Transcript Document
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Supporting Transition for New Graduate Nurses
: via a Statewide Nurse Internship Model
Vermont Nurses In Partnership Susan A. Boyer, RN, M.Ed., FAHCEP © 2003 - 2008 Vermont Nurses In Partnership, Inc. All rights reserved. No copying without permission. [email protected]
Collaborative approach
Origins: N urse leadership group Inclusive of various practice settings, specialty services, academia, & regulation
Goal:
To Implement a statewide nurse internship Supports “transition to practice” Applicable in multiple HC settings Environment of nurture & support
Process:
Based in Preceptor Program (Clinical Coaching) Requires preceptor development/support 2 © 2003 - 2008 Vermont Nurses In Partnership, Inc. All rights reserved. No copying without permission. [email protected]
Transition to practice 3 levels of internship were needed
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New graduate transition New to specialty Undergraduate 3 © 2003 - 2008 Vermont Nurses In Partnership, Inc. All rights reserved. No copying without permission. [email protected]
Program Outcomes:
Statewide use of single competency tool Same expectations for all staff Performance outcomes vs grocery list of “tasks & procedures” Concept-based vs. case or task-based Foster critical thinking development Prioritizing evaluation, caring relationships, leadership, management & critical thinking 4 © 2003 - 2008 Vermont Nurses In Partnership, Inc. All rights reserved. No copying without permission. [email protected]
Program Outcomes:
Concepts and framework fit across continuum of care Applicable for full allied healthcare team Statewide standardization of preceptor development and support Evidence-based preceptor development Focus on Preceptor’s role of ‘Protector’ for the patient and new graduate 5 © 2003 - 2008 Vermont Nurses In Partnership, Inc. All rights reserved. No copying without permission. [email protected]
What we have learned from: 10 years of program implementation Across the continuum of care Across the state With ongoing data collection and analysis With formative and summative research application An evolving project, product and process 6 © 2003 - 2008 Vermont Nurses In Partnership, Inc. All rights reserved. No copying without permission. [email protected]
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Why Preceptorship?
Builds one on one relationship Improves satisfaction, retention, and orientation process Provides bridge between theory and reality Develops capability
Protects and ensures safety for patient, new care provider and organization
Collects evidence of competence
11 © 2003 - 2008 Vermont Nurses In Partnership, Inc. All rights reserved. No copying without permission. [email protected]
Why mentorship?
Ongoing development of clinical capability Support through 2 nd & 3 rd phases of Boychuk’s “Transition Stages” Development of nursing judgment Development towards proficient practice Transition within the profession Deciding how and where you fit within the nursing profession 12 © 2003 - 2008 Vermont Nurses In Partnership, Inc. All rights reserved. No copying without permission. [email protected]
Determining content?
How do we determine “what to teach” in regards to development of preceptors and clinical coaches?
What's the goal?
13 © 2003 - 2008 Vermont Nurses In Partnership, Inc. All rights reserved. No copying without permission. [email protected]
Establish our goal
Preceptors will collect evidence of clinical capability of the novice care provider.
Must effectively develop capability, where it is missing
14 © 2003 - 2008 Vermont Nurses In Partnership, Inc. All rights reserved. No copying without permission. [email protected]
Clinical capability with emphasis on Nursing Judgment Analyze – Evaluate - Synthesize
Psychomotor
Develop Precision Articulation Become automatic Integrate related skills Naturalization Technical skills
Affective
Act upon Attitudes
Develop value system Organize own values Adopt behavior Internalize values
15 © 2003 - 2008 Vermont Nurses In Partnership, Inc. All rights reserved. No copying without permission. [email protected]
Goal: To effectively develop & collect evidence of capability
Preceptors will require: Effective Communication Supportive Interpersonal Skills Core teaching/learning principles
Foster critical thinking skills
Team process:
Relationship-based care Relationship-based development 16 © 2003 - 2008 Vermont Nurses In Partnership, Inc. All rights reserved. No copying without permission. [email protected]
To develop capability
Preceptor roles & responsibilities
Teaching and learning theory
Learning styles, Novice to expert, Simple to complex, Principles of adult learning Story-telling, Use of case scenarios, and/or practice with difficult situations
Collaborative team approach
Relationship-based process, Interpersonal issues, conflict management, Socialization 17 © 2003 - 2008 Vermont Nurses In Partnership, Inc. All rights reserved. No copying without permission. [email protected]
To validate capability
Define “competent practice”
Delegation, accountability, liability
Nurse practice act, job descriptions, P & P
Performance management
Communication & feedback Assessment & evaluation of capability
Data collection
Validating performance, collecting evidence, complete documentation tools 18 © 2003 - 2008 Vermont Nurses In Partnership, Inc. All rights reserved. No copying without permission. [email protected]
Preceptor development
Preceptor Development & Support Multi-disciplinary approach Need to: Revise/update the preceptor model Develop high level preceptor workshops Consider recognition and reward Prioritize protector role Delineate evaluator/validator role Establish protocols 19 © 2003 - 2008 Vermont Nurses In Partnership, Inc. All rights reserved. No copying without permission. [email protected]
Core Concepts
Theory and evidence-based Clearly defined expectations Competency-based – COPA model Concept focus rather than task, procedure, case-based Preceptor development and support Protector and Evaluator roles Critical thinking development Data collection/evaluation = Evidence based Clinical coaching plans – “roadmap” for teaching & evidence collection that is based in the clinical setting 20 © 2003 - 2008 Vermont Nurses In Partnership, Inc. All rights reserved. No copying without permission. [email protected]
VNIP: Collaborative Outreach
Electronic manuals with site license,
Roles, JD, survey tools and protocols How to teach, how to foster critical thinking development Tools for competency assessment Tools for clinical coaching PowerPoint Presentations, activities, notes, etc. for preceptor development Same for intern development 21 © 2003 - 2008 Vermont Nurses In Partnership, Inc. All rights reserved. No copying without permission. [email protected]
VNIP: Collaborative Outreach
Consulting services & collaborative workgroup
Explanation of VNIP framework, core concepts, and key processes Instruction specific to use & roles of various resource materials Cyber-communications network Expert contributors adding to resource pool Web-based updates as they occur Linkages for shared workshop delivery/participation 22 © 2003 - 2008 Vermont Nurses In Partnership, Inc. All rights reserved. No copying without permission. [email protected]
VNIP: Collaborative Outreach
Key processes
Preceptor development and support Critical thinking & critical thinking development Data collection/evaluation of process change &/or effectiveness Clinical coaching with instruction specific to various learning styles Clinical Coaching plan development & use Competency based evaluation – COPA model Concept focused rather than case-based 23 © 2003 - 2008 Vermont Nurses In Partnership, Inc. All rights reserved. No copying without permission. [email protected]
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Protector
- Safeguards patient & preceptee
Preceptor
Educator
- Teacher, Coach, Evaluator
Facilitator
- Role model, Socializer & Team leader © 2003 - 2008 Vermont Nurses In Partnership, Inc. All rights reserved. No copying without permission. [email protected]