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Nurse Residency Reflections:

Strengthening Our Future Through Transition to Practice Programs

Dear OADN Members,

December 2024 marks the 25^th 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:

• What is the precepted experience like? How many preceptors will I have during my residency?
• What kind of professional development opportunities are available?
• How will my performance be evaluated, and how often? How will I receive feedback?
• How are the residency classes structured and linked to the precepted experience?
• How long is the precepted experience?
• In addition to clinical practice development, what other support will I receive during my transition?

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

A Recollection of Service

Dear OADN Members,

During a conversation with a colleague, I received an invitation to serve the Organization for Associate Degree Nursing (OADN). Life often presents us with invitations—some we decline, while others we embrace wholeheartedly. This invitation was different. It was a call to support the educators who play a pivotal role in shaping the next generation of nurses. I couldn’t bring myself to turn it down. This opportunity came from a colleague in my own Associate Degree Nursing program, and I truly believe we have a responsibility to give back to the communities, organizations, and mentors who helped shape our paths.

In the fall of 2020, I quickly realized just how strong and impactful OADN truly is. During a time when the world faced unprecedented challenges due to the pandemic, difficult decisions had to be made, including the cancellation of a national conference and the shift to a virtual format. I was truly amazed by the dedication, resilience, and commitment of the small but mighty OADN staff and board. They worked tirelessly to support nurse educators across the nation. As a hospital executive, this experience opened my eyes to the remarkable qualities of educators—their resilience, determination, collaboration, and unwavering support for their communities.

As we navigated these challenges, I continued to learn and grow. Deans and directors sought my insights on the workforce’s needs, and I was glad to contribute. It was clear that what I shared was not only heard but thoughtfully absorbed, integrated, and utilized. Educators have an incredible ability to learn, adapt, and produce at every turn. This team taught me the complexities of managing an academic department, the scarcity of information available for forecasting salary requirements, and the numerous challenges of maintaining a robust academic organization. Who knew educators worked so hard behind the scenes?

Nearly four years in, I remain deeply grateful for the exposure to the countless educators, deans, directors, vendors, pioneers, board members, and others affiliated with OADN who have imparted so much knowledge. One of the most valuable lessons I’ve learned is the critical importance of sustaining partnerships between academia and practice, especially as we face the looming wave of retirements on both sides. Strong partnerships are essential to overcoming challenges in both educational and workforce management, and we must be intentional in maintaining these relationships despite inevitable leadership changes.

I am encouraged by OADN’s proactive efforts to address these concerns. The ongoing salary studies will empower current and future leaders to advocate effectively for faculty. The leadership development and mentoring programs will nurture our future academic leaders, and these efforts are already making a significant impact. Political advocacy at the local, state, and national levels will ensure future funding opportunities, while our commitment to research will generate new nursing knowledge to fuel growth.

Every board meeting presents an opportunity to align our efforts with our strategic plan and deliver value to our members. Our discussions rarely stray from our mission: to serve academic programs, support academic leaders, and develop faculty. OADN’s bylaws are designed to ensure smooth transitions and effective leadership turnover, and this month, we will welcome new board members. There are always opportunities for fresh voices who are passionate about our mission.

Your opportunity to serve might be waiting, just as mine was. I’m grateful my colleague was thoughtful enough to start a conversation that invited me into the service of OADN—a conversation that trusted me to have some small impact on the future of nursing. As I conclude my tenure on the board, I am confident that the next generation of leaders is ready to step up. There will always be opportunities to create value, expand knowledge, and build lasting friendships for those willing to embrace them. Whether it’s a board position, a subcommittee role, a task force membership, or involvement with the foundation, there may be a place for you—or for someone you believe can make a difference in nursing.

I encourage you to consider serving and to seek out others who are ready to join this community of leaders. Trust me, it will feed your soul, and you will be all the better for it.

In service,
Matthew Morris, DNP, RN, NEA-BC, CENP, NPD-BC, FAADN
Chief Nurse Executive, Wilmington VAMC