Thursday, December 5, 2019

Nurse Residency Apprenticeship: A New Era for Residency Programs  

After the Institute of Medicine’s Future of Nursing Report, the Iowa Action Coalition established a Task Force comprised of stakeholders from both acute and long-term care, including nurse executives, nurse educators, leaders from five hospital-based residency programs, as well as a new nurse graduate and a nursing student. Their mission was to develop a standardized turn-key nurse residency that was ready for facilities to use with very little start-up or implementation costs and was adaptable in any health care setting for newly licensed registered nurses from both associate degree and baccalaureate degree programs. A flipped classroom design, online modules, cohort discussion, and application of the content through a change process on unit are the components of this innovative program.  

There are two options facilities can choose from for the Iowa Online Nurse Residency Program (IONRP), blended or online. The online option is a comprehensive, turn-key residency program using online modules and monthly synchronous discussions via live webinar with the Nurse Residency Program Manager. The Nurse Residency Program Manager provides the resident with coaching and support to complete a quality improvement or evidence-based practice project in their facility. The second option, blended, provides the online modules as the base curriculum for an in-house residency program. Nurse residents complete the didactic content online at their convenience and attend discussion groups at their facility that are organized and led by a facility-based residency coordinator. The facility’s residency coordinator mentors and supports the residents through completion of a quality improvement or evidence-based practice project.  

 After five years the program has reached nearly 1,300 new nurse graduates from across the country. Even though the program  has shown statistically significant improvements in organizational and prioritizing skills, confidence in communication, and leadership skills, as well as a decrease in negative safety practices and patient errors via self-reporting for newly graduate nurse (Wilson, Weathers, & Forneris, 2018), many organizations do not have financial resources to utilize the program.  

Recent movement by the Department of Labor to approve nursing as an apprenticable occupation, was one of the deciding factors for the IONRP to begin offering their successful residency program as a Registered Nurse Resident Apprenticeship program. Working with health care facilities using this apprenticeship model allows for a seamless transition from onboarding and orientation to the support of a robust nurse residency program. This transition also led to the availability of funding that has been used to expand the program resources to include training for organization mentors and preceptors, competency validation tools, as well as scholarship assistance to support enrollment cost.   

The Iowa Action Coalition work that began more than five years ago has made a huge impact in the world of transition to practice support. Not only does any new graduate nurse regardless of setting or location have access to a robust nurse residency program, but there is now a funding source that organizations can use to optimize a seamless transition for their new nurse graduates. 

Nicole Weathers MSN, RN 

Lori Forneris MS, RN 


* Wilson, T., Weathers, N., & Forneris, L. (2018). Evaluation of outcomes from an online nurse residency program. The Journal of Nursing Administration, 48(10), 495-501.