The transition from nursing student to professional nurse can be daunting and intense.

Graduating nurses can find themselves uprooted from the classroom and planted on the overnight shift in a stressful medical setting, caring for critically ill people with complex health profiles.

It may be small wonder, then, that nearly one-in-three newly minted resident nurses will leave their first jobs within a year – many never to return to the profession.

To address the transition from school to direct care, the University of Iowa College of Nursing has helped create an online curriculum for newly licensed registered nurses to earn educational credits as they enter the workforce. The Online Nurse Residency Program is a 12-month, web-based initiative designed to prepare budding registered nurses for real-life care settings.

Rita Frantz, the UI’s College of Nursing dean, will describe the online nursing initiative to the Iowa Board of Regents at the educational oversight body’s meeting on Wednesday, March 11 on the UI campus in Iowa City.

The certificate program, which started last August, is the first of its kind in the nation to be offered totally online. The Robert Wood Johnson Foundation funded its conception.

To date, 254 nurse residents from nine states have enrolled. Of that number, 140 are students in Iowa, from 25 hospitals, most of them serving rural areas.

"Making an online nurse residency program accessible to employers of new graduate nurses provides a means to facilitate their professional development from novice to experienced nurse," Frantz says. "It also assures that patients and their caregivers across the state of Iowa can be provided with the highest possible level of clinical care."

The certificate program consists of 13 modules to help students build competencies for the job, and is capped by a research project to solve an everyday problem in the field, based on a review of the literature and collecting direct-practice evidence.

Graduates earn 9.6 contact hours for Continuing Education credit that can be applied to renewing their registered nurse (RN) license.

The need is not simply one of educational and professional development. In Iowa, 46 percent of registered nurses are at least 50 years old and thus nearing retirement, according to the Iowa Board of Nursing. There is a need for new nurses, and well-trained clinical practitioners at that, to replace them—especially as the state’s population tilts more to aging.

"With the impending retirement of close to half of Iowa’s nursing workforce, it's vital that all health-care facilities—regardless of their size—have access to the tools necessary to facilitate a timely transition of newly licensed registered nurses into practice," says Nicole Weathers, a registered nurse who runs the UI's program. "The Iowa Online Nurse Residency Program is a great way to offer the resources and support necessary for those in our mostly rural state."

The certificate program was inspired by a 2010 report from the Institute of Medicine, titled “The Future of Nursing: Leading Change, Advancing Health,” which recommended that all new registered nurses complete a residency program. The report cited multiple studies establishing that nurse residency programs reduce turnover in a facility’s nursing workforce, stabilize staffing, enhance morale, improve patient safety and reduce costs.

Compounding the issue, most medical or health-care agencies don’t have the capacity to offer residency programs. Only seven hospitals in Iowa have in-house residency programs for new graduates.

In response, UI’s College of Nursing and the Future of Nursing Iowa Action Coalition created a task force to figure out how best to address the impending RN shortage in Iowa and the need for better-trained graduates in the profession.

The curriculum is standardized, its core being the online modules. It’s supplemented by several facets, including:

• Working directly with an onsite mentor
• Live webinars
• Monthly peer discussion groups
• Discussion forums
• Self-evaluations

Students also have access to peer-reviewed journal articles and other research information through the UI’s library system.

"Since many health-care facilities have limited resources to support a nurse residency program, having access to the faculty and library resources of the University of Iowa is an added strength of the program," Frantz notes.

The university is expected to seek accreditation from the American Nurses Credentialing Center this summer, after waiting the required year before applying.