Monday, August 22, 2022

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

In eight years of working with the Iowa Online Nurse Residency Program (IONRP), I have had the opportunity to help countless healthcare organizations implement nurse residency programs within their organizations. Through these implementations, I have learned so many Do's and Don'ts when getting started. Here are four Do's and Don'ts as you get started.

DON’T just start a program to start a program.

While our program allows organizations to get up and going in a short time frame, organizations must do their homework first to ensure not just a successful launch but, equally important, sustainability. Organizations must start by identifying their ‘why’ for the program. Why are you interested in launching a nurse residency program? What problems are you having? What gaps exist?

You can do this by conducting an environmental scan of internal and external influences stimulating the need for a residency program. Do you have difficulty attracting nurses to apply to your organization? Do your neighboring competitors offer a residency program that gives them an advantage? Are your current training and development strategies costing you too much? Are your new nurses simply lacking the skills and competencies they need to function in the current work environment? Do you have a high turnover in your new graduate nurses? Are there concerns with the quality of care or safety of your patients? Whatever it is, get to the bottom of why you want to do this.

DO identify the goals of the program and communicate those goals throughout the organization.

Not only do you need to get very clear on your 'WHY,' but it is also essential to ask...‘WHAT’

What do you want the new nurse to gain through participation in a nurse residency program? Is it clinical skills? Is it the ability to function well within the team? Is it to see their role beyond just checking boxes but instead seeing the big picture of what healthcare is all about? What are the learning needs of the new nurses coming into your organization?

You also have to be realistic in your expectations...Involve key stakeholders. Ask nurse leaders what they WANT or NEED your new nurses to be able to do by the one-year mark. Remember, to only focus on what you need from them by the one-year mark. Many times, I think there is a significant discrepancy between what nurses realistically can do in the first year and the expectations of the leaders and experienced nurses within the organization. Asking this question allows you to clarify realistic expectations and ensure the residency program helps to meet those expectations.

Another question is what do you hope your organization gains from implementing a nurse residency program? Is it about the financial return? Does it relate to patient outcomes? Is it simply about better, more well-adjusted nurses? Maybe accreditation is part of the picture and something you hope your organization will achieve. Knowing your goals and objectives for both the new nurse and the organization will allow you to create a program that meets your unique needs.   

DO ensure your organization is in an excellent position to start a program.

You need stakeholders to be able to embrace the change this program will bring. Consider what other things are happening at the organization that might make implementation difficult or indicates now might not be the best time to get started. Also, get a pulse on how open your organization is to change. Does the culture support this type of program? Do your stakeholders, such as managers, educators, and human resources departments, buy-in and support the need for a residency program?

You will also want to consider how the program aligns with the organization's mission, vision, values, strategic plan, and goals. Successful residency programs are integrated into the organizational culture; they are a piece of the stairway that leads organizations to their greater mission. Successful programs align with the vision and values while supporting the organization's strategic goals. 

DON’T forget to plan for evaluation. 

What can you measure to show that you reached your goals? If your goal is retention, ensure that it is measured and that you have an accurate baseline. If your goal is will that be measured? If you want nurses to become leaders at the bedside and engage in improving practice, what does that look like for you?

Brainstorm all the possible measures you could use to determine how you will show you are on the way to meeting your goals. Not only is this an essential piece of improving and changing your program, BUT it is also crucial to garnering the buy-in and support for the time and resources associated with providing the program. 

Needing help launching your first nurse residency program? Did you know the Iowa Online Nurse Residency Program provides consultation and ongoing support for organizations utilizing our online curriculum?  Contact us today to learn more about we can support your new graduate nurse transition to practice efforts.

Nicole Weathers, MSN, RN, NPD-BC

IONRP Manager,


Weathers, N. (January 2022). 4 Steps to Launch a Nurse Residency in 2022. Oral presentation for the National Rural Health Association via Online Webinar.