The Nurse Residency Program at Saint Agnes: An Interview with Heather Morris

SAMC Heather Morris

In 2010, the Institute of Medicine issued a report recommending that acute care hospitals implement transition to practice programs, or what we call a nurse residency program. We started our Nurse Residency program in 2015 and partnered with Vizient/The American Association of Colleges of Nursing; this partnership supplies us with an evidence-based curriculum that focuses on leadership, quality outcomes, and professional  development. In addition, our nurses have to complete an evidence-based practice project. The goals of the program are to develop critical thinking and clinical judgement, improve self confidence in patient management and decision making, and develop knowledge and skills around safety and quality for patients. Overall, our goals are to invest in and integrate the nurse resident into their professional career as a lifelong learner.

Our Nurse Residency program combines clinical work experience with a preceptor with classroom sessions that directly relate to our work. The residency class sessions offer the newly licensed nurse a learning environment with the use of case studies, skills lab stations, simulated clinical scenarios and speakers' sessions from our subject matter experts throughout the organization. 

What we have noticed here at Saint Agnes, and which the literature supports, is that many new nurses have significant trouble transitioning to working in an acute care setting. There are giant gaps between what they are taught in nursing school and what they need to know as a registered nurse in an acute care environment. Current literature indicates that between 30-50% of new nurses are leaving their first jobs because they don’t feel supported, and that many are leaving the field entirely because they’re not prepared and their experience is so difficult. 

In nursing school, you read a lot of books but when you get into clinical practice as an RN, there are many experiences that you were not taught in the classroom. Nursing school doesn’t prepare you for some of your   first clinical situations that create high emotion and self-doubt. Our goal is to help our new nurses work through some of those things to help build their confidence. We provide support through encouraging words and cohort debrief sessions that allow them to talk about these experiences. The cohort model allows them to gain validation of their emotions from their peers.

We utilize this year of residency as a way to support the new nurse by identifying an individual's gap in knowledge or development, then provide them the tools they need to be successful. Everyone on their teams can identify them as a newly licensed nurse; they don’t expect them to function at the highest level of clinical expertise. The teams provide guidance and support in the clinical environment to allow them time to grow,  develop confidence, and to build new skills sets. The nurse residents are also provided support by their clinical educators, managers, and their practice coordinators.

In the classroom, everything we do focuses on direct application to the clinical environment. Our speakers talk about how they are a part of an interdisciplinary team, how they act as a resource to the new nurses and about building relationships within the team to help to support one another. It really is a direct application of what they will experience in the clinical setting . We also run simulations, which we keep as close to clinical settings as possible by using the same equipment and kits. The case studies that we talk about in the classroom are built around real patient care scenarios. Documentation is another important skill we teach. Correctly documenting on your patient with the electronic medical record can be very time consuming, so we teach them how to do it properly. As nursing students, they only get experience looking at a certain section of the patient chart, so we encourage them to start looking at the other parts. We want them to get a bigger picture of the patient than just what they are doing that day - we want them to consider: where has the patient been? What is their continuum of care? How can I, as their nurse, help to facilitate interventions that will help this patient get better and get discharged?

Our overall goal, particularly as a faith-based organization, is really to invest in our nurses early on. We want to help transition them into practice and give them the professional development that will allow them to grow as leaders. We try to understand what it is that they want to do and how we can help facilitate that growth within our organization.

The Nurse Residency program is one year long. Every year we take on two new cohorts of new nursing grads, one in March, and one in August. We consider any newly licensed nurses or nurses who have had less than a year of acute care experience, to be eligible to apply for our program. We do get a lot of applications and our application window is only open for a limited amount of time each year. We do invitation-only interviews. Our cohorts range in size with 25 being the maximum we take. Currently, we are taking new nurses interested in working in Medical Oncology, Inpatient Surgical, Telemetry, ICU, ED, Women and Infants, and the OR.

We think that our program is really a win-win for new nurses; it’s the same competitive pay you would be getting working anywhere else, but you’re getting significantly more training and support built into your schedule. Many of the nurses who have graduated from our cohorts have stayed with us here at Saint Agnes, and we’ve even had some go on to become preceptors themselves and help train new nurse residents!

Are you interested in learning more about our Nurse Residency Program at Saint Agnes? Click the button below to learn more about the program and how to apply!

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Written by Heather Morris

SAMC’s Nurse Residency Coordinator

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