On a spring morning, a group of first-year nurses gathered for workshops on the campus of UTMB. What distinguishes this group is they are all participants in a post-baccalaureate nurse residency, a one-year program designed to help new graduates make the transition from student to practicing professional.
Dr. Charlotte Wisnewski, faculty advisor for the UTMB Nurse Residency program, meets with students working on their evidence-based projects.
The nurse residency program at UTMB recently was honored as one of four in the country, and the only one in Texas, named as “consistent better performers” in the 2011 Outcomes Report from the University Healthcare Consortium, an alliance of academic medical centers and their affiliated hospitals.
“To be named one of four is pretty remarkable,” said coordinator Cathy Ivash, who has managed the program at UTMB for the last six years. She considers her work “an opportunity to return some of what I received,” when she participated in a similar homegrown program at UTMB many years ago when she was beginning her practice as a nurse.
The nationwide, year-long program has many components but one primary goal — to help a new nurse make the transition from the theoretical to the practical, from the classroom to the bedside. 
The great majority of new nurses begin work in a hospital setting because the work with patients who are acutely ill is very important for their training and professional development.
It can also be highly stressful.
This reality shock has been well-documented as the new nurse struggles to adapt the lessons of the classroom to the reality of what they encounter in their daily work. Their best efforts are not always enough, and they often are privy to the most difficult and painful moments in a person’s life.
More than most of us, they witness suffering first hand.  
The stresses of real-world practice led to large turnover rates and, in some cases, nurses leaving the profession altogether.
More than a decade ago, in the throes of a burgeoning nursing shortage, academic and health care leaders across the country recognized the need to help recent graduates make the transition.

The UHC and the American Association of Colleges of Nursing developed the nursing residency program to address this crucial need to provide support and feedback during the critical first year of a nurse’s practice. 
The results speak for themselves. In the first three years of the program, participating hospitals experienced an aggregate turnover rate of only 5.6 percent compared to the national average of 27.1 percent.
More than 12,500 nurses across the country have participated in the program. UTMB joined the program in 2003, its second year. The Methodist Hospital and Memorial Hermann Hospital in Houston, along with San Jacinto Methodist Hospital in Baytown, are the other Texas participants in the program. All in all, the program now includes 63 institutions in 26 states.
“The UTMB Nurse Residency program is a prime example of how UTMB nursing education and practice work together for the public good,” said Pamela G. Watson, dean of the School of Nursing. “It is because of this program that UTMB nurses, many of whom are UTMB graduates, function so well clinically, demonstrating compassion, excellence and a high level of patient quality and safety.”
The residents benefit from the continuity of a faculty adviser, along with a liaison in the hospital setting. They meet at least once a month and cover a variety of topics from end-of-life issues to pain management for patients and stress management for themselves.
There’s an activity where they envision where they want to be in three years: What are they wearing — scrubs or a suit? Are they delivering a baby, working in a clinic or passing a scalpel? And once they have that vision, identifying the steps needed to make it a reality.
One creative exercise requires them to sculpt the perfect nurse, and results have included big ears for listening, or a huge heart or six arms.
Resident Kristine Murray said the program has helped her development as a nurse.  “It’s made me more comfortable in a clinical setting,” she said. 

Her sentiments are echoed by Summer Filidei-Chapman who said it was great to enter the nursing profession and this new phase of life with familiar faces. “The best part of the program is being able to see everyone once a month and share experiences with people who you have relied on in school and continue to rely on in a professional role. We basically hold each other’s hand.”  
Across the hall, another group of residents is participating in a “tales-from-the-bedside” activity, led by residency facilitator Karen Hand. Aptly named, these sessions focus on topics such as patient care issues, ethical dilemmas and nursing advocacy. On this morning, she gently encourages discussion on that toughest issue, the death of a patient.
One resident describes the sorrow felt when families are grieving. Another resident talks about families reaching the point of withdrawing treatment and not knowing what to expect. Hand explains that, unlike on a television program, death may take two minutes, two hours or two days.
The residency program is remarkable on a number of levels, with positive outcomes in retention, stress reduction, competence and increased nurse satisfaction.
“I am continually inspired by the professionalism, dedication and commitment of the nursing residents who participate in this program,” said Hand.