As Post-Baccalaureate Registered Nurse Residents (PBRNR) employed by the Veterans Administration (VA) Medical Center, we entered this 12-month residency program with no prior registered nurse (RN) experience. During our time in the program, we have been certified in: Advanced Cardiac Life Support (ACLS), Basic Life Support (BLS) Mental Health First Aid, Out of Operating Room Airway Management (OOORAM), Lean Six Sigma White Belt, Collaborative Institutional Training Initiative (CITI), and American Association of Critical Care Nurses (AACN) Essentials of ECG and Dysrhythmia Monitoring (EDM). In addition, we are active participants in shared governance committees such as the nursing leadership council, nursing research council, quality improvement, and patient education, etc. Outside of our work obligations, we are also active members of nursing organizations.
New graduate nurses face various challenges when transitioning to practice, as noted by National Council of State Boards of Nursing (NCSBN) (2025). They experience increased stress levels, and the complexity of patients often leads to errors. Approximately one-fourth of new nurses leave during their first year of practice. However, the NCSBN (2025) has reported that organizations incorporating a nurse residency program have lower attrition rates. Our residency allows us to feel fully supported as we embark on our nursing journey and, by learning and improving our patient care under safe supervision and guidance, our stress is relieved, facilitating clinical growth.
A central tenet of PBRNR is continued education. During our residency, we utilize didactic days to complete simulations, presentations, and online modules, building upon our existing knowledge. We also complete various projects, including evidence-based practice and quality improvement initiatives, and disseminate our findings via poster, presentation, or manuscript. Another central tenet is well-rounded professional nursing practice. We spend at least two weeks on most hospital units, including medical-surgical, long-term care, mental health, intensive care units, and specialties such as interventional radiology and the operating room.
The PBRNR program distinguishes itself through its comprehensive exposure across most units and specialties in the VA Medical Center. This immersive program provides hands-on RN experience with a diverse patient population, exposing residents to unit-specific patient conditions, care plans, nursing assignments, and expectations. The program’s blend of clinical and didactic days, coupled with a flexible schedule for gaining experience in chosen areas, creates abundant learning opportunities. With protected time, the program fosters an environment for optimal learning, significantly promoting resident success. Ultimately, these unique features contribute to more holistic approach to patient care and safety, cultivating increased confidence in practice, improved time management, and a wealth of knowledge that leads to proactive critical thinking.
Advice for New Nurses
For new nurses considering a residency, our advice is to strategically use your time in the program to discern your preferences. When it’s time to choose a permanent placement, remember to advocate for yourself and your career aspirations. Don’t hesitate to ask questions, and view mistakes not as failures, but as learning opportunities. Most importantly, prioritize finding a healthcare organization that aligns with your values and genuinely appreciates your time and continued professional development. A strong cultural fit can significantly enhance your career satisfaction and long-term success.
Disclaimer: The content of this article is solely the responsibility of the authors and does not necessarily represent the official views of the U.S. Office of Academic Affiliations (OAA), U.S. Government and Department of Veterans Affairs.
References
National Council of State Boards of Nursing. (2025). Transition to Practice. NCSBN.org; National Council of State Boards of Nursing, Inc. https://www.ncsbn.org/nursing-regulation/practice/transition-to-practice.page
