Transcript Mid Coast Hospital’s Nurse Residency Program

Mid Coast Hospital’s
Nurse Residency
Program
An enriched learning environment for new
graduate nurses
Cate Parker RN ACSM-CES
History
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Proposal developed in the spring of 2011
Submitted to Joan Dolan, Program Manager for
Health Care, Maine DOL.
Project was eventually supported through
Coastal Counties Workforce and DOL grant
under ARRA covering On the Job Training,
May 2011
About Mid Coast Hospital
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94-bed community hospital located in
Brunswick Maine
Level II Trauma Center
Magnet Hospital
Aging nursing workforce, particularly in the OR
Units: Med Surg (54 beds), ICU (12), MAT (17),
ACU, OR, Cardiopulmonary rehab, Inpatient
Behavioral Health (11), ED
Background
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National turnover rate of new graduate nurses
ranges from 35-60% within the first year of
employment. Mid Coast Hospital averages 23%
turnover of new graduate nurses within the first
two years.
Background
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Issue has been addressed by many:
Kramer: reality shock
 Pat Benner: call for at least a one-year post-graduate
residency in a specific practice setting
 Joint Commission endorsement (2010)
 Institute of Medicine (2011)
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Program Design
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Mid Coast Hospital created seven Entry Into
Practice (EIP) positions in
OR (2)
 Med Surg (2)
 Emergency Department (1)
 Maternity (1)
 ICU (1)
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Positions were over and above usual staffing
pattern
Goals
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To blend basic skills training, orientation, and
professional nursing education to ensure new grad
nurses have the foundational skills necessary to succeed
To build confidence, collaboration, mentoring, and
support services to overcome “reality shock”
To provide education and training in specialty practice
units
To improve patient safety and quality of care
Program Particulars
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Interviews and hiring May-June 2011
Candidates must have been recent (within the
last year) new grads from a school of nursing.
Candidate must have BSN or, if ADN, contract
to complete their BSN within five years. Tuition
reimbursement program available for them to do
this.
Program Particulars
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40 weeks in length
Paired with mentors
Case conferences weekly to start, then transition
to monthly
New grads keep a journal and use that as the
basis of their case presentations
Planned didactic content from nurses, APRNs,
and ancillary departments
Program Particulars
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Customized commercially available orientation
programs for specialty units:
AWHONN Perinatal Orientation and Education
Program
 AORN Periop 101 Core Curriculum
 ANCC Essentials of Critical Care Orientation
 ENA Emergency Nursing Orientation Course
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Mosby's Preceptor Course (for mentors)
Benefits to New Grads
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Expanded orientation and education
Employment guarantee upon completion
Skills feedback and personalized education plan
Safe environment to discuss their experiences
with other new grads
Grant Details
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Total of $45,000 from Coastal Counties
Workforce
Approximate cost breakdown:
 $3000 for class instructor hours (7%)
 $13,700 for instructional materials (30%)
 $7000 for mentor incentive (16%)
 $21,200 for classroom instructional time for
residents (47%)
Benefit to Hospital
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Able to provide premium pay for mentors
Goal is reduced turnover of new grads: research
project
References
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Benner, P, et. al., Educating Nurses: A Call for Radical Transformation, Carnegie
Foundation for the Advancement of Teaching, 2010.
Halfer, D and Graf, E. Graduate Nurse Perceptions of the Work Experience,
Nursing Economics, 2006; 24(3):150-155
Herdich, B and Lindsay, A. Nurse Residency Programs: Redesigning the Transition
Into Practice, Journal for Nurses in Staff Development, March-April 2006,
22(2), 55-62.
Institute of Medicine, The Future of Nursing: Leading Change, Advancing Health,
2011, National Academies Press. Accessible from
http://www.thefutureofnursing.org/sites/default/files/Future%20of%20Nur
sing%20Report_0.pdf
Kramer, M. Reality shock: Why nurses leave nursing. St. Louis, MO: Mosby.
Joint Commission, Testimony submitted to the Robert Wood Johnson Foundation
Initiative on the Future of Nursing, 2010. Accessible from
http://www.jointcommission.org/assets/1/18/RWJ_Future_of_Nursing.pdf.
Ulrich, B, Krozek, C, Reinsvold S. RN Residencies for New Graduates. NSNA
Imprint, www.nsna.org, accessed January 31, 2011.