For new grad nurses there are two pathways to employment within the hospital setting. First, there is direct hire to a RN I position and second, a residency program. After graduating with my ADN I became a resident in a level IV NICU. My residency outline was eight weeks with a preceptor on orientation, four weeks on nights and four weeks on days. After the completion of the first eight weeks there was four months on on your own, and then three weeks back on orientation for the higher acuity training. Because I was a nurse resident in an ICU I was first trained on lower acuity patient; room air, nasal cannula, high flow, non-invasive ventilation, feeder-growers, sugar babies, before being trained on intubated babies with drips, and etc.
I specifically sought residency positions out of nursing school, because I personally wanted the extra hand holding for transitioning into my own clinical practice. From what I have gather from friends that were direct hires the biggest difference between direct hire and residency positions is the length or orientation. A typical residency has a preceptorship or orientation period ranging from one to six months, whereas an RN I position has an orientation period on two to four weeks. Note that each residency differs, not only between hospitals but between units as well. All together my orientation ran about eleven weeks total, excluding the gap between my higher and lower acuity orientations.
In addition to my floor orientation I had coursework and classroom training, similar to lab in nursing school to work of patient case studies, simulations, and skills specific to the NICU population. Getting hired in as a resident puts you in direct association with other new grads, starting and learning at the same time as you. I immediately felt more connected to the people on the unit. I came in with connections to my preceptors, the other seven resident in my group, and my nursing educator.
As stated in other posts, nursing school does not have a predominant focus on pediatrics, so I am so grateful for the concept of residency programs. Neonates are just completely different than adults. Nursing expectations for premature neonates is not at all what they teach in nursing school, quite often I felt as though it contradicted what is taught.
Each month I attended one to two classes for a year, and every couple of months I received a new three ring binder packed with powerpoints, policies, and information pertaining to my specialty. In the moment, it was completely overwhelming to have all that information at my fingertips, because at times I felt like I needed to memorize and understand everything that was being discussed, but that’s an impossible task. Often there are things where until you see it in practice or experience it yourself just don’t connect, and that’s okay! When it comes to nursing you signed up for a career of life-long learning, I am fifteen months in and still have ah-ha moments from things in the binders I learned six months prior.
You really have to evaluate your goals as a nurse, where you see yourself both long-term and short term to figure out if a residency is best suited for you. From what I have gathered residencies seem to be the new standard for hiring new nurse graduates. If you have any further or specific question regarding my residency experience or want to know my tips for going in to a hospital as a resident let me know and I’ll try to share.