Brandon (Fla.) Regional Hospital has a new nurse recruitment strategy: The 438-bed facility is hiring registered nurses fresh out of nursing school and enrolling them in weeks- or months-long residency programs to learn the technical skills needed to care for patients in critical care and other specialty areas.
While still evolving in approach, the number of nurse residency programs has been growing steadily after being endorsed by the Institute of Medicine in its 2010 report, "The Future of Nursing." The proportion of hospital residency programs for new RNs increased to 45 percent in 2013 from 36.9 percent in 2011, according to a follow-up report from the IOM that was released late last year.
“With this residency program, we’ve been able to kind of grow our own nurses,” says Christine Taramasco, R.N., chief nursing officer, Brandon Regional. “We are helping new graduate nurses achieve their professional goals while securing a future for their families." Brandon Regional is also benefiting: Because of a reduced reliance on agency nurses, contract labor costs declined 47 percent in one year, saving more than $1 million.
And with many aging baby boomers retiring or leaving nursing, hospitals are having trouble filling skilled nurse vacancies they create. One reason: RNs have more job options today, says Barbara Jacobs, R.N., CNO, Anne Arundel Medical Center in Annapolis, Md. “When I graduated, the only real nursing job in town was at a hospital. But now, hospitals have to compete for nurses with outpatient centers that can offer a Monday through Friday schedule with no call, weekends, or holidays,” Jacobs says. At the same time, a hospital is still one of the few places where new nurses can get post-academic specialty training; even then, those nurses often treat such positions as a stepping stone of sorts.
Improving RN retention rates is a primary goal of Brandon Regional’s nurse residency program, which is offered using an approach called StaRN that was supplied by a unit of its HCA parent, Parallon. As a part of its StaRN program, Brandon asks the nurses hired to commit to two years of employment; during the 16-week residency, they are on Parallon’s payroll. Brandon Regional then pays Parallon a placement fee for each nurse who successfully completes the program. One-year retention is at 90 percent among the first 57 RNs in the program, according to Brandon officials. The program has also significantly cut time-to-fill rates.
Anne Arundel also offers a 12-month residency program to new RNs, but with support from the statewide Maryland Nurse Collaborative. The Maryland program is based on a standardized residency approach developed by the University HealthSystem Consortium and American Association of Colleges of Nursing, which has a 95 percent retention rate of first-year nurses, according to the UHS consortium. A key to the program, Jacobs believes, is that the nurses regularly meet with their peers. “The peer groups get together throughout the residency year. They can ask each other, ‘What challenges did you have this month?’ ”
Taking Up Residency
The stages of Brandon Regional’s RN residency program
1. Online and classroom instruction with nurse specialty experts
2. Hands-on training at a local medical simulation lab
3. A mentorship with a nurse preceptor at Brandon Regional
Source: Brandon Regional Hospital, 2015