Impact of Nurse Residency Program on Time-to-Fill Nurse Vacancies at the Veterans Health Administration

Abstract

Background: The Department of Veterans Affairs (VA) offers a 1-year Post-Baccalaureate-Registered Nurse Residency (PB-RNR) Program. The impact of the PB-RNR program on local RN recruitment was unknown. Objectives: We aimed to evaluate the effect of the size of the PB-RNR program at a VA facility on its time-to-fill RN vacancies. Project Design: We used an instrumental variable approach with a 2-stage residual inclusion specification. Subjects: We included RN filled vacancies in the VA that were posted nationwide between 2020 and 2021. Measures: Our independent variable was the facility-year level number of PB-RNR program allocations. The 3 binary outcomes were whether the RN vacancy was filled within 90, 60, or 30 days. Results: An increase of one training allocation was significantly associated with a 5.60 percentage point (PP) (95% CI: 2.74–8.46) higher likelihood of filling a vacancy within 90 days, 7.34 PP (95% CI: 4.66–10.03) higher likelihood of filling a vacancy within 60 days, and 5.32 PP (95% CI: 3.18–7.46) higher likelihood of filling a vacancy within 30 days. The impact was significant in both 2020 and 2021 positions, and in facilities located in areas with lower social deprivation scores, higher-quality public schools, or with either no or partial primary care physician shortages. Conclusions: We found favorable impacts of the size of the PB-RNR program at a VA facility on filling RN vacancies.