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I have been working for the same health care system for 31 years now and have so much change. As one of the “older” staff members, and now a manager one ongoing and ill addressed issue is recruitment and retention. I see staff that is either; let’s call them tenured like me, or green and brand new nurses. There seem sot be no in between. As a system we must study the whys to this in order to stay competitive in today’s job market, while maintaining a high quality of care for our patients. We have a responsibility to the patient population to provide the best care, in best facility. This has become a problem for our specialty units and critical care areas simply due to the lack of experience. New nurses who are of the millennial age group are looking for the best bang for their buck. (Best areas to work, best areas to learn and best pay) If we as modern health care providers can’t provide this they tend to stay a year or two then move on. The day of the dinosaur like me who stays with and organization for their entire career seems to be over. Where I work we recently brought back our Nurse Extern program and just recently started implementation of a nurse residency program to entice new, intelligent, motivated and skilled nurses to our facility. As nurse shortages continue to be a growing problem nationwide, rural health care systems like mine will struggle to fill open positions unless we can offer something that no one else does. We hope that our nurse residency program can bolster our nurse extern program that has been quite successful in recruiting new young talent to our facility. Everything that I have read or seen is very positive regarding nurse residency programs and we hope holds true for us as well.