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The initial transition into independent practice as a nurse is overwhelming for many new graduates. Although completion of their degree and the certification examination ensures the nurse has built up an educational foundation, the transition in the clinical setting is crucial for new nurses to succeed in their specific clinical context. In addition, new nurses need to master their communication skills to collaborate effectively with all members of the healthcare team, particularly patients and their families. When this transition is met with disorganization, a chaotic progression into independent practice, or challenging learning environments, it is difficult for the new graduate to grow to become a confident, independent nurse and to provide the best care for patients. The implementation of nurse residency programs, particularly in pediatric hospitals, attempts to combat this difficult transition to practice through establishing a more thorough, standardized orientation. The literature demonstrates that improving the transitional experiences of new graduate nurses with a focus on communication, organization, critical thinking, and stress management has, in turn, improved job satisfaction and nursing retention. This article reviews the current structures of nurse residency programs available for new graduates and the benefit each program provides in allowing the growth in these four foundational skills: communication, critical thinking, organization, and stress management. New graduate nurses should be aware of and understand their options as they look toward deciding on their first career path after graduation to promote success during their initial transition and beyond.
The concept of "reality shock" experienced by a new graduate starting his or her career was first described by Kramer in 1974 with a discussion about the widening gap between a new graduate nurse's comfort level, confidence, skills, and ability to deliver safe and adequate care (Kramer, 1974). Kramer (1974) discussed the seven major challenges that befall a new nurse in trying to work through this transition, including challenges with delegation, prioritization, decision-making, collaboration, conflict resolution, and the ability to give and accept constructive feedback (Kramer, 1974). In addition, there is often a disconnect between a new graduate's expectations of his or her role and the organizational or leadership expectations, which can contribute to a feeling of incompetence and increased stress in navigating this new professional reality (Villanueva, Taylor, Dickson, & Foster, 2015)....