What Is a Nurse Residency Program?
Nurse Residency Programs (also known as New Grad Nurse Programs or NewGrad Nurse Residencies) are formalized extensions of nursing education and practice that occur within the first year of a registered nurse’s career. While all hospitals offer orientation to new grads in their first job, Nurse Residency Programs differ in that they are longer-term, more formalized programs.
These programs are usually created and hosted by hospital systems to transition nurses into practice from their academic programs. These programs can last from three months to one year in length and consist of both hands-on and classroom-based learning content on clinical and professional topics.
Why Should IPursue a Nurse Residency Program?
The American Academy of Nursing (AAN), the American Nursing Credentialing Center (ANCC), and the American Association of Colleges of Nursing (AACN) have all supported policy that all new graduate nurses should enter into a residency program during their first year of practice. Data shows that nurses that complete residency programs have higher career satisfaction, less burnout and stress, and tend to stay working at their hosting facility for longer periods of time.
Those that do not attend residency programs may have less time orienting to clinical nurse practice and subsequently have higher instances of burnout, turnover, and practice issues within the first year of work. One study suggested that new graduates’ retention in their first job went up by between 6% and 10% if they completed a Nurse Residency Program.
Since new grad residency programs can sometimes be hard to find and accepted into—and they typically improve work satisfaction by only 10% according to the above study—are there other reasons you should take on the effort of finding and applying to new grad programs?
To start, all hospitals have some sort of orientation for new grads. The residency is just additional content. And overall, 10% retention is actually pretty good for new grads that often leave after one year at their first location. Other benefits of residency programs for new grads include learning and orienting more intentionally to the profession rather than being thrown right in with minimal preparation.
Ultimately, it’s a great idea to look for your first professional role with an organization that supports you through a transition-to-practice program so you set off on your amazing nursing journey on a foundation of excellence.
How DoI Choose a Residency Program?
While there are several factors that play into the choice of your first professional nursing position, we suggest a few key areas that should inform this important choice. You may be tempted to simply search, "nurse residency programs near me," but keep in mind that where you spend your residency will have a big impact on your early career.
1. Spend Time Thinking About What You Want to Specialize in
(Note: if you haven't read our article for choosing a specialty as a new grad, you can check that out here.)While nursing is flexible and adaptable in regards to moving between care settings, the first setting you enter has a profound impact on your professional self.
For example, during nursing school, I fell in love with the Emergency Department. I could not see myself working anywhere else in the hospital, and despite the fact many faculty and friends said I should start in Med-Surg, I knew that would kill my passion for nursing. So, I found residency programs that allowed new graduate nurses to start in the emergency department. It was the single most impactful choice of my career.
On the other hand, Sarah Gray, Trusted's Founding Clinician, said that when she applied to UCSF, she already had a specialty in mind, but to increase her chances—because a foot in the door and experience is better than getting turned down for a specialty (and you can always switch later)—she applied to most specialties in the new grad program and remained open at first.
2. Do Research on the Facility You Are Most Interested inOne thing I often encounter with new graduate nurses is that many of them pick their first hospital or facility by feel rather than by using information.
While it may have been great to have been a student at a nearby hospital, working there will be very different. Nursing culture, Magnet Designation, nursing leadership, union vs. non-union, benefits, and financial health are all things you want to consider when choosing a location to practice.
Do NOT be afraid of looking across the country for the best possible place to work. Your first year of practice is foundational to your success as a nurse.
3. Research the Facility's New Graduate Residency ProgramRecently there have been two organizations that have begun accrediting residency programs. Accreditation means that a third-party organization has assessed the residency program’s content, faculty, outcomes, student satisfaction, and viability and has certified that it meets certain standards.
Both the AACN and the ANCC have accreditation pathways for residency programs to complete. Note that if a program is not accredited, it does not mean the program is lesser than those that have met accreditation standards. Many programs may be in the process of becoming accredited or have chosen to develop a custom pathway for new graduates.
Make sure you ask questions about the curriculum, preceptors, and outcomes of programs to find your best fit!
What Do Accreditation Programs Look Like?
The American Association of Colleges of Nursing has partnered with a company called Vizient to develop a standardized curriculum and accreditation process for New Graduate Residency programs. Additionally, the ANCC has built an accreditation program that aligns with the Magnet Designation requirements that many hospitals are working towards.
Generally, both programs ensure that residency content focuses on the following:
- Quality and Safety
- Patient and Family-Centered Care
- Management of Patient Care Delivery
- Management of Changing Patient Condition
- Communication and Conflict Management
- Informatics and Technology
- Professional Role and Leadership Skills
- Performance Improvement and Evidence-Based Practice
- Ethical Decision Making
- Stress Management
- Business of Healthcare
They evaluate program success by looking at:
- Satisfaction of residents
- Formal feedback mechanisms
Ultimately, you can bet accredited programs will focus on building you as a clinician and a professional.
Am IEligible for a Residency Program?
While program requirements can vary (make sure you check for each program you’re interested in) there are some general ones that you should be aware of.
- You must pass the NCLEX and obtain your license by the hire date
- You might need to meet both of the following criteria (at time of offer) to be eligible for participation in the program:
- (1) Graduated from an accredited nursing program within the last year; and
- (2) Completed six months or less of nursing experience in either an inpatient or outpatient setting (i.e. acute care, subacute, home health, long term, school nurse)
Some programs are also limiting admission to BSN graduates as well. The reasoning behind this is that hospitals that wish to achieve Magnet status need a high percentage of BSN-prepared nurses on staff to meet criteria.
They tend to focus on hiring BSN nurses to ensure they maintain this ratio. While this is not ideal for ADN nurses, don’t lose hope! There are plenty of residency programs that also admit ADNs!
What is the average acceptance rate for a new graduate program?This is highly variable by program, and you really need to research the individual application processes to find the answer. Some programs only accept hires once a year, while others accept them twice a year. Some even have rolling admission, which means that if there are positions open year-round, you can onboard into the program at any time.
Do not wait until you graduate to begin looking at deadlines. For my residency program at UCLA, interviews began over six months before the actual program and hire date began. I knew before my last semester of nursing school that I had been accepted, even to the specific unit.
Use our resume builder to help you get your application spruced up to have the greatest impact on the hiring manager and recruiter.
Standing Out WhenApplying to Nurse Residency Programs
Let’s be clear, it’s a competitive process to earn a spot in a new graduate residency program. You are likely competing against dozens or even hundreds of applicants who all had similar schooling, grades, and experiences in nursing school. So, how do you differentiate yourself?
There are a few paths that you can take in showcasing your life experiences in a way that best resonates with the residency recruiters and hiring managers. There is no “right way,” and you should choose a path that speaks to your passions and interests.
Path 1:Geek Out in Clinical
Most advice about securing a residency spot is to ensure that you have clinical experience in the specialty in which you wish to work. Experience can be in your school clinical rotations, volunteering on a selected unit, or shadowing nurses in the speciality. By getting exposed to the unit or speciality, you will gain insights that enhance your ability to interview better.
If you have the opportunity to do clinical rotations in your chosen specialty, make sure that you geek out! Take notes, ask lots of questions, and embed yourself into the culture of the unit. Try to gain as much information you can so that you can demonstrate that you have researched the speciality and can explain why you know it’s the one for you.
Path 2:Non-Traditional ExperiencesNo nursing career follows the same path. Your life is filled with opportunities… so take them! Not every new graduate nurse has the opportunity to rotate through the specialty of their choice, nor get an externship, or even volunteer.
Life happens, whether it’s family, an opportunity to travel, or some other event that changes your path; it’s all going to be great!
Many programs look at diverse life experiences as more valuable than actual clinical experience. For example, if you had a passion for volunteering with migrant farmworkers, it shows your dedication to the profession, ability to work without resources, and focus on delivering care to those that need it most.
If you had a chance to travel, you can speak to the growth of learning about other cultures, squashing the travel bug so you can focus on your new job as a nurse, and developing skills in navigating complex and changing environments between countries (not to mention learning another language).
The experiences you have outside the clinical space are key to showcasing your amazing abilities and will help hiring managers see you are a truly dynamic nurse.
Additional Factors to Getting Accepted into a Residency Program
1. It's All About Your NetworkThe key to getting the job of your dreams in any profession is to have an amazing network of people who can support you in your pursuit. This means networking with all sorts of nurses and leaders so that they get to know your passions and see how you might add value to their teams.
Take advantage of your clinical rotations to meet nurses and nurse leaders. You are a student, and people love speaking with students. While you are on clinical rotations, take the opportunity to eat lunch in the break room, ask for introductions to the nurse manager, and shadow charge nurses.
These interactions allow them to put a face to a name and increase the chance they will invite you for an interview.
2. Attend Nursing Meetups
In many cities, there are nursing meetups where you can go to meet fellow professionals. Trusted Health hosts them often, and you can meet nurses from across the city and country who might help provide insight into your desired hospital, know someone who is hiring, or become a mentor in your new career!
3. Reach Out
Don’t be afraid to reach out to residency program leaders. Many times their emails are on the hospital webpages. Tell them how interested you are, why you think that program is key, and how you plan to apply. Ask for an informational interview to learn more.
There is very little downside in sending an email, and the return could be great (you never know until you try)!
Starting Your Career Without a Formal Program
What happens when you either choose not to do a nurse residency program or you do not get into one. First of all, don’t stress! All hospitals have some sort of new graduate orientation and support system even if they are not formal residency programs. The key is to find the hospitals with six-month to one-year orientations that allow you to transition into practice.
Choosing your first role is very important. Remember that not all hospitals are the same, and that you need to feel safe, supported, and have access to the skills you need to learn to be successful. Make sure that the orientation and precepted transition to practice is long enough for you to feel comfortable and is built around your personal and professional development.
Here are a few questions we recommend answering when assessing a non-residency new graduate position:
- What is the length of onboarding and preceptorship?Look for at least three months, but six to 12 months is even better.
- Are the preceptors trained to guide you, or are you placed with whomever is working? Focus on jobs with dedicated preceptors.
- Are there opportunities for education, training, and certification as you progress?
- Does the unit educator and manager seem supportive of new nurses?
Remember that you’re allowed to be choosey! Don’t rush your decision simply to have a job right away. There is a high demand for nurses after all.
Improvement in Clinical Judgment and Critical Competencies
Residency programs help new employees improve their critical thinking, communication, and problem-solving skills before they begin practicing independently, empowering nurses to trust their clinical abilities and improve patient outcomes.
Questions For New Grads to Ask
Roughly how many preceptors can I expect to work with? What is the breakdown and timeline for clinical hours and class hours? How many education hours will I receive in total? During the residency program, who are my support people, and how often will I have contact with a nurse educator?
How Hard is it to Get a Nursing Job Right Out of School? According to one study, 76% of new nursing graduates had a job offer at the time of graduating. In my experience, I saw all of my 33 classmates get jobs after graduating — and we all spent plenty of time worrying that we would never get jobs!Why should I be chosen for a nurse residency program? ›
In a nutshell, you have the opportunity to better yourself with all the clinical and didactic learning that will be provided to you while getting paid for it! That is pretty great! Most nurse residency programs will also provide you with full health benefits as well.What do new grad nurses struggle with? ›
Performance anxiety, fear of making mistakes, lack of confidence in nursing skills, communicating with doctors, exhaustion from workload demands, and having the responsibility of your own patients can be a lot to handle in your first year.What are three things you look for in a residency program? ›
They look at communication skills, leadership qualities, and your attitudes. They want to know about your achievements and competitiveness, whether you are a team player, and whether you will fit into their program.How do you ace a residency interview? ›
- Make sure your personal statement is in good shape. ...
- Know some of the common questions. ...
- Practice your interview skills. ...
- Don't come in with prepackaged answers. ...
- Research every program. ...
- Make the most of the entire interview experience. ...
- Plan your rotations wisely.
- Desired geographic location—cited by 88%.
- Perceived goodness of fit—87%.
- Reputation of program—82%.
- Work-life balance—74%.
- Quality of residents in the program—73%.
It is possible to negotiate a higher salary as a new nurse. There is no rule book that says you can't. No one will scold you or punish you if you negotiate. As a matter of fact, according to the 2019 Job Seeker Nation Survey report from Jobvite, your potential employer expects it.What percentage of new grad nurses quit? ›
But, one study found that a staggering 17% - 30% of new nurses leave their job within the first year and up to 56% leaving within the second year.
- Become a Certified Registered Nurse Anesthetist (CRNA) ...
- Become a Nurse Practitioner (NP) ...
- Become a Nurse Midwife. ...
- Advance in Nurse Leadership. ...
- Begin travel nursing assignment. ...
- Change Nursing specialties. ...
- Relocate to a higher paying state. ...
- Make sacrifices.
75% of those surveyed cited staffing shortages as their main concern. 55% of the new graduate nurse population plans to leave the field before retirement. Only 15% of recent nurse graduates feel highly confident in finding a job that will meet their expectations.Why am I not getting hired as a new grad nurse? ›
From someone who has been an RN for many years (35+) and having served in many types of administrative positions, the general reason it is difficulty to get that first RN job is because as a new RN graduate, there is a lack of experience and/or knowledge to perform the job expectations.What floor is best for a new grad nurse? ›
And frankly, the easiest and fastest way to get a job as a new grad is to go to a med/surg floor. They are always some of the most challenging floors to keep staffed in the hospital and are usually the most willing to hire new grads.What do residency programs look at most? ›
What do residency programs look for? It's no surprise that residency programs consider USMLE scores, letters of recommendation, and the personal statement among the top factors when choosing residency candidates.How many nurses quit in the first year? ›
More specifically, over 17% quit within the first year, and a whopping 56% quit after the first two years. This issue has also been exacerbated by the COVID-19 Pandemic, as 95% of nurses have reported feeling burnt out within the past three years.Which residency application is most important? ›
The priority for residency programs is determining if you're a good fit for them as well as the specialty. Your residency application must demonstrate maturity, growth, a deepened dedication to medicine, as well as an increased focus on what you hope to accomplish with your specialty.What is imposter syndrome nursing? ›
What Is Nurse Imposter Syndrome? Imposter syndrome is having intense feelings of unworthiness, inadequacy, and experiencing self-doubt in one's capabilities. It's described as holding the fear of being a fraud, as if you're hiding a secret, and eventually will be “found out” or exposed.How long does it take to get comfortable as a new grad nurse? ›
While new nurses possess the clinical skills to succeed, she cautions that they "have to find the order that works best for utilizing those skills. It generally takes 1-2 years to truly find your 'flow' and feel comfortable."How do new grad nurses get rid of anxiety? ›
- Get rest at least 6-8 hours rest at night: this will allow your mind and body to reset each day.
- Planning your day in advance: this will decrease your level of anxiety by having a prepared and organized day, thus giving you some control in what is to come.
- Strong USMLE Scores. ...
- Solid grades. ...
- Excellent letters of recommendation. ...
- A positive Medical Student Performance Evaluation. ...
- A thoughtful personal statement. ...
- Relevant skills and experience.
Medical knowledge, including basic sciences and medical practice (USMLE scores) Perceived commitment to specialty and relevant experiences (residency personal statement, medical student CV)What makes a strong residency application? ›
The four main elements of your application to residency are letters of recommendation, the medical school performance evaluation, and your personal statement and curriculum vitae. Providing complete and accurate information about yourself is crucial to connecting with residency programs during the Match process.Is it OK to take notes during residency interview? ›
Take notes during the interview. This will make you seem interested. Always be positive and enthusiastic, even when you think no one is listening. Do not talk ill of your program or other programs.How many interviews is enough residency? ›
Dr. Allen said that University of Washington tells students that 15 interviews is a good number to aim for. So, an early invitation from a school in the middle of your list—depending on how long your list is—may be one you should strongly consider accepting.What is the easiest residency program to get into? ›
- Family Medicine.
- Emergency Medicine.
- Physical Medicine & Rehabilitation.
- Child Neurology.
You CAN tell a program that they are your number one choice.
However, it is important to keep a few things in mind. First, and most importantly, we highly discourage anyone from making this claim to multiple programs. Why? Well, because the number one virtue for residency applicants is honesty.
- Plastic Surgery.
- Orthopedic Surgery.
- Neurological Surgery.
- Interventional Radiology.
- Diagnostic Radiology.
California tops our list of the highest-paying states, where registered nurses make $124,000 per year on average. Following it is Hawaii, at $106,530, and Oregon at $98,6300.How do new grad nurses make the most money? ›
- Earn an advanced degree. ...
- Get certified in a specialization. ...
- Consider a leadership role. ...
- Become a travel nurse. ...
- Become a private duty nurse. ...
- Become an immunization nurse. ...
- Become an instructor. ...
- Become a nurse health coach.
- Pick Up Extra Shifts. The most common nursing side hustle is probably also the most obvious: picking up extra shifts. ...
- Travel Nurse. ...
- Freelance Writing. ...
- Medical Transcription. ...
- Caregiving. ...
- Pet Sitting. ...
- Health Coaching. ...
- Online Focus Groups.
The highest-paying states by median NP salary are California ($151,830), Hawaii ($111,070), Oregon ($99,410), Alaska ($99,910), and Washington ($96,980). The lowest-paying states are South Dakota ($60,540), Alabama ($61,920), Mississippi ($63,130), Iowa ($64,990), and Arkansas ($65,810).What is the biggest problem in nursing today? ›
- Inadequate Staffing. Being short-staffed for brief periods of time is common in most professions, and in many of those situations, it is a minor inconvenience. ...
- Stress. ...
- Safety on the Job. ...
- Workplace Violence. ...
- Improving Self-Care.
Researchers estimated that the US will have a 10 to 20 percent nursing gap by 2025 as the number of patients needing care exceeds the number of nurses. The RN supply could potentially see a low of 2.4 million, while the RN demand could be a low of 2.8 million nurses.What is the impact of nurse residency programs? ›
According to Vizient/AACN, there are multiple benefits associated with new nurse residency programs, including: Strengthens critical thinking skills and use of evidence-based practices to improve clinical judgment. Builds competence and confidence in clinical decision-making.Do nurses need to do residency? ›
Are Nurse Residency Programs Required? No, nurse residency programs are not required. However, nurse residency programs have increased in popularity in recent years as administrators have become familiar with the benefits associated with these programs.What is the advantage of a new residency program? ›
you get personalized, individualized education/mentorship/attention that you likely wouldn't be seeing elsewhere. you actually know and interact daily with your program director. you actually can shape and make the residency even better, whereas older programs are already stuck in their ways, if you will.Why is clinical leadership important for new graduate nurses? ›
Leadership for nurses, however, is important for successful practice development and the provision of safe, effective and person-centred care. Leadership in nursing often overlaps with multiple domains, such as patient care, team and clinical processes, and community leadership.