New Nurses in a SNAP: The Student Nurse Apprenticeship Program

Purpose: Readiness for practice programs are needed in today’s healthcare systems. Acute care hospitals are hiring more new graduate nurses (NGNs) than experienced nurses, and yet, NGN turnover is 20% to 40% nationally (1-2). Student nurses (SNs) report nursing programs did not adequately prepare in leadership, electronic health entry, delegation to peers, caring for multiple patients, and recognizing patient health changes (3). SNs spend limited time in actual practice environments posing a challenge to application of concepts learned in the classroom until after graduation (4-5). Lack of preparedness influences NGN self-confidence levels (6). Self-confidence perception in turn impacts nursing care, and thereby patient safety. A strategy to ready the NGN for safe practice during nursing school, prior to the first day of licensed practice, is critical.

Methods: To mitigate the readiness for practice gap, a program for intentionally investing in the student nurse was created. Using the registered apprenticeship format, the first registered state and federal student nurse employment model was built to strategically align with three areas: culture, clinical, and confidence, the 3’C’s. A quasi-experimental, nonequivalent control group posttest only study was conducted following the completion of the program. NGNs who completed the program, and a control group were given the Health Professional Education in Patient Safety Survey (H-PEPSS) tool post-graduation (7).

Results: One hundred-twelve SNs completed the program. Statistically significant (p<0.05) increases in perceived self-confidence related to patient safety were found in the program graduates. Organizational retention was captured at 91%. Of the one hundred-two electing to stay with the organization as NGNs, orientation time decreased an average of three weeks, with organizational cost avoidance of $524,835.

Conclusion: Planning for a confident and safe nurse workforce is no longer a luxury, it is essential to quality nursing care. A SN apprenticeship employment model is an example of nursing innovation, merging academia into bedside practice, creating a solution for mitigating the NGN readiness for practice gap. Completing the program led to higher NGN self-confidence, which supported the organizational investment of employing student nurses.