Turnover is a natural cycle for any job, and nursing is no exception. At Salinas Valley Memorial Hospital, twice a year between 12 and 20 new graduate nurse residents join the staff.
The turnover presents challenges to a health system committed to maintaining a culture of nursing excellence. That’s why the Education Department spent the past two years elevating an already outstanding six-month program of classes and preceptorship by leveraging the residency program curriculum from its HealthStream learning management system.
“We have a very robust New Grad Nursing residency program that we are continuously evaluating to see how we can improve and bring in additional tools to enhance our curriculum,” says Director of Education Vanessa Irwin-Nieto, DNP, RN, NPD-BC, NE-BC, CNML, CNE, CLC.
The improvements have certainly resonated with the nurse residents. “The program helps build the confidence, skills, high quality, and culturally sensitive care to help new graduate nurses serve our community,” says Alejandro Jimenez, BSN, RN, who was part of the fall 2021 cohort.
“The program has been a very enriching experience that not only allowed me to solidify what I learned in school but, most importantly, it introduced me to the incredible team that I have to fall back on, if I ever were to need anything,” says Monica Loza Gonzalez, RN, who was part of the fall 2020 cohort.
An Intensive Introduction to SVMH Nursing Culture
New nursing residents begin their careers by undergoing six weeks of intensive blended training that involves lectures, simulation and the completion of HealthStream Nurse Residency modules. “Someone from the Magnet® team speaks to new grads about what it means to be part of a Magnet® hospital, and we have Practice Council members talk about topics like shared governance or evidence-based practice,” says Education Department Manager Stephanie Frizzell, MSN, RN, NPD-BC, CMSRN. “Residents use this time to establish a baseline of knowledge, skill and confidence.”
The skills and knowledge conveyed are in sync with best practices, the American Nurses Association’s professional standards, as well as with the nurse-sensitive patient safety goals SVMHS values. “Our amazing specialty educators support the program and we collaborate with so many others – respiratory therapists, physicians, risk management, quality – to get the new grads the curriculum that supports their transition, professional development and growth,” Frizzell says.
Residents also spend time working with preceptors that SVMHS has trained and approved. During their residency the preceptors, who orient the residents to their specialty unit, play an essential role in enhancing the residents’ clinical growth and confidence, while immersing them in SVMHS culture.
Half-day professional seminars, once a month, on topics ranging from ethics and informatics through well-being and clinical skills, supplement the precepting in the residents’ fourth, fifth and sixth months of the program. Additionally, the residents complete an evidence-based project, which they present at their final seminar.
Ensuring Skills and Confidence
One of the reasons the Education Department decided to leverage the HealthStream program is its ability to assess each nurse’s confidence across different practice domains, including assessment and evaluation, clinical practice, interprofessional communication and the professional role. A knowledge assessment is also conducted using HealthStream that provides insight into strengths and potential knowledge gaps for each nurse. This is especially important at a time when the pandemic has sometimes kept student nurses from doing all of their hands-on training.
“It allows us to acquire actual data and bench-mark against other organizations so we can tailor the curriculum in two ways, first to the cohort’s needs, and then specialty educators can drill down to individual needs,” Frizzell says. The program also has content for self-care, including mindfulness for nurses.
“The program allows you to slowly integrate yourself and find your place and voice as a new nurse without feeling pressured or unsafe,” Loza Gonzalez says. “It gave me a safe place that allowed me to learn, make mistakes, all while feeling confident and proud of the nurse that I am becoming.”
Frizzell says that the program improvements have encouraged the department to apply for the American Nurses Credentialing Center Practice Transition Accreditation Program® (PTAP) – and are also a source of pride for the entire education team.
“I love that a year or two later, we see these same nurses coming to preceptor workshops, getting certified in a specialty or participating in shared governance,” Frizzell says. “I feel like we’ve given them a foundation of professional development, this spark – and I love seeing the work we’re doing come to life.”
