Internships, Residencies, and Fellowships: A Community Approach to Developing a Foundation for Leadership

In past decades, there has been an unwritten expectation that new nurse baccalaureate graduates need to have a minimum of 2 years in-hospital–based practice prior to being employed in public health or community-focused nursing practice. The explanation often given for imposing this expectation is that new graduates need to attain experience in their basic nursing practice skills before moving into the community. Although basic skills are important in all settings, the knowledge, skills, and attitudes for working in the community are distinctive. Imposing such a requirement often confuses the nurse when the community-focused employment is attained. It is also probable that new nurses are lost to this setting for the remainder of their careers as a result of this expectation.