Perspectives of tomorrow’s nursing leaders: Eight trends for newly licensed nurses

As the healthcare landscape evolves, the importance of supporting newly licensed nurses cannot be overstated. These professionals represent the future of nursing leadership, and their early experiences hold a significant influence on their long-term impact in the field. The 2024 Vizient/AACN Nurse Residency Program™ (NRP) Outcomes Report — which focuses on the 38,042 nurse residents hired in 2022 who completed the NRP in 2023 — offers telling perspectives on the successes and challenges these newly licensed nurses face.

As we head into 2025, eight key trends healthcare leaders need to consider for newly licensed nurses include:

1. Demographics remain consistent: The average newly licensed nurse NRP participant is 27 years old, predominantly female (86%) and academically strong, with 94% holding a GPA of 3.0 or higher with little changes over the last year.
2. Med-surg dominates: Newly licensed nurses were most commonly placed in medical-surgical units (13%), emergency departments (12%) and telemetry (7%) areas, reflecting workforce needs across care settings.
3. Significant growth in skill development: From mastering high-intensity skills like chest tube and central line care to foundational abilities like patient-family communication, newly licensed nurses report significant growth throughout the year-long NRP.
4. Steady growth in autonomy, advocacy and competence: The NRP’s impact on newly licensed nurses’ growth is evident in their progression toward autonomy and advocacy. Through the NRP, newly licensed nurses gained confidence in engaging with their units and taking on leadership responsibilities. Competency levels, self-rated by newly licensed nurses (using a 0 to 10 scale), showed a steady increase from a mean of 5 at the start of the program to near 7 by completion, reflecting the ongoing development the NRP fosters.
5. Stress levels down and satisfaction up: While newly licensed nurses reported stress levels remained low throughout the NRP, satisfaction slightly dipped around the six-month mark, coinciding with reality shock related to the adjustment from academia to clinical practice. Nevertheless, satisfaction levels remained above 3 out of 4, indicating that newly licensed nurses continued to find their roles fulfilling despite transitional challenges.
6. LPN/LVN integration into the acute care setting: Inclusion of licensed practical/vocational nurses (LPNs/LVNs) in some healthcare teams was a trend in 2024, reflecting shifts in workforce composition. While LPNs/LVNs faced unique challenges — such as role clarity and balancing work with continuing education — their experiences underscore the importance of tailored support to maximize their contributions to the care team. An analysis of LPN/LVN data from July 1, 2023, to July 31, 2024, showed that 10% (73 member sites) included LPNs/LVNs in the NRP. Ohio had the highest participation (29%), followed by Pennsylvania (20%) and Louisiana (12%). The first-year retention rate for LPNs/LVNs in the NRP was 83%, which is 6% lower than the overall Vizient/AACN NRP retention rate.
7. Leadership development and post-NRP growth: The NRP’s impact extends beyond its initial 12 months. Many program alumni from 2021 and 2020 have advanced into leadership roles such as charge nurses, preceptors and mentors. This trajectory demonstrates the NRP’s role in preparing nurses for leadership positions that drive organizational success.
8. Increased retention — finally: Retention rates continue to be a standout metric. The overall retention rate for nurse residents reached 89%, a 2% increase from the prior year and nearly 13% higher than the national benchmark for first-year employment.

The Vizient/AACN NRP continues to play a critical role in preparing newly licensed nurses for the challenges of modern healthcare. By emphasizing skill development, fostering resilience, providing support and nurturing leadership potential, the NRP equips nurse residents to excel in their roles and shape the future of healthcare.

As we move into 2025, the continued growth and leadership of NRP graduates will be pivotal in driving positive change, ensuring that the nursing workforce remains adaptable, capable and committed to delivering high-quality patient care.

The Vizient/AACN NRP team thanks Mary R. Lynn, PhD, Vizient/AACN NRP evaluation consultant, professor, School of Nursing, University of North Carolina at Chapel Hill for authoring the 2024 NRP Outcomes report.

Authors

Kelly Gallagher is the senior director for Nursing Programs at Vizient working on the Nurse Residency Program team. Her role focuses on operations and thought leadership of the Vizient/AACN Nurse Residency Program™. Prior to this role, Gallagher was the Director of the Nurse Residency Program at Penn Medicine in Pennsylvania and New Jersey where she provided oversight and strategic leadership for more than 700 newly licensed nurses hired across Penn Medicine at the health system level. Gallagher earned her BSN from Villanova University and MSN in nursing and healthcare administration from the University of Pennsylvania. She has a certificate in human resources management from the Wharton School. She also is Board Certified in Nursing Professional Development (NPD-BC) and Nurse Executive Advanced (NEA-BC). Gallagher has published and presented nationally on nurse residency programs and evidence-based practice. She also serves as a team leader for Nurse Residency Program accreditation for the Commission on Collegiate Nursing Education.

Dana Garcher is a senior programmatic advisor for the Vizient/AACN Nurse Residency Program™ (NRP). She is responsible for curriculum and resource development, assisting with new and existing NRP programs and presenting educational offerings. With over 15 years of healthcare experience, prior to this role, Garcher was an NRP coordinator, responsible for planning, implementing and evaluating a system NRP. She earned her BSN and Master of Science degree in adult-gerontology (clinical nurse specialist track) from Mount Carmel College of Nursing. Garcher has a passion for nurse residency programs and enjoys engaging with NRP coordinators and teams across the country.