Retention is often the headline metric for nurse residency programs, but does staying really mean thriving? Retention tells us who stayed, but it doesn’t tell us how they’re doing, whether they feel supported, or if they’re growing in their role. If our goal is to build a workforce that is capable, resilient, and committed, we have to look beyond retention.

A nurse might stay because of benefits or personal circumstances, or leave for reasons unrelated to their work experience or organization. Retention doesn’t distinguish between someone who is energized, learning, and contributing (engaged) and someone who is isolated, disengaged, or burned out (retained). Too often, engagement is reduced to a survey score. That score captures a single moment in time. But engagement is far more complex. In healthcare, where both humans and organizations are open systems, engagement is not static. It ebbs and flows with life stressors, workload, staffing, leadership behaviors, and how well the organization listens and responds.

Engagement also tends to feel one-sided: we hire nurses to fill a role, pay them to do the work, and expect unwavering commitment. But when engagement is treated as a one-way street, it becomes transactional, work for pay. True engagement is relational: we listen, support, and create environments where nurses feel competent, safe, valued, and heard. Without that, engagement erodes, and retention becomes a hollow metric.

To put it plainly, retention tells us who stayed; engagement tells us how they’re doing, but it’s only helpful if we treat it as a living, breathing relationship, not a static score.

So, what does this mean for nurse residency programs? Residency programs are designed to provide structure, support, and skill-building during the transition to practice, exactly the kind of environment that fosters engagement. But here’s the challenge: if the work environment nurses step into after residency doesn’t mirror or reinforce that experience, engagement will suffer, and ultimately, retention. Then the residency coordinators and the program get “blamed” for not improving retention, and nothing changes in the work environment that actually drives engagement.

Residency is the foundation. The organization must build on that foundation to translate that investment into engagement, performance, and ultimately retention. For example:

• Nurse A completes residency, joins a unit with consistent staffing, a supportive manager, and a clear development path (councils, precepting, quality projects). She asks for feedback, contributes ideas, and feels heard. She stays and thrives.
• Nurse B completes the same residency, but joins a unit with frequent short staffing, rotating managers, and little time for learning. Ideas are dismissed. She stays for the benefits, but disengages.  

Same retention outcome; profoundly different organizational impact. This is why measuring the success of a residency program by retention alone misses the mark. Residency programs jumpstart engagement, but they cannot carry it alone. If we want nurses to thrive, and if we want retention to mean more than “who stayed”, we must measure and cultivate engagement as an ongoing, reciprocal relationship. When organizations build on the residency foundation with ongoing professional development and consistent supportive environments, engagement strengthens, and retention follows with meaning. That’s the conversation we’re having with Dr. Katie Boston-Leary on this month’s podcast: what engagement really means, why it matters more than retention, and how we can create environments where nurses feel supported, connected, and able to grow. Hope you can check it out.

Nicole Weathers, DNP, RN, NPD-BC 
Iowa Online Nurse Residency Program Director 
nicole-weathers@uiowa.edu
Wanting a Program Overview? Need to schedule a meeting? Book time with Nicole 
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