Building Bridges: Academic-Practice Partnerships as the Future of New Graduate Nurse Preparedness
The nursing workforce is at an inflection point. As experienced nurses retire or leave the profession and care delivery continues to shift in complexity, health systems are increasingly dependent on new graduate nurses to sustain operations, ensure patient safety, and deliver high‑quality care. Many organizations are finding that today’s graduates are entering practice underprepared for the realities of modern clinical environments, despite meeting licensure requirements. This disconnect is no longer a temporary growing pain; it is a systemic challenge with direct implications for workforce stability, financial performance, and patient outcomes.
At the same time, academic nursing programs are navigating their own constraints —faculty shortages, limited clinical placements, rising costs, and mounting pressure to demonstrate value. While both academia and healthcare organizations share the same end goal of preparing competent, confident nurses, often they operate in parallel rather than in partnership. The result is a transition‑to‑practice gap that places strain on new nurses, frontline teams, and the organizations relying on them.
Transformations in the nursing workforce
While there has been a growth in the nursing workforce amid transformation within the industry, health care organizations continue to experience a shortage of staffing. By 2038, the overall projected adequacy of registered nurses (RNs) will be at 97%, which is a positive trend from 92% adequacy in 2028. However, there is a significant maldistribution of RNs across the United States with some states such as Georgia and North Carolina projected to have a shortage of 20% and 22%, respectively.
On top of the workforce shortage crisis, the industry is tackling:
- The growing emergence of burnout and well-being in workforce strategies
- Technology adoption and digital transformation
- Shifts in delivery models, with patient care moving away from hospital-based care
- New graduate nurse gaps in technical skills, communication, and clinical judgment necessary for safe patient care
These rapid and emerging changes to the field, though necessary to address, are adding to the pressures faced by educators, new nurses, and health systems alike.
Financial pressures on both sides
Academia continues to experience a shortage in faculty, especially when many faculty shifted back to the hospital setting during COVID. Interestingly, both academia and practice are impacted by financial constraints. Funding streams for nursing programs are tightening due to competing institutional priorities and declining federal support. Nursing schools are under scrutiny to demonstrate financial sustainability and ROI, leading to the consolidation, restructuring, or closing of programs when enrollment, margins, or outcomes fall short. With inflation and rising operational costs (faculty salaries, clinical placement fees, simulation, technology) outpacing revenue growth, many nursing programs are left without a choice.
Health care organizations are also victims of the rising labor costs straining operating margins, while reimbursement isn’t keeping pace with inflation or increasing patient acuity. Workforce shortages, turnover costs, and the expense of onboarding and supporting new graduate nurses (NGNs) who require transition-to-practice investments contribute to additional expenses. At the same time, organizations are absorbing higher costs for supplies, technology, regulatory compliance, and infrastructure while navigating declining margins, payer mix challenges, and the pressure to demonstrate value, quality outcomes, and operational efficiency. Many organizations are restructuring and consolidating, delaying investments, or reducing discretionary spending to maintain financial sustainability.
Academia and practice are both forced to “do more with less,” threatening the capacity to produce ready-to-practice RNs, which potentially have downstream effects on quality and safe patient care. Despite these efforts, nurse leaders report that many new graduate nurses are not consistently practice-ready upon entry to the workforce, citing gaps in technical skills, communication, and clinical judgment necessary for safe patient care.
The implications for the next generation of nurses
Despite these gaps in education and workforce support, NGNs are the primary source of staffing for health care organizations out of necessity, entering a rapidly evolving health care environment. This dependence on NGNs pressures organizations to effectively onboard, support, and retain NGNs to maintain safe staffing levels and ensure quality patient outcomes.
As of mid 2025, Gen Z makes up the second-largest cohort of RNs in health systems. However, retaining Gen Z remains a struggle with 24% of Gen Zs having left their organization in 2024. Particularly, turnover rates spike after the 30-day mark, presumably when structured training and support programs end. For health care organizations actively facing rapid transformation and financial pressures, retaining this generation of nurses who need extra support, training, and interaction is highly difficult yet of the utmost importance.
Health care organizations must bridge the gap between academic preparation and real-world clinical practice to train and retain the best possible nurses. Employing the following strategies can bolster the NGN pipeline:
- Competency-based transition-to-practice programs
- Supportive clinical learning environments
- Intentional mentoring for professional development
- Early career pathway discussions
These strategies target the very issues that cause NGN turnover: high workloads, inadequate staffing, limited support, lack of career progression opportunities, moral distress, and burnout.
Supporting the transition of new graduate nurses into the workforce
Successfully supporting NGNs as they enter the workforce requires aligned efforts from both academic and practice leaders. The following three actions can make a meaningful difference:
- Align education and practice expectations through stronger partnerships.
AONL-AACN’s national guidelines help address academic-practice gaps through structured partnerships that connect educational outcomes to practice realities. Dedicated Education Units (DEUs), for example, have regained momentum as a proven strategy to strengthen student learning and practice readiness during academic preparation.
- Invest in experiential learning before graduation.
Apprenticeship programs and student externships give students valuable clinical exposure and opportunities to work alongside interprofessional care teams. These experiences build confidence, competence, and readiness for practice in ways that even the most rigorous courses cannot.
- Build structured pathways for transition, development, and retention.
Nurse Residency Programs are critical for helping NGNs ease into practice while developing clinical judgment and professional skills. In addition, competency-based onboarding adds another layer of support by emphasizing demonstrated capability, clear expectations, and consistent feedback. When paired with competency-based clinical ladder advancement, this approach creates a seamless pathway for growth that supports accountability, retention, and long-term career development.
Better Together: Academia and Health Care Organizations Moving Forward
As workforce pressures intensify and care delivery continues to evolve, leaders must embrace collaborative strategies that better support the transition from education to practice.
When this gap goes unaddressed, the consequences ripple across healthcare, fueling turnover, worsening workforce instability, and making it harder to deliver consistent, high-quality patient care.
Shared ownership between educators, institutions, and healthcare organizations is essential to redefining practice-readiness and strengthening the nursing workforce. That work can also be supported by the intentional use of simulation technology, competency tracking, and digital onboarding, assessment, and learning tools, which help make preparation, progression, and support more visible, consistent, and less burdensome.
Together, these approaches can better equip new graduate nurses for success and help secure the future of stronger patient care.
About Larissa Africa, MBA, RN, CENP, FAONL, FAAN
Larissa Africa, MBA, RN, CENP, FAONL, FAAN, is a healthcare leader known for advancing workforce development and nurse residency programs. She spent more than two decades leading a nationwide NRP strategy and created the first nurse residency web management system. She is well-published and presented internationally on these subjects. Currently, she is Vice President at Ascend Learning, CEO of the nonprofit SoloVeri, and Deputy Editor of the Journal of Continuing Education in Nursing. She was named one of Fierce Healthcare’s Most Influential Minority Executives in 2025.
