Nursing is always one of the most popular career options for people who want a stable job and good pay. The attraction lies in the variety of different types of jobs available, reliable pay, and predictable hours. Whether you are looking for a challenging task, like med-surg nursing or intensive care nursing, or your heart is set on something more routine, like outpatient nursing, it’ll be easy for you to find an option that suits your style.
While nursing school is very challenging, the first year as a nurse can be just as tough. To ease this transition, many hospitals have implemented something called nurse residency programs. But, not all programs are created equal. Let’s discuss what these are, what to look for, and outline some of the best nurse residency programs in the USA.
What Are Nurse Residency Programs?
As nurses graduating nursing school and enter the workforce, something that has become abundantly clear is their lack of readiness to care for patients in the fast-paced hospital environment. Therefore, to ease this transition to practice, hospital have implemented programs called “Nurse Residency Programs”. You may also hear these called “Transition to Practice Programs”.
To work as a nurse at a hospital, you must complete an orientation period in which you are with a nursing preceptor who will teach you all of the specifics of how to function on your unit successfully. This can be anywhere from 6-12 weeks in length, depending on the unit and hospital. However, this instruction is highly specific to the functioning on on your unit and is on the job, actively providing care to patients. However, there are big-picture concepts that are crucial to understand during this period of professional development that are best provided in a classroom setting, not during a busy nursing shift.
Therefore, residency programs will provide additional instruction away from the bedside to solidify important concepts, offer mentoring, troubleshoot complex situations, discuss policies and procedures, and familiarize the new staff members with aspects of the culture of the hospital.
How does this help new nurses?
You get to practice skills in a lower-risk situation and receive feedback in real time. You’re also able to talk through and make sense of situations that quickly unfolded at the bedside. You also bond with other new nurses during a very challenging transition.
The overall goals of these programs are to reduce burnout and stress, improve patient outcomes, and also improve job satisfaction.
What Makes a Nurse Residency Program Different?
First of all, not all hospitals have residency programs. If you’re on the hunt for a job as new nurse, it’s important to know how the support the new graduate’s unique needs as they transition to practice if they do not have an established residency program.
Next, while accreditation for nurse residency programs exists, it’s not required. These programs are a bit newer to the scene, and not highly established like nursing schools themselves. Therefore, there is not a uniform national standard for these programs.
They can be anywhere from 6 weeks – 12 months in length, and require weekly or monthly classroom time. There may also be additional aspects, like regular check-ins with a mentor or coach, assignments to complete, or shadowing experiences to log.
Some residency programs will hire you into a large group of applicants, have you complete shifts on different units, and then will select the unit you will work on on your behalf. With other programs, you may be hired onto a specific unit right away and stay their for the entirety of your employment while you also complete your residency program.
Additional things that can differentiate programs:
- Length: Can be anywhere from 6 weeks to 12 months (ANCC recommends 12 months)
- Frequency of lectures/meetings: Weekly, monthly
- Additional support: Established coaches, mentors
- Job selection: You can be hired to a specific unit immediately, or hired into a pool of new nurses who are then placed onto units after a certain point in residency program when hours on different units have been completed
- Floating experience: During orientation you may spend specific weeks on different units, while other programs may not allow you to float at all until orientation is over
- Required length of employment: Some residency programs will require you to stay for a certain length of time (1-3 years is common) while other may not have that requirement.
- Sign-on bonuses and contracts: Some may offer a sign-on bonus, but this often comes with a contract stating that you will not leave within a certain time frame (often 1-3 years) or else you will be required to pay that bonus back
- Pro-Tip: Let’s say you start a hospital and sign one of these contracts, and the hospital turns out to be an awful place to work and you need to get out of the contract. When you get a job at another hospital, ask if they can buy you out of the previous contract during salary negotiations.
- Quality of education provided: Some programs provide very helpful information that actually move the needle, while others just add another event on your calendar that you have to show up for but it doesn’t actually make a difference
Are Nurse Residency Programs Specialized?
Nurse residency programs can be specialized. The degree of this depends on how large the hospital is, and the number of specialty units and their size. It is common to have a nurse residency curriculum that is general and covers common needs of medical-surgical patients and similar units at that level of care. (Most of the links to residency programs below will tell you which specialty tracks they have available.)
For example, at a hospital, the oncology, observation, cardiology, neurology, orthopedics, and med-surg nurses may all go through a certain curriculum designed to support their specific needs for that level of care. The ICU, neuro ICU, cardiovascular ICU, trauma ICU, stepdown, and emergency department nurses may complete a different curriculum more customized to their needs. You may also see a much more specialized residency program for labor and delivery, NICU, surgical services (OR, PACU, pre-op), pediatrics, or psych/behavioral health.
Keep in mind, some hospitals do not permit new graduates into specialty units (OR, labor and delivery), or high-acuity units (ICU, NICU) due to the high degree of complexity. At some hospitals, your only option as a new grad may be to start out in the med-surg residency program.
Reputable Nurse Residency Programs in the USA
Please note, multiple programs below are at children’s hospitals, therefore jobs at those locations would be in pediatrics and pediatric sub-specialties.
- *University of Iowa Health Care – Iowa City, IA
- *Carle Foundation Hospital – Urbana, IL
- Hospital for Special Surgery – New York, NY
- *Johns Hopkins Medicine – Baltimore, MD
- *New York-Presbyterian Hospital – New York, NY
- *NYU Langone Medical Center – New York, NY
- *Penn Medicine – Philadelphia, PA
- *Virginia Commonwealth University Health – Richmond, VA
- Children’s Healthcare of Atlanta – Atlanta, GA
- *Cook Children’s Medical Center – Forth Worth, TX
- *Emory Healthcare – Atlanta, GA
- University of California Health – UC System Locations
- Seattle Children’s Hospital – Seattle, WA
- *Houston Methodist – Houston, TX
- Rush Medical Center – Chicago, IL
- Mayo Clinic (Florida Program) – Jacksonville, FL (please note, this link shows all Mayo Clinic residency programs)
- *Memorial Hermann – Houston, TX
- *UNC Medical Center – Chapel Hill, NC
- Vanderbilt University Medical Center – Nashville, TN
- Children’s Hospital of Michigan – Detroit, MI
- University Hospitals Cleveland Medical Center – Cleveland, OH
- *UW Health – Madison, WI
- WakeMed – Raleigh, NC
- *Cleveland Clinic – Cleveland, OH
- *University of Kentucky HealthCare – Lexington, KY
- *University of Kansas Health System – Kansas City, KS
- *Children’s Hospital Colorado – Aurora, CO
- University of New Mexico Health Sciences Center – Albuquerque, NM
- University of Colorado Health – CU System Campuses
* indicates national accreditation designation
The time period of the above programs is anywhere from 12 -18 months.
What If My Hospital Doesn’t Have a (Good) Residency Program?
Residency programs are extremely expensive to create and maintain. There are great hospitals out there that don’t have solid residency programs (and some that don’t have one at all). But, don’t worry. If your hospital doesn’t have one, that doesn’t mean you won’t be able to have a great new graduate experience. I created my own self-guided nurse residency program that you can take at your own pace.
This can help fill in the gaps in the absence of a residency program, or one that’s failing to meet your needs. Learn in the privacy of your own home, so that when you’re at the bedside you can look like a pro and ask really smart and thoughtful questions to you preceptor.
The FreshRN® New Nurse Master Class is the first-ever self-guided holistic nurse residency program. This comprehensive program was specifically created for the ambitious newly licensed acute care nurses who want to get ahead of them and build both their confidence and their clinical skills – all while learning how to adjust to the unique lifestyle of a nurse.
I am not sure that most nurse residency programs replace university education. In my experience most of them are for RNs (who already have a degree and a license) to get on the job training and support.
Hi Liz, there were some inaccuracies in this post that I’ve updated and corrected. Appreciate your comment!