This story was originally published by The Intersection.
Up and down the San Joaquin Valley, hospital programs for newly-hired registered nurses are providing a year of additional training and experience beyond what they received en route to their nursing degree.
CommonSpirit Health, which operates about 30 hospitals in California and 138 nationwide, is in the midst of expanding a nursing residency program in both California and across the U.S. In the San Joaquin Valley, it has hospitals in Stockton, Merced and Bakersfield.
CommonSpirit Health is the largest Catholic system of hospitals in the U.S., created from the merger of Dignity Health and Catholic Health initiatives in 2019.
The company’s residency program is in place at 84 of its hospitals across the U.S., including four in the San Joaquin Valley: Bakersfield Memorial Hospital, Mercy Hospital and Mercy Southwest Hospital, all in Bakersfield, and Mercy Medical Center in Merced. Jennifer Hubek, the company’s system director for nursing residency, said the company plans to bring that number to 130 of its hospitals by the end of 2026.
Since launching the program in early 2023, about 4,000 nurses have either completed the program or are currently going through it. Hubek estimates that once it is fully installed by the end of next year, as many as 1,500 to 2,000 nurses will roll through each year.
In California, more than 360 nurses have graduated from CommonSpirit’s national nurse residency, and another 470 are currently making their way through their residencies.
Hospitals operated by other organizations in Fresno, Stockton, Visalia, Porterville and other communities also have residency programs available to support new nurses.
What exactly is a nursing residency?
A nursing residency is an opportunity for new graduates from nursing school to get a year of on-the-job immersion, training and mentorship under experienced nurses in the high-stress environment of working in a hospital, Hubek said.
“When you go to nursing school, you get a good baseline of what nursing is, and you get some experience in the different specialty areas, some clinical experience, some clinical knowledge, but there’s still a lot more to learn,” Hubek told the Central Valley Journalism Collaborative in an interview. “Our patients are very acute. They have a lot of health problems when they come in that we need to be able to treat.”
“So when these new nurses graduate from nursing school, they just need more time and more training to be prepared to care for the patients, to provide the kind of care that we’re looking for them to provide,” she added.
So far, the company’s retention rate for nurses is 86% among nurses who have completed their residency. That, Hubek said, is an accomplishment in a field where turnover in the early stages of a hospital nursing career can be a problem.
A study published in 2024 states that as many as 33% of registered nurses leave the profession within their first two years of practice. Sometimes, Hubek said, such career second-guessing can rear its head within four to six months.
“One of the reasons for the turnover, for new graduate nurses, is that they’re just challenged,” Hubek said. “You have people’s lives in your hands, and it can be overwhelming, with the complexity of cases when the patients are so sick.”
“So the benefit of a program like this is that we provide that support through that time frame, to help them get through that questioning of ‘Can I really do this?’” she added.
The first portion of CommonSpirit’s one-year residency is what’s called an orientation, in which a new nurse is paired up with an experienced nurse to work alongside them in the specialty unit for which they were hired, whether critical care, medical-surgical, emergency room, pediatric or other units. The rookie nurse and the experienced counterpart take care of patients together, and eventually the new-graduate nurse takes over more and more responsibility.
The second segment of the residency pairs up new nurses with mentors with an eye toward professional development and advice about specific situations in which they may have struggled.
Nursing residencies are not unusual at hospitals, whether stand-alone medical centers, systems with a handful of hospitals or large organizations with hospitals across the country. But Hubek said CommonSpirit’s program is one of the largest to be standardized across its participating hospitals.
That allows a company to use resources and subject-matter experts spread across an organization to create a uniform program for all of its facilities – not just procedures for care, but also for an organization’s culture and mission, Hubek said.
Patients stand to reap the benefits of the additional training that nurses receive in their residency, she added, particularly “exposure to the different skills you need, the exposure to the patient situations.”
“It develops kind of what we call the ‘gut instinct’ of nurses, where an experienced nurse can walk into a room and know something’s wrong with the patient. That’s what we call ‘novice to expert,’” Hubek said. “If we keep them in the program … and they continue on the same unit, their competency increases.”