By Heather Stringer
In 2010, the Institute of Medicine issued eight recommendations that dared to transform the nursing profession by 2020. This year marks the midway point for reaching the goals outlined in the report “The Future of Nursing: Leading Change, Advancing Health,” Recommendation 3 of which is to implement nurse residency programs. Statistics at halftime offer a glimpse into nursing’s progress so far.
Recommendation 3: A closer look
The Future of Nursing: Campaign for Action leaders acknowledge that it has been challenging to execute Recommendation 3. “There is evidence that residency programs help increase the competency of nurses and retention, but it is hard to pay for these programs,” said Susan Hassmiller, PhD, RN, FAAN, the Robert Wood Johnson Foundation senior adviser for nursing. “Whose responsibility is it? The schools of nursing, the hospitals, the insurance providers? With everything being cut back in healthcare and some hospitals in the red, they have to make hard decisions about allocating resources, and residency programs do not always take a first priority.”
Despite these challenges, a study released in February in the Journal of Nursing Administration reported a 10% increase in the number of hospitals offering nurse residency programs between 2011 and 2013. In 2013, 41% of institutions offered RN residencies to new graduates.
To encourage more facilities to implement the recommendations, the RWJF created grants of up to $150,000 that could be used by the state action coalitions. So far six of the 31 allocated state grants are being used for nurse residency programs. The six states are Rhode Island, Idaho, Utah, West Virginia, Arkansas and Nevada.
Proving their worth
Although the cost of a nurse residency program may seem like a barrier, nurse leaders in some hospitals made the case to hospital administrators that these programs would not only save money but also improve the quality of care.
“Our residents work closely with staff nurses who serve as coaches,” said Joan Kavanagh, MSN, RN, NEA-BC, associate CNO of education and professional development at the Cleveland Clinic in Ohio. “Learning in context with an experienced coach compresses the time to competency and that is the big money saver and also the key to patient safety.”
The Cleveland Clinic launched a nurse residency program in 2014 in which nurses were assessed before entering the residency to determine the areas where they lacked experience, and their training was tailored accordingly. The residents also were not paid a full salary until they demonstrated a level of competency, and then they moved to a full salary while still working with a coach.
“This has been a passion of ours for many years because we really wanted to support new grads and nurses who are making a major clinical career change,” Kavanagh said. “With the support of a coach, educator and manager throughout the core curriculum, we have seen an improvement in speed to practice and confidence to care for patients independently.”
Heather Stringer is a freelance writer.