Friday, July 22, 2022

By: Nicole Weathers, MSN, RN, NPD-BC (IONRP Manager

New graduate nurses are arriving to practice after completing their academic preparation during a global pandemic. COVID-19 has created a situation where more education is provided online, and our nursing students spend less time in the physical clinical environment. In many areas of the U.S., new graduates are entering practice with minimal clinical exposure.

The Iowa Online Nurse Residency Program (IONRP) believes that every new graduate nurse deserves to start their career with the support and tools to be successful regardless of where they choose to practice early in their career.   While we have been able to stay true to our mission of providing an effective and affordable transition solution for new nurses, funding the program can still be an issue from a nurse leader's perspective. 

Over the last eight years of providing the IONRP, we have worked with several organizations across the country and have explored different ways to fund the necessary and comprehensive support. Budget allocations and hospital foundations have been two more traditional routes, but recent years have brought more innovative funding sources. We have now seen success utilizing HRSA Flex Program dollars and, most recently, Registered Apprenticeship funds.   While the Flex Program is specific to rural organizations, Registered Apprentice Programs (RAP) are utilized by all sizes and types of healthcare organizations.

What is a RAP? 

For employers, registered apprenticeships are a tool to help recruit workers to in-demand jobs and prepare and retain workers by providing them with the knowledge and skills needed to be successful. Apprenticeship programs are customized to meet employers' needs and apprentices' skills, utilizing an earn while you learn model.

The U.S. Department of Labor requires that apprenticeship programs provide four components

  • on-the-job learning
  • competency validation
  • related training instruction
  • wage progression 

Apprentices receive hands-on training from an experienced mentor at the job site. On-the-job training focuses on the skills and knowledge an apprentice must learn during the program to be fully proficient on the job. This training is based on national industry standards and customized to the employer's needs. One of the unique aspects of apprenticeships is that they combine on-the-job learning with related training instruction (RTI) on the technical and academic competencies that apply to the job. Education partners collaborate with businesses to develop the curriculum, which often incorporates validated national-level skill standards.

There has been a push to expand RAPs, and with this, they have added newly apprenticeable occupations, an R.N. Resident being one of them. The R.N. Resident RAP begins after the Nurse is a licensed Registered Nurse participating in a specified training program that is standardized based on the area of specialization. The specialized training includes unit-based, precepted clinical experiences and didactic instruction, communication, critical thinking/problem-solving skills, and applying knowledge, skills, abilities, or behavior to demonstrate consistently safe quality patient care.

Who can operate a RAP?

Sponsors can be a single business or a consortium of companies. Alternatively, the sponsor can be a workforce intermediary, such as an industry association or a labor-management organization. Colleges and community-based organizations can also serve as sponsors of apprenticeship programs.

Sponsors are responsible for the design and execution of apprenticeship programs. The programs operate voluntarily and often receive support by collaborating with community-based organizations, educational institutions, the workforce system, and other stakeholders. 

The Iowa Online Nurse Residency Program functions as a Sponsor for many of our employer partners here in Iowa and as an RTI provider for RAPs in other states. For instance, the Colorado Center for Nursing Excellence's (The Center) Workforce Innovation Nursing Network (WINN) provides a state-wide RAP for new graduate nurses throughout rural Colorado. The Center partners with the Iowa Online Nurse Residency Program to provide our RTI to their participants.   

A significant amount of funding has been available to those developing and utilizing programs. As recent as June of 2019, there was an announcement awarding a total of $283.8 million to support the development and expansion of apprenticeships to expand apprenticeships and close the skills gap, specifically in the areas of advanced manufacturing and information technology and none other than healthcare. With the addition of the R.N. Resident occupation and increased funding, it is easy to see how this is a perfect fit to support the transformation of new graduate nurses into bedside leaders and open the door to funding sources.

Nicole Weathers, MSN, RN, NPD-BC

IONRP Manager,


U.S. Department of Labor (DOL). (n.d.). Apprenticeship overview.

U.S. Department of Labor (DOL). (24, June 2019). U.S. Department of Labor makes major announcements on apprenticeship expansion.  

U.S. Department of Labor (DOL). (10, September 2018). Bulletin 2018-76 New occupation: Registered Nurse (RN) Resident.