In 2007, the American Journal of Nursing published a study entitled “Newly Licensed RNs Characteristics, Work Attitudes, and Intentions to Work” which reported that 13 percent of newly licensed RNs had changed principal jobs after one year and 37 percent admitted they felt ready to leave.
Surely, it is not a lack of dedication to the profession: nursing students put in hard work and long hours to earn the credentials for that first job. I find it impossible to believe that more than one in ten nurses in the above study or indeed a single one started the first day of work with anything less than a full heart for what they would accomplish for themselves and their patients.
The Health Resources and Services Administration projects that the nation’s nursing shortage will grow to more than one million nurses by the year 2020. Innovative approaches must be undertaken to mentor new nurses who need a structured path to develop comfort in the role of an RN, apply theoretical concepts at the bedside, strengthen their commitment to nursing as a career choice, and improve critical thinking skills.
Two years ago, Holy Cross Hospital in Fort Lauderdale launched its one-year Nurse Residency Program. The prototype for the program was developed in 2002 by the University HealthSystem Consortium in collaboration with the American Association of Colleges of Nursing and is now being implemented at over 50 sites throughout the United States.
Eligible candidates for the program at Holy Cross Hospital must be a Florida licensed new BSN graduate with less than six months work experience who will commit to working at the hospital for one year after program completion. The results have been eye-opening and offer some guideposts to increasing job satisfaction among new graduates.
Mind Over Daily Matters
One of the common reactions we hear is that the new nurses did not anticipate the workload. In response, the program offers a lighter workload during orientation so that nurses have the ability to thoroughly learn the new policies and procedures.
Quality Care, Not Quantity Care
Participants also report amazement and trepidation that they are given the independence to make decisions on their own. To develop the confidence necessary to take over responsibility for patient care, the program begins with a reduced nurse to patient ratio. Depending on the assigned nursing unit, this could be one nurse to two patients before expanding a nurses care to four patients.
No One Is Alone
In addition to the support of each other, the nurses will receive one-on-one mentoring on the floor from experienced nurses. I have had participants tell me that they would have changed careers if not for the ability to speak to other nurses in their own area and on other floors facing similar frustrations and challenges.
Education Never Ends
A cornerstone of the Nurse Residency Program is monthly seminars containing educational content along with small group discussions of professional experiences and case studies which foster better communication and critical thinking skills.
Learning From Those Who Went Before
We have a waiting list of veteran nurses at Holy Cross Hospital who wish to participate as program facilitators. In addition to financial compensation, nurses report being energized by the new ideas the graduates bring to the field.
New Voices Are Worth Listening To
Before completing the program, participants must present an evidence-based research project. One groups research on the cost- and clinical-analysis of disposable blood pressure cuffs was later presented to the hospitals Value Analysis Committee for possible hospital-wide implementation.
Its Not for Everyone
Holy Cross Hospital has seen an increase in nursing retention rates, yet we must be realistic that nursing may not be for everyone. That is also part of our job: to help young nurses ascertain as early as possible whether they will find fulfillment and see nursing as the job of a lifetime.
In 2007, the American Journal of Nursing published a study entitled “Newly Licensed RNs Characteristics, Work Attitudes, and Intentions to Work” which reported that 13 percent of newly licensed RNs had changed principal jobs after one year and 37 percent admitted they felt ready to leave. 
