Racial Disparities in the UHC/AACN Nurse Residency Program

The UHC/AACN Nurse Residency Program (NRP) has been successful in increasing first-year employment retention in participating hospitals, but the program has not been studied for racial disparities. Therefore, this study aimed to investigate NRP retention rates among different ethnicity sub-groups and any associations to workplace stress and satisfaction factors. The NRP ethnicity sub-groups were non-Hispanic whites, African-Americans, Hispanics and other races. The corresponding retention rates were compared using chi-square and adjusted residual analysis. The data collected from the NRP’s survey on stress and satisfaction were categorized to an additional level of ethnicity (3-way contingency tables) and analyzed using chi-square analysis. The lowest program retention rates corresponded to African-Americans (92.8%; Z=7.4) followed by Hispanics (94.9%; Z=-2.4) and non-Hispanic whites (96.1%; Z=6.7) suggesting that racial disparities in retention affected African-American minorities to a larger degree than any other minority sub-group. In terms of surveyed satisfaction and stress factors, satisfaction with salary, workplace-responsibilities and supervisor-feedback were all significantly associated with increased retention in all groups. On the other hand, the effects of stress on retention varied significantly based on the racial cohort studied. Stress in personal-life (stress-PL), finances (stress-F) and job-performance (stress-JP) were all associated with decreased retention rates in the non-Hispanic white sub-cohort (stress-PL: X²=16.59, p<0.001), (stress-F: X²=20.33, p<0.001) and (stress-JP: X²=7.404, p=0.007) but not in the African-American or Hispanics sub-groups. Taken together, these findings suggest that targeting African-Americans more aggressively and reducing stress and increasing satisfaction may be effective tactics in reducing racial disparities in nursing and public health.