KRISP Project
krispproject@gmail.com
L. Michele Issel, PhD, RN
Univ of Illinois at Chicago
College of Nursing & School of Public
Nurse Residency Programs and Public Health Nursing
May 2012
Introduction
In response to the challenges of integrating new graduate nurses into their professional
work environments, many Nurse Residency Programs (NRPs) are being created across
the country [6]. A literature review was performed to review NRPs and their curriculum
components as a means to understand how they might be applied to public health. A
brief background and summary follows.
Definitions and Distinctions
 Nurse Orientation: A program providing institution-specific information for faculty new
to the institution, and faculty development that focuses on continued faculty growth
[21]. Often described as a decentralized process of orienting new nurses to a specific
unit or ward; lacks standardization [5].

Nurse Residency Program: A joint partnership between academia and practice that is a
learner-focused, postgraduate experience designed to support the development of
competency in nursing practice; often includes preceptorship [13].

Nurse Preceptorship: Structured programs that involve pairing students or new
graduates with an experienced nurse preceptor for a defined period to ease the
transition from student to professional nurse and reduce role conflict [22].

Nurse Competence: Ability of the caregiver –nurse—to integrate knowledge, skills, and
personal attributes consistently in daily practice to meet established standards of
performance [9].
Nurse Residency Programs

The result of the sudden growth in nursing programs in the 1990s combined with nurse
vacancy rates led to a dramatic increase in the number of new RN graduates entering to
work in acute care settings. Nurse Residency programs were created to combat new
nurse inexperience and nursing shortage and have since then been implemented to
reach various goals for hospitals and their new hires [8].

The standard training time for a resident is 12 months and preceptors are encouraged to
facilitate the process [30].
Nurse Residency Programs, May 2012
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
Many organizations identify Nurse Residency Programs as a vital component in easing
the transition of new student nurses and aiding in their recruitment and retention [15,
16, 28].

While successful, such programs have been implemented largely in acute or critical care
hospital settings, frequently in university-affiliated teaching hospitals, centered on acute
and critical care nursing, but are obsolete in the public health sector.
Outcomes of Nurse Residency Programs
 Increased residents’ confidence, competence and readiness for independent practice [5,
23, 10].
 Strengthened assessment and clinical skills; enhanced ability to apply critical thinking to
clinical practice [5]
 Increase in job satisfaction, leading to decreased nurse turnover rate and recruitment
and orientation costs [12, 17]
 Increased Nurse retention rates and correlating recruitment and training costs [16,
14,24, 32]
 Improved clinical competency, decreases sense of threat and improves communication
and leadership [14, 23]
Common Nurse Residency Programs Curriculum Components
A literature review was conducted using the key words: Nurse Residency Programs in
CINHAL, Ovid, EBSCO, Web of Science and Pub Med databases. The most prevalent
curriculum components from US-based programs lasting 12 months or more in duration are
as follows:

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










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Leadership [1, 21, 7, 11, 17, 19, 25, 26, 27]
Evidence-based Practice [1, 21, 7, 11, 17, 19, 25, 26]
Patient Safety [1, 2, 21, 7, 11, 17, 19, 25, 26, 27]
Unit-Specific Skills [1, 2, 21, 7, 11, 17, 19, 25, 26, 27]
Professionalism [1 , 2, 21, 7, 11, 17, 19, 25, 26, 27]
Time Management [1, 2, 21, 7, 11, 19]
Organization and Prioritization of Care [1, 2, 21, 7, 11, 19, 25, 26]
Resource Management [1, 7, 11, 17, 19, 25, 26 27]
Care Management [1, 2, 21, 7, 11, 17, 19, 25, 26, 27]
End of Life Care /Aging [1 , 21, 7, 11, 17, 19, 25, 26, 27]
Culture and Diversity [1, 7, 11, 17, 19, 25, 26, 27]
Stress Management [1, 21, 7 11, 17, 19, 25, 26]
Patient Education [1, 7, 11, 17, 19, 25, 26, 27]
Self Care for Nurses [1, 6, 11, 19, 25, 26]
Interdisciplinary Collaboration [1, 2, 21, 7, 11, 17, 19, 25, 26, 27]
Communication [1, 2, 7, 11, 17, 19, 25, 26, 27]
Critical Thinking [1, 2, 21, 7, 11, 17, 19, 25, 26, 27]
Nurse Residency Programs, May 2012
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


Conflict Resolution [1, 21, 7, 11, 19, 25, 26, 27]
Delegation to UAP [1, 21, 7, 11, 19, 25, 26, 27, 17, 19, 25, 26]
Critical Events [1, 2, 11]
Application to Public Health
The Quad Council of Public Health Nursing (Quad Council) competencies are a means for
PHNs to understand their role in a meaningful way and to integrate knowledge, skills, and
personal attributes consistently in daily practice to meet established standards of performance
in public health. These competencies are listed as eight competency domains: analytic
assessment, policy development/program planning, communication, cultural competency,
community dimensions of practice, basic public health sciences, financial planning and
management, leadership and systems thinking. Current established Nurse Residency Programs
only cover a small percentage of these competencies and therefore would require extensive
restructuring to meet the needs of public health nurses.
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