The Costs and Benefits of an Academic Nurse Residency Program and Its Effect on New Nurse Graduates' Satisfaction and Turnover

Defense Date


Graduation Date

Spring 1-1-2003


Campus Only

Submission Type


Degree Name





School of Nursing

Committee Chair

Joan Such Lockhart

Committee Member

L. Kathleen Sekula

Committee Member

Sandra Ferketitch


education, graduate, nurse, orientation, residency, satisfaction, turnover


A significant nursing shortage exists in the United States. This shortage is compounded by high rates of nursing turnover related to job dissatisfaction, especially among new nurse graduates. A secondary analysis nonexperimental research study design was used to examine the relationship of a 2-year academic nurse residency program (ANRP) on job satisfaction, turnover, and cost of turnover. The total sample (N=224) consisted of 74 new nurse graduates of which 45 self-selected to enter the ANRP and 29 selected to not enter, and 150 regular registered nurses (RNs) hired from January 1999 to January 2001. Each subject group received a different orientation and education program intervention. The ANRP subjects were given the Index of Work Satisfaction (IWS) (Stamps, 1997; Stamps and Piedmonte, 1986;) which measured the critical level associated with intent to leave (*154 or 50%). A final sample size of 41 (91%) had a total score of 165.4 (54%). Data were tested for reliability using Cronbach's alpha, and the total scale alpha was .7796. The turnover rate for the ANRP was statistically significant (p* 0.027) at 4.4% compared with non-ANRP which was 23%. The turnover rate was also statistically significant (p* 0.001) for ANRP (4.4%) compared with regular RN (38%). Projected turnover costs were analyzed from turnover rates and sample sizes were standardized to the ANRP. Turnover costs for ANRP subjects were $160,829, compared with $943,432 for non-ANRP subjects and $1,525,499 for regular RN subjects. Total program costs, which included the costs of turnover, were $5,011,876 for the ANRP subjects, compared with $5,995,937 for non-ANRP subjects and $7,716,691 for regular RN subjects. There was a cost-savings benefit of $984,061 to hire 45 new RNs as new nurse graduates in an ANRP over the same number of RNs in a non-ANRP, and $2,704,815 over regular RNs. Results were interpreted within the context of professional nursing practice with specific implications for nursing research. The implications of this study are far-reaching in that the content can be used and modified to advance the knowledge of nursing while impacting recruitment and retention decisions that can now be based on actual cost data.





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