Residency Programs for New Nurse Graduates

How Widespread Are They and What Are the Primary Obstacles to Further Adoption?
Doctors and nurses push patient on gurney.

Nurse residency programs transition nurses from school to practice and reduce nursing turnover.

The Issue:
Turnover of nursing personnel costs hospitals $10,000 to $88,000 per nurse depending on various factors. New nurses often leave a job because they feel their education did not prepare them for practice. Employers are countering these trends by offering a structured post-licensure nurse residency (NR) internship training program for up to a year. Nurses are paid during the NR and required to work for the employer for up to two years afterwards. Hospitals with residency programs report significant reductions in turnover (from 27% before the program to 7% after).

Key Findings

  • Some 36.9 percent of hospitals offered NRs (85% urban hospitals; 15% rural hospitals). Residencies were most common in nonprofit mid-sized hospitals located in the South.

  • Most residencies were optional (92.8%) and developed in-house (68%).

  • Other training programs were almost universally offered in leadership, quality and safety, and multidisciplinary team care.

Respondents cited financial costs as the greatest challenge to starting a residency program.

About the Study:
Participants included hospital and health system chief nursing officers and chief nursing executives, some 219 members of the American Organization of Nurse Executives, participated in the 2011 survey.