Recommendations from the Institute of Medicine promote nurse residency programs for experienced nurses (EN) transitioning to new areas of specialty. A large non-profit healthcare system in the Southwest implemented three Transition-to-Specialty (TtS) residency programs using a blended cohort approach consisting of graduate nurses (GNs) and ENs. Upon review of program outcomes, ENs reported to have higher attrition rates than their GN counterparts. Given the substantial pecuniary loss related to EN turnover, understanding the ENs’ perspectives to achieve successful role transition to a new area of specialty is critical to a successful program. This qualitative descriptive study sought to describe the EN’s perceptions of being a nurse resident in these programs. A thematic analysis, generated from nine participant interviews, revealed five themes: Facilitators, Hindrance, Emotional State, Motivations, and Previous Work History. Facilitators represented the conditions and situations resulting in a positive impact during role transition as a resident to a new area of specialty, while Hindrances focused on the negative impact. Motivations detailed the reasons why the ENs chose to participate in the residency. Emotional State described the emotions expressed by the participants during their transition, and Previous Work History explored the impact of their prior nursing experience. Study results support blended cohort TtS residency programs and address unexpected findings of bullying and marginalization. Implications for practice include EN-focused program promotion and recruitment efforts, addressing bullying in work culture, tailoring the program based on work history, curriculum modifications, continuation of a supportive environment, and consideration of blended cohort model accreditation.

Keywords: experienced nurse, residency, resident, fellowship, transition, role change, specialty, emergency room, operating room, critical care, Transition to Specialty



Document Type

Scholarly Project

Degree Name

Doctor of Nursing Practice (DNP)

Level of Degree


First Committee Member

Angeline Delucas, DNP, MPH, RN, NEA-BC

Second Committee Member

Joy Stoddard, DNP, RN


experienced nurse, residency, fellowship, transition, role

Included in

Nursing Commons