: A convenience sample of 13 registered nurses who completed the nurse-residency program or who were currently enrolled in the program and graduated within a year of beginning the residency program were surveyed using the Casey-Fink Graduate Nurse Experience
Survey (New Graduate Survey). Also, a convenience sample of 41 staff members of the local emergency department, which included registered nursing staff who didn’t participate in the nurse-residency program, operations specialists, physicians, and paramedics, were given an adapted Casey-Fink Graduate Nurse Experience Survey to evaluate their perception of the new graduates’ readiness to practice.
Results: The results of the project indicate that graduates of the nurse residency program have an increased readiness to practice when compared to findings in the literature. While they may feel ready to practice, participants indicated that that new graduates lack experience and confidence to perform critical-care skills. Casey, Fink, Krugman, & Propst (2004) found that “throughout the first year of practice, graduates
expressed feelings of inadequacy with their clinical knowledge, deeming themselves incompetent to care for their patient assignment” (p. 307), which would indicate the need for continued support and mentoring of the new graduates through the nurse-residency program. When the new graduates have confidence and competence caring for patients, this can have a direct correlation to increased patient outcomes. The overall impression of the nurse-residency program from the different perspectives is that the program is serving the needs of the new graduates, staff, patients, and facility. It should be noted through the participant responses that there might be a gap between perception and reality of new-graduate prioritization and organization of patient care needs.
As of January 1, 2018, there was a 100% retention rate of new graduates who participated in the nurse-residency program. Eighteen months prior to the implementation of the program, the new-graduate retention rate was at 0%, meaning 100% of the new graduates left the emergency department. All new graduate nurses hired in the emergency department when cohort 1 started were mandated to attend the nurse-residency program.
Furthermore, the results indicate that utilizing the research-estimated cost savings of $7,988 per
new graduate oriented, it can be assumed that the facility had an approximate cost savings of $103,844 for the 13 retained new graduates (Silvestre et al., 2017, p.116).
Conclusion: Facilities and management can incorporate these findings into developing and maintaining nurse residency programs in order to improve patient outcomes and new-graduate satisfaction and retention rates. All of the results and lessons learned demonstrated the powerful position of improving healthcare outcomes that Clinical Nurse Leaders are in and that, in order to have an impact, they must continuously collect data and information to develop, implement, and evaluate programs and processes.