ajn@wolterskluwer.com AJN ▼ December 2016 ▼ Vol. 116, No. 12 61 PROFESSIONAL DEVELOPMENT Developing a Framework to Help Bedside Nurses Bring About Change A new graduate finds his school’s curriculum gave him the tools to address a workplace issue. T he first-year transition from a nursing pro- gram to direct patient care is a challenging time for new nurses. Kovner and colleagues, in a study analyzing data from the RN Work Proj- ect, a 10-year longitudinal study of new RNs, esti- mate that 17.5% of new graduate RNs will leave their first nursing job within a year and 33.5% will leave within two years. 1 In an effort to ease the inte- gration of new graduate RNs into the workplace and give them the skills they’ll need to contribute to the improvement of patient care and outcomes, the Institute of Medicine (IOM) in its 2011 report, The Future of Nursing: Leading Change, Advancing Health, recommended a transformation of nursing curricula and the expansion of the use of nurse resi- dency programs. 2 When new graduate RNs are ade- quately prepared to transition from nursing student to professional RN and supported at the start of their careers, they are more likely to develop bedside leadership roles and to have increased job satisfac- tion and a reduced first-year turnover rate. 3, 4 The voice of a new grad. The purpose of this ar- ticle is to describe my transition as a new graduate RN from nursing student to professional RN. It will examine how aspects of my nursing curriculum, as well as my participation in a nurse residency program at my hospital, better prepared me to respond effec- tively to a perceived problem in my unit’s policy of making new graduate RNs with three months’ expe- rience on the unit available to float to comparable units. It will describe how it was possible to work within hospital and unit processes to influence a change in this floating policy. It will also describe how a for- mer nursing professor acting as a writing mentor and I retrospectively developed the RN LEADER framework to identify the steps that were used to strategically influence this change, in the hope of providing a model for other nurses who also seek to bring about change. A NURSING CURRICULUM INCORPORATING IOM RECOMMENDATIONS In its analysis of ways the nursing profession could play a more integral role in influencing the shape of our complex and rapidly changing health care sys- tem, the IOM Future of Nursing report examined the current state of nursing education and recom- mended several curriculum changes to better pre- pare new nurses to act as leaders at the bedside and Jordan S. Porter, BSN, RN, and Kelley A. Strout, PhD, RN ABSTRACT Nurses across all care settings and experience levels are being called upon to lead. In a 2011 report, The Future of Nursing: Leading Change, Advancing Health, the Institute of Medicine examined the ways nurses could more fully apply their knowledge of direct patient care to address the increasing demands placed on the health care system since the passage of the Affordable Care Act. The report asked: “What roles can nursing assume to address the increasing demand for safe, high-quality, and effective health care services?” Multiple variables influence a nurse’s ability to assume a leadership role, and multiple barriers to these roles continue to exist. This article uses the first-person voice to share the experience of a new graduate nurse in a formal nurse residency program who found himself in a position to identify the need for, advocate for, and ultimately influence a policy change in the staffing practice of floating as it was applied to new RNs on his unit. In a retrospective analysis of the process, the new graduate RN and his former professor acting as a writing mentor developed a leadership framework for nurses called RN LEADER, which they hope will em- power and guide other nurses to lead evidence-based change in their workplaces. Keywords: evidence-based practice, nursing education, nursing practice, transition to practice