Residency program supports newly licensed RNs as they transition from students to professional nurses

Mar 31, 2024

by Matt Batcheldor

One hundred-fifty new nurses gathered recently in Langford Auditorium for orientation at 6:30 a.m. It was an exceptional time for an exceptional group of nurses.

They were just half of the July cohort of the Vanderbilt University Medical Center’s Nurse Residency Program, a 12-month program that supports newly licensed RNs as they transition from students to professional nurses. The program, which began in 2008, supports the development of 500 to 700 effective, competent and committed VUMC nurses each year through multiple practice settings, both inpatient and outpatient. The competitive program has been twice awarded Accreditation with Distinction as a Practice Transition Program (PTAP) by the American Nurses Credentialing Center’s (ANCC) Commission on Accreditation in Practice Transition Programs.

The VUMC Nurse Residency Program gives new nurses the opportunity to practice at a large, academic medical center with all the research, technology and teaching resources that entails. Each nurse resident commits to a year in a particular unit and entity, with new cohorts starting throughout the year.

“We’re looking for individuals who are excited about not just nursing in general, but being a Vanderbilt nurse, and then also excited about their entity, said Crystal Jackson, MSN, RN, NPD-BC, senior director of Nursing Education & Professional Development. “Our program teaches residents a lot that they need to know as they are transitioning, including how to be resilient. There will be moments that they may have challenging patients, and we give them the tools to critically think through situations.”

Nurse residents receive specific education and skills training throughout the year to help them develop effective decision-making skills, sound clinical judgement and professional performance. The program’s professional development opportunities incorporate evidence-based practice to strengthen the nurse resident’s commitment to professional nursing as a career choice and target specific transitions in the first year of practice as a nurse.

“One of the things that I like to highlight about our nurse residency program is the true values of Vanderbilt it exemplifies,” said Tessa Hensley, MSN, RN, NPD-BC, CDCES, CPN, program director of the Nurse Residency Program. “We see people as a whole. You are more than just your job. You are a person with a life, and we value the total you. So, prior to nurse residents starting with us, we start those lines of communication and establish that culture. We hold information sessions and weekly open office hours, and we really help mentor people through that transition period of graduating nursing school and applying for residency.”

The first 150 nurses in the cohort — all acute care nurse residents at Vanderbilt University Hospital (VUH) began orientation on July 24, and another group of that size began orientation on July 31 in the VUH Critical Care & Peri-Op, Pediatric, Behavioral Health, Ambulatory, and regional hospital areas.

“Once our nurse residents are here, they start in cohorts,” Hensley said, “so that people have other folks around them that are all experiencing the same thing at the same time.”

Nurse residents said they were excited about the opportunity to learn on the job at a major medical center, where they can discover what specialty of nursing best suits them.

Ashley Gibson, RN, came to Vanderbilt from her small hometown of West Point, Mississippi. She said she specifically wanted to live in Nashville and is interested in a career in pediatric nursing after her experience in the adult hospital.

“Being able to go to different departments if I want to, the flexibility, and being able to learn more,” were some of the things that appealed most to her. “Each week, you learn something different.”

But what appealed to her most is the ability to work with a preceptor, versus going to a community hospital right out of school with a short orientation.

“The preceptor is the No. 1 thing,” she said. “We can ask questions and tell them about what we don’t understand, and it won’t be so hard if we don’t know it. It’s more of a teaching hospital.”

Graham Hooker, RN, of Asheville, North Carolina, said he applied to Vanderbilt’s nurse residency program because he wanted a program where the orientation wasn’t rushed. “I wanted a year to really learn,” he said. He started looking at academic medical systems and found Vanderbilt. After completing his residency and commitment to Vanderbilt, he plans to get his master’s degree to become a certified registered nurse anesthetist (CRNA).

He was attending the orientation along with Marawon Eldahan, RN. They both recently graduated from nursing school at Milligan University, near Johnson City, Tennessee.

“I just wanted to be part of something where I can learn more,” said Eldahan, who comes to Nashville from Memphis and is originally from Cairo, Egypt. He’s also interested in becoming a CRNA.

“COVID was kind of hard for us on the whole education. It kind of changed everything,” including shorter clinical time in the hospital, he said. “I felt like instead of going in cold turkey onto a floor, getting rushed through orientation, I felt like getting more sturdy on my feet.”

In addition to the year of experience and guidance, nurse residents qualify for a large suite of employee perks, including a $10,000 sign-on bonus, relocation assistance and a nursing student loan repayment plan that will contribute $500 monthly toward student loans for those in good standing. This means a nurse can reduce their debt by up to $24,000 while remaining a VUMC employee.

Nurse Residency Program Lead Megan Unfried, MSN, RN, NPD-BC, said the program is structured around the theory of three phases of nurse transition from Canadian nurse Judy Boychuk Duchscher, BScN, MN, PhD, RN. Phase 1 is the “doing phase” when nurses first begin the program and are excited about “checking all the boxes.” Phase 2 is the “being phase” when nurses struggle with moral and ethical dilemmas about their nursing job and the profession as a whole.” And Phase 3 is the “knowing phase” in which the new nurse becomes more confident in their knowledge and skills and takes on more leadership roles in their areas. Three live, virtual workshops are structured around each phase to let nurses talk about what they’re experiencing. The workshops also discuss the resources that are available to them at Vanderbilt that coincide with what they are experiencing in each phase.

“Being a nurse resident, it really is that dedicated support of your physical, mental, emotional and professional well-being from the minute you walk in the door — through your entire tenure at Vanderbilt — but very focused in that whole first year,” Unfried said. “I think that’s what sets a residency program apart from a program that does not have residency.”