What Is a Nurse Residency Program?

By the end of their first year, 17% of new registered nurses quit. Three years into their professional career, 30% of new nurses quit. If you want to be one of the nurses that continues in nursing, learn how a nursing residency program could better prepare you for the demands of nursing, increase your job satisfaction, and help you stay in the field longer.

What Is a Nurse Residency Program?

A nursing residency program is a program that combines classroom instruction specific to your nursing specialty with clinical experience under the supervision and guidance of preceptors, coaches, and the program director.

Nursing residency programs seek to improve patient outcomes, job satisfaction, and communication. They can reduce nurse turnover, error, and self-reported stress.

Nurse residency programs can benefit nurses who recently graduated nursing school or who are new to their chosen nursing specialty.

Nursing fellowships differ from nursing residencies. Accredited nurse residency programs last for six months to one year. Nurses start their nursing residency in the transition phase where they listen to lectures and read case studies about the nursing specialty they wish to enter.

Then, nurses start the integration phase where they gain clinical experience. The program director watches the nurse residents closely to evaluate skills such as patient evaluation, decision-making, clinical judgment, and communication.

Benefits to new nurses:

• Improves clinical judgment
• Builds strong communication skills
• Teaches nurses to consistently use evidence-based practices
• Increases job satisfaction
• Decreases error

Transition Phase

During the first week of a nursing residency program, nurses may be introduced to the rest of the new nurses in their cohort, the hospital policies, and their hospital's records system. For the next 1-3 months, nurses will complete self-directed online learning and certifications, such as the MediTech training.

This transitional period can also include lectures on topics such as informatics in healthcare, the American Nurses Association code of nursing ethics, and how to safely handle sharps. Nurses may also participate in discussion groups or go through preceptor-led training. Shifts during this phase usually last from 8 a.m. to 5 p.m. on weekdays.

Integration Phase

After the transitional phase, nurse residents enter the integration phase. The integration phase is a nursing preceptorship that can last a few weeks to several months depending on the program. Nurses will work regular shifts ranging from 8-12 hours during the day, night, or a mix of both as decided by their employer.

Nurses will care for patients, practice clinical judgment, and communicate with family members, patients, and the rest of the healthcare team under the supervision of their preceptor and the program director.

The program director and the preceptor will provide consistent feedback throughout the transitional and integration phases about the nurse’s performance in areas such as decision-making, clinical judgment, and communication. Nurse residents will fill out surveys rating their progress throughout the program.

How Do Nurse Residency Programs Work?

More than 600 hospitals and healthcare systems in 47 states take part in the accredited nursing residency program created by the American Association of Colleges of Nursing (AACN) and Vizient.

Hawaii, Wyoming, and Utah are the only three states that do not currently take part in the year-long program. New York City, Pennsylvania, Maryland, and New Jersey adopted their own versions of the program.

Nurse residency programs do not need nursing accreditation at this time, so nursing residency programs have a lot of differences in length, content, structure, and outcomes.

Pros and Cons of Nurse Residency Programs

The pros of a nurse residency program include better outcomes for nurses and their patients in the long run because of the valuable experience nurses gain. In the short-term, nurse residency programs present factors, like going to school, that may not be for everyone.

What to Expect in a Nurse Residency Program

Program directors, instructors, preceptors, and coaches make up the staff of the nursing residency program. Program directors evaluate the nurse residents, coordinate the program, and serve as a go-between for the nurse residents and the rest of the healthcare team.

Instructors lead the transitional training. Any healthcare provider teaching the transitional training can be an instructor, including the program director. Preceptors help with the evaluation and instruction of the nurse residents.

A coach is someone who is not directly involved in the nursing residency program. They add an extra layer of support for the nurse resident.

Employers and program directors control the number of hours per shift and the number of shifts the nurse residents work. Responsibilities, hours, and shifts of nurse residents will vary depending on the needs of the hospital and their department.

The number of hours per shift can vary from 8-12 hours. Nurse residents can expect to work day shifts, night shifts, or both. Transitional training may have different hours than integration into the clinical setting.

Nursing residency programs look for nurses who:

• Graduated from an accredited program with at least an associate degree in nursing less than a year before they apply (bachelor's degree preferred)
• Hold a current RN license in the state where they will work
• Hold a current cardiopulmonary resuscitation certification
• Hold a current basic life support certification from the American Heart Association

What to Look for in a Nurse Residency Program

Accredited nursing residency programs make more consistent outcomes because an accrediting body regulates the quality of their content.

However, nursing residency programs do not need program accreditation. They still have a lot of variation in program length, instructors, work expectations, and work environment.

Unaccredited programs can last as few as six weeks. The Commission on Collegiate Nursing Education (CCNE) and AACN both require accredited programs to last at least six months to one year.

The hospital and the unit the nurse resident works for controls much of the nurse's experience, duties, and work environment. Examples of units that offer nurse residency programs include the emergency department, operating room, and critical care unit.

Nursing residency programs use program directors and instructors to teach nurse residents in the transitional period. Then, preceptors, coaches, and program directors help nurse residents adjust to clinical experience in the integration phase.

Is a Nurse Residency Program Right for Me?

Nurses who consider applying to a nurse residency program should think about whether they care more about their working conditions right now or their skill level in 5-10 years.

Nursing residency programs present challenges and limitations for new nurses, but for many, the knowledge and experience they gain can provide success and satisfaction in their career, which can make residency worth the effort.

To find accredited nursing residency programs near you, search for schools:

• On the AACN's Member Schools page
• On the AACN's list of participating schools by state
• On the CCNE's Nursing Residency Program Directory

Frequently Asked Questions About Nurse Residency Programs

Are nurse residency programs paid?

Yes, nurse residents can expect to make about the same salary as other nurses with the same experience level. Nurse residency programs also offer benefits such as tuition reimbursement and signing bonuses.

Do nurse residency programs lead to a full-time job?

Yes, nurse residency programs can lead to a full-time position and have been shown to lead to higher retention rates, greater job satisfaction, and improved nurse competency. Some positions may require you to work for the hospital for up to 12 months after you complete the residency.

How long does it take to complete a nurse residency program?

Nursing residency programs can be as short as six weeks, but the CCNE and the American Nurses Credentialing Center recommend that nurse residents complete an accredited program that lasts at least six months to one year.

Are nurse residency programs worth it?

It depends on your priorities when seeking your first job. Nursing residency programs can reduce stress, increase job satisfaction, increase nurse retention rates, and provide support for new nurses. Nursing residency comes with a lot more supervision. Employers choose the hours you work and what department you work with.

Page last reviewed July 9, 2022