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Historically, the United States has seen a cyclical trend in nursing shortages, which is not predicted to change. Fifty-five percent of the nursing work-force is over the age of 50 years and more than 1 million RNs will reach retirement age in the next 10 to 15 years (Budden, Zhong, Moulton, & Cimiotti, 2013). Limited retention (ability to keep employees), especially of newly licensed nurses, increases vacancies and organizational costs, possibly affecting the nursing shortage. According to the National Healthcare Retention & RN Staffing Report (NSI Nursing Solutions, 2016), nurse vacancies increased to 8.5% in 2015, a 1.3% increase from the previous year. Some hospitals have greater than 10% nurse vacancies (NSI Nursing Solutions, 2016) The national average 1-year turnover rate (the rate that nurses leave an organization and are replaced) among all newly licensed RNs is 17.1% (NSI Nursing Solutions, 2016), and the 2-year turnover rate is 33.5% (Kovner, Brewer, Fatehi, & Jun, 2014).
The average cost of turnover for a bedside RN is estimated to be between $37,700 and $58,400 (NSI Nursing Solutions, 2016). These costs are incurred from overtime payment to existing staff, hiring temporary staff, closing beds, and new staff training and orientation. One strategy to address retention and turnover in new graduate nurses (NGNs) is the implementation of a nurse residency program (NRP).
Many NGNs are not prepared for the fast-paced, high-acuity health care environment (Twibell & Pierre, 2012). The complexity of the environment often leads to high stress levels for the new RN and as a result leads to higher turnover. As NGNs enter professional practice, they require additional resources to enable a smooth and successful transition from student to professional. One resource is an NRP, which focuses on providing not only additional skills and knowledge but also the peer support and mentorship needed for the transition. Therefore, the purpose of this review was to explore what the literature informs us regarding the implementation of NRPs in acute care settings and their ability to retain nurses.
Method
A search was conducted using Cumulative Index to Nursing and Allied Health Literature (CINAHL)®, Ovid Nursing Journals®, and ProQuest Health and Medical Complete® databases. A combination of keywords was used, which included nurse residency programs, r