OADNOADNDecember 12, 2024
Dear OADN Members,
December 2024 marks the 25th anniversary of completing my nurse residency program (NRP) at Children’s Hospital Los Angeles. As I
reflect on my nursing journey and with the holidays upon us, I can’t help but feel nostalgic, fortunate, and grateful for my preceptors, mentors, educators, leaders, and colleagues who have supported me over the years. The NRP gave me the foundation to prepare myself as a pediatric nurse and the supportive environment to develop as a nurse leader. My story is not unique in how a well-structured, competency-based, and data-driven NRP has prepared new graduate nurses (NGNs) for success. However, here we are 25 years later; nurse leaders still struggle with demonstrating that NRPs are an investment rather than a cost, even though the literature is replete with evidence of its value.
Over the summer, my high school student intern conducted an environmental scan to learn about NRPs or Transition to Practice Programs (TTPs) and new graduate nurse (NGNs) perceptions of TTPs. Surprisingly, NGNs’ perceptions of NRPs are mixed. While most saw the benefits of a structured precepted experience, some found that the TTP classes were not helpful. As we investigated why some had negative experiences, it was clear that not all TTPs have the same structure, content, and framework. While there are evidence-based TTPs, some are simply re-branded orientation programs.
In 2010, the Future of Nursing Report highlighted the importance of post-graduation training for NGNs to better prepare them for practice. In 2014, the American Nurses Credentialing Center launched its Practice Transition Accreditation Program to set a global standard for TTPs. In 2019, the American Academy of Nursing published a position paper that stated that NRPs should be mandated for all new graduate nurses. Consequently, many organizations have either developed their own TTPs, partnered with vendors to deliver their TTPs, or implemented a combination of them, resulting in TTPs having all shapes and sizes. Over the years, many workgroups and organizations have been formed to address the academic experience and transition to practice. In 2023, The National Collaborative for Transition to Practice Programs was established to become the unified voice for TTPs with the goal of providing space for educators, hospital leaders, students, and NGNs to learn about best practices and strategies to transition NGNs into the workforce successfully.
It is well known in the literature that NRPs with the most favorable outcomes are those with structure and standardization, evidence-based for content, precepted experience, support systems such as subject matter experts and mentors, transparency and accountability, active stakeholder engagement, organization-wide commitment, rigorous NGN performance and program evaluations for research, and continuous improvement.
As SNs begin to search for their future employment, it is critical that they understand what the onboarding process is like for the organization. They should consider asking questions such as:
As we all contemplate the future of the nursing workforce, it is our duty to begin the conversations about TTPs early in our student’s academic experiences. While our work is focused on developing practice-ready nurses, it is as important that they understand the importance of having a supportive culture and environment that will prepare them for their transition into the workforce. 2024 is coming to a close, and the new year is soon unfolding. We must set our sights on new opportunities, endless possibilities, and bold intentions to continue to strengthen the future of the nursing workforce.
In your service,
Larissa Africa MBA, RN, CENP, FAONL, FAAN
Vice-President-Healthcare Workforce Solutions, Ascend Learning
CEO & Co-founder, The National Collaborative for Transition to Practice
President & CEO, Versant Healthcare Competency Solutions