Improving Retention, Confidence, and Competence of New Graduate Nurses: Retention, Confidence, and Competence of New Graduate Nurses:

NURSING ECONOMIC$/November-December 2010/Vol. 28/No. 6 I N 1999, CHILDREN’S HOSPITAL Los Angeles (CHLA) found itself in the position of many hospitals today; despite much effort and expense to provide an inhouse internship for new graduate nurses, the results were disappointing. Turnover was high; 36% of the new graduates hired at CHLA were leaving in less than a year and 56% within 2 years. The resulting cycle of hire-educatereplace was negatively impacting nursing and patient care. A visionary chief nursing officer, a nursing education director, and a small group of committed nurses embarked on a quest to find a better way to bring new graduate nurses into the profession of nursing and into CHLA. Ten years of development, evaluation, and improvement have resulted in a RN residency with documented evidence of positive outcomes for hospitals, new graduates, and patient care that is now provided in hospitals across the United States. The evolution of the RN residency, the lessons learned along the way, and the outcomes achieved are described, and a model for successfully recruiting, onboarding, engaging, and retaining new graduate nurses is presented.