During the coming five years, the healthcare sector will continue experiencing transitions while the effect of the “Baby Boomer Exiting” will lead to the issue of nursing shortage. In the U.S., the nursing shortage issue has approached a crisis level for a number of years. The biggest segment of the healthcare staff in America comprises of 3 million nurses with the nursing profession being among the fastest growing in the country. However, the supply of nurses is not able to keep up with the rising demand. The country is experiencing an aging population with Americans aged over 65 year being more than any other time in the history of the country. By 2030, estimates expect the senior citizen population to rise by 75 percent, although big percentage of the nursing staff catering for the demographic is leaving the profession. During the recent recession, several baby boomer nurses deferred existing their careers. Presently, however, they are approaching retirement age, with signs of leaving starting. Around 1 million registered nurses are aged over 50 years, which is approximately a third of the approximated 2.7 million individuals comprising the nursing profession (Barrett, 2016) . These will attain retirement age in the coming 10-15 years thereby leading to a growing shortage in the profession. In this case, it will be crucial to devise a strategy that will facilitate in addressing the rising nursing shortage, which will mostly focus on supporting the next generation of nurses. The paper will therefore discuss the nurse residency program as an approach that will contribute toward addressing the imminent nursing shortage, particularly with the exit of baby boomers from the profession.
Retention Strategy for Addressing Nurse Shortage
In the present nursing field, it is vital to realize that new graduates show eagerness in leaving the classroom environment behind and commence their careers. With most present nursing staff attaining retirement age, approximated at 1 million in 2025, healthcare institutions are focusing on adding extra recent graduates to the job environment to remain relevant. Identifying means of developing these novice nurses to become experts in the nursing profession serves as the duty of administrators. Here, a nurse residency program (NRP), serves as a key option that would allow the students to make a smooth transition. A nurse residency program would serve as an ideal retention strategy for addressing the nursing shortage crisis (Healthleaders, 2019) . The initiative aims at assisting recent graduates in transitioning into the clinical environment. The program usually lasts for between 6 and 12 months while providing graduates with a means of improving evidence-based decision-making and critical thinking skills. For the residents, they have means of learning ways of serving patients and their families effectively as well as understand the procedures, policies, and technology that their institutions use. The NRP emphasizes on patient safety, leadership, and interdisciplinary care (NursingCAS, 2018) . Here, by adopting the NRP, healthcare institutions would be adequately prepared to addressing the nursing shortage crisis, which has become prevalent due to the exiting of the baby boomers in the field in the recent years while at the same time facilitating retention.
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By applying the nurse retention program, healthcare institutions will realize increased benefits beyond increased rates of retention. For example, they see a rise in critical competencies. When new nurses commence their hospital careers, they need to learn the diverse procedures, policies, and routines of the institutions. Whereas this is necessary, it is possible to lose focus on the broader core competencies. NRPs emphasize on developing areas including communication skills and evidence-based decision-making. Combining practical critical skills with mentorship allows nurses to feel empowered while shifting from the learning to professional environment. NRPs also play a crucial role in minimizing nursing turnover. Employee turnover prevails in every job. Nonetheless, in the healthcare setting high rates of turnover among nurses can lead to disruptions that affect other personnel as well as patients (Nock, 2017) . With the nurse retention programs, however, they improve/increase the level of retention, job satisfaction, and performance of the newly registered nurses.
With NRPs, nurses are able to deliver increased levels of patient centered care. Studies reveal that most graduate nurses are inadequately prepared to offer effective and safe care. Tis serves as a major area of concern for different healthcare institutions, particularly for the ones embarking on efforts aimed at applying for Magnetic Recognition Program. To commence the Journey to Magnetic Excellence, healthcare institutions need to ensure that they analyze the existing gaps and establish action plans for realizing higher levels of performance (Goeddeke, 2019) . This might mean devoting efforts to NRP investments to produce nurses with adequate training, and who emphasize on the safety of the patients. They should ensure to have programs consisting of measurable goals, emphasize on improving quality, evidence-based, and patient centered (Nock, 2017) . Identifying means of bridging the gap between practice and school would be a crucial part of welcoming and retaining new nurses while benefiting the healthcare institution for the coming years.
Implementing the NRP Strategy
Creating a nurse residency programs, which has the capacity of producing measurable results takes effort and time. However, this does not mean that developing a program that meets organizational needs while addressing those of newly graduated nurses is impossible. Implementing the NRP to ensure its success would require several considerations. One of the major areas to emphasize on is getting everyone onboard. To ensure that the nurse residency program becomes successful, it becomes essential to have the backing of the entire nursing workforce. This consists of clinical nurses, nursing leadership, staff nurses, and clinical nurse educators (Lippincott Solutions, 2018) . Also, the hospital human resource and administration should approve the program making it easier to create and implement the plans for the NRP.
Lining up the existing resources would also be a vital undertaking. It is not possible to create an NRP in the absence of resources. In this vein, it becomes crucial to take stock of the human and financial assets of the hospital since lacking the two would present challenges in getting the program off the ground. It would be crucial to select a residency planning coordinator and committee to facilitate in assessing the prevailing resources accurately. Utilizing best evidence for building the program is also vital. The nursing profession revolves around evidence-based practice while developing an NRP needs to follow similar guidelines. Investigating other institutional perspectives and residency programs assists in shaping decisions while at the same time providing insights regarding the ones that would work and ones that would fail (Lippincott Solutions, 2018) . Assessing measurable and reliable evidence needs to be a continuous process to create room for modifying the residency elements as needed.
Moreover, implementing the program should follow stages. New nurses usually develop skills and confidence in stages over a period rather than at once. The program needs to support nurses when transitioning between development stages. It would be possible to achieve these via scheduling educational check-ins and sessions regularly with the nurse educators and preceptors. Also, it is important to assess the new nurses in line with measuring their outcomes. The ideal means of actually knowing whether the NRP initiative is successful is through assessing how the graduate nurses perform. Reviewing measurable outcomes, including changes in the confidence, skills, and work attitude among graduate nurses would help in determining whether the program has attained its goals. Sustaining the program is also an essential area to consider. The process of ensuring that an NRP remains running is difficult, although it is possible to do it. Realizing this would require that all the organizational leaders, from nursing management to administration is aware of the program’s progress and the outcomes (Lippincott Solutions, 2018) . Continuing to collaborate with institutional stakeholders is crucial to making sure that the programs continues during the longer term.
Challenges in Strategy Implementation
When implementing the nurse residency program, certain challenges prevail. For instance, it might be possible to lack countrywide policies that support structured orientation programs. Orientation programs are usually insufficient. Hospitals are responsible for controlling the orientation process and training the nurses as opposed to following a unified protocol to facilitate the process. As such, the resources utilized in supporting the nurses usually differ between the hospitals. An additional challenge that prevails relates to the reality shock that novice nurses portray. Here, a gap prevails between nursing education and actual practice and has negative effect on socializing new nurses to the roles they need to serve (AlRub & Alhaija'a, 2018) . The theory-practice gap serves as the major challenge that graduate nurses encounter.
Furthermore, implementing the nurse residency program faces the challenge of senior nurses’ turnover resulting in lack of role modelling. Various senior nurses are departing their jobs to look for openings of betting their financial incentives thereby leaving the new graduate nurses without individuals to emulate. The absence of unified NRPs or training also presents challenges in implementation. This difficulty is mostly to do with the challenges that new graduates encounter in their practice (AlRub & Alhaija'a, 2018) . Preceptorship programs and NRPs are regard effective for novice nurses to take part in the nursing practice easily.
Ensuring Successful Implementation
To make sure that the NRP approach becomes successful, it is vital to ensure that the didactic element of the residency of a nurse guides and supports them while addressed at unit levels. The mentors should take part in facilitating the residents in incorporating clinical knowledge and experience. The incorporation, in this case, leads to efficiency and competency while allowing the new nurses to have confidence in their practice. It is also essential to hold routine meetings between mentors and residents away from clinical environments for review and discussion (AlRub & Alhaija'a, 2018) . The time can comprise of going over new knowledge and experience, which is crucial to the specialty area and other avenues that support learning.
Guided time or self-study would also assist in accomplishing additional education. They can undertake assignments, which would allow then to incorporate specific to their areas of practice. These might comprise of reviewing units depending on competencies, procedures, policies, or specific classes. The residents might need to visit alternate sights, which offer insights regarding patients’ care continuum. Furthermore, the residents need access to comprehending nurse leadership. The mentors should ensure to take accountability for introducing the residents to things, such as peer review, resource usage, and quality improvement. Shadowing nurse leaders at unit or organizational levels would provide nurse residents on perspectives of coping with demanding challenges (AlRub & Alhaija'a, 2018) . These areas of emphasis would ensure that the implementation of the nurse residency program becomes successful to retaining new graduate nurses.
References
AlRub, A., & Alhaija'a, A. (2018). Perceived benefits and barriers of implementing nursing residency programs in Jordan. Retrieved from https://onlinelibrary.wiley.com/doi/full/10.1111/inr.12452
Barrett, J. (2016). The impact of baby boomers on the nursing shortage. Retrieved from https://peopleelement.com/the-impact-of-baby-boomers-on-the-nursing-shortage/
Goeddeke, V. (2019). Developing an effective nurse residency program. Retrieved from http://www.strategiesfornursemanagers.com/content.cfm?content_id=236464&oc_id=602
Healthleaders. (2019). Developing an effective nurse residency program. Retrieved from https://www.healthleadersmedia.com/nursing/developing-effective-nurse-residency-program?page=0%2C1
Lippincott Solutions. (2018). Nurse residency programs: Best practices for helping new nurses succeed. Retrieved from http://lippincottsolutions.lww.com/blog.entry.html/2018/08/07/nurse_residency_prog-QwtG.html
Nock, B. (2017). 3 benefits of creating a nurse residency program at your hospital. Retrieved from https://www.gebauer.com/blog/nurse-residency-program-at-your-hospital
NursingCAS. (2018). Inside the nurse residency experience. Retrieved from https://www.nursingcas.org/inside-the-nurse-residency-experience/
