Post-graduate Nurse Practitioner (NP) Residency Programs have become more prevalent and necessary throughout the United States. The emergence and continued growth of NP transition to practice residency programs have been greatly impacted by the escalating graduation rates for master’s and Doctorly-prepared Nurse Practitioners entering healthcare systems across the country. “…Over 70% of NPs in the United States are educated as primary care providers, including adult NPs (17.9%), family NPs (49.2%), and gerontological NPs (3%) ... (Painter, Sebach, and Maxwell, 2019).” The Veterans Health Administration (VHA)’s Office of Academic Affiliations (OAA) has increased the overall number of health professions trainee programs for various disciplines to include NP Residency Programs within the United States. NP Residency Programs serve to emphasize the importance of preparing novice NPs for the interdisciplinary team role as prescriber/provider in a very complex and diverse healthcare system. “The VHA is the largest integrated healthcare system, serving the health care needs of over 9 million veterans and operating more than 1,700 sites including hospitals, clinics, community living centers or nursing homes, Domicilliaries and other facilities (Lysaght and Cadavid, 2022).” VHA NP Residency programs uniquely offer newly licensed and board-certified Family and Psychiatric Mental Health NPs a twelve-month structured clinical and professional training experience that bridges the transition from an academically prepared/post-graduate phase to the licensed independent, competent, and confident phase of NP clinical practice. “Several factors that positively affect the RN-to-NP transition are support/mentorship, autonomy, the opportunity for professional growth and development, flexibility with work–life balance, and a sense of purpose in their work. In contrast, lack of support, role ambiguity, lack of support or isolation, unrealistic workloads, and low compensation were barriers for NPs transitioning to practice. A successful transition appears to be the best predictor for patient outcomes (Mounayor and Cox, 2021).” VA NP residency programs continuously emphasize the importance of prioritizing safe, positive, evidenced-based practices and patient outcomes. Independent anonymous feedback obtained from residents across NP residency cohorts identify transitional gaps specifically in preparing the novice NP for “real-life” integration into their new role within respective healthcare settings.  In an article written by Painter, Sebach, and Maxwell (2019) “…At the completion of the initial 12-month residency program, the program director completed a formal evaluation inclusive of feedback from the preceptors, residents, and other key participants. There was high satisfaction from the residents, as well as the faculty and other stakeholders (Painter, Sebach, and Maxwell, 2019).” NP residents from various cohorts agree that although academic programs prepare them with core curriculum-based knowledge and clinical practicum requirements for their new role, application of knowledge as well as other important role elements necessary for providing high-quality healthcare to veterans greatly influenced their decisions to apply to a NP Residency Program. VA NP residency programs uniquely differ in comparison to community facility programs in that residents acquire and hone their clinical skills and knowledge through veteran-centric competencies, professional collegiality with NP’s working within VA, innovative teaching methods, interdisciplinary trainings as well as supervised clinical experiences. In addition to clinical and professional NP preparation within VA, NP residency programs also have unique intraorganizational accessibility to resources such as whole health and provider wellness. Incorporating resources that educate, increase awareness, and mitigate the risks of NP burnout during the initial years of professional practice assist greatly with the retention and resiliency of NP’s. “…Reduction in NP turnover as well as cost savings of orientation and recruitment are significant benefits... These multiple successes predict increased establishment of residencies as viable post graduate pathways for NPs (McGuinness, Shirey, Cleveland, Richardson, et. al 2020).”  In summary, applicants accepted into post-graduate VA NP residency programs are truly provided an invaluable, structured, and supportive, in-depth, post-graduate training that uniquely prepares the novice NP for long-term success as an integral member of the VHA healthcare system. 

References
Lysaght, M. & Cadavid, M. Preparing the Novice Nurse to Care for Veterans Through a Nurse Residency Program. Nurse Leader, 16, 257-260.
McGuiness, T., Shirey, M., Cleveland, C., Richardson, J., Campbell, R., & Harper, D. (2020). An Innovative Approach for Graduate Education for Psychiatric Nurse Practitioners. Journal of Professional Nursing, 36, 526-530.
Mounayar, J., Cox, M. (2021). Nurse Practitioner Post-Graduate Residency Program: Best Practice. The Journal for Nurse Practitioners, 17, 453-457.
Painter, J., Sebach, A., Maxwell, L. (2019). Nurse Practitioner Transition to Practice: Development of a Residency Program. The Journal for Nurse Practitioners, 15, 688-691.