Implementation of an Ambulatory Oncology Nurse Residency Program


Standard nursing programs often lack specialized training, resulting in new graduates that are under-prepared to function independently in professional practice. Due to this, Tennessee Oncology (TO) has opted to hire only experienced nurses and has no program to incorporate new graduate nurses into the system. The primary objective of this project was to implement an ambulatory-focused new graduate nurse residency program (NRP) to increase nurse retention through the provision of a specialized curriculum and professional support. Secondary goals include improvement in nursing confidence, increased knowledge base and clinical skill development, and improved job satisfaction.


A comprehensive literature review identified the need for effective NRPs to transition new graduates into practice however, only four oncology focused NRPs were found in the literature. It was anticipated that the development of an oncology-specific curriculum to support newly graduating nurses would provide the level of support and education necessary to promote safe patient care and nursing retention. A planning committee was formed with representation by executive leadership, clinical education, nursing, and human resources. A NRP length of 12 months was determined and small cohorts of five graduates twice per year was chosen based on organizational need and preceptor resources. A curriculum was planned to deliver oncology specific education in areas such as care delivery, supportive cancer care, and clinical skills.


Due to COVID-19, the NRP was unable to be fully implemented. Upon successful implementation, retention will be measured at one and two years post-NRP completion. Secondary objectives of nurse resident confidence levels, knowledge and skill development, and job satisfaction will be measured utilizing the Casey-Fink Graduate Nurse Experience Survey.


Although this program encountered several barriers at the implementation stage and outcomes could not be assessed, a number of valuable lessons were learned during the planning and organization of this project. Obstacles included: changes in the nursing students’ clinical experiences, reduced hiring capacity at TO, NCLEX testing delays, limited TO training space due to social distancing requirements, and limited program applicants. Based on these issues, it was decided that the program start date would be moved forward to allow for an increased number of applicants, NCLEX results before program start date, and more comprehensive clinical experiences prior to graduation.