During Phase I, the project team developed an innovative program that offers an educational and psychosocial support system for new graduates that extends beyond general hospital orientation and the formalized preceptored experience. This program was successfully implemented in urban and rural acute care hospitals with resultant significant improvements in new graduate nurse retention and clinical practice. Participating hospitals have adapted and incorporated this program as an element of their standardized new graduate orientation process. Basic components of the nurse residency program follow.
Every month, over the course of a year, new graduates participate in an all-day educational session to enhance their development of clinical competency. Facilitated by advanced practice nurses and health care experts, new nurses are guided in the process of reflection, critical thinking, and application of knowledge to strengthen clinical judgment skills and ability to effectively problem-solve. A specialized curriculum and interactive teaching techniques build new graduates’ capacity as acute care practitioners and ability to function as leaders within the health care team, the organization and the profession.
Individual sessions focus on topics that are essential for new graduates to master, such as time management, delegation and interdisciplinary communication. Content is structured around helping new graduates recognize abnormal assessment findings and critical indicators to avoid failure to rescue, applying best practice and evidence-based care guidelines, and proactive nursing strategies aimed at prevention. During these sessions, new graduates are active participants in this enriching learning process through use of a high-fidelity human patient simulator and other activities, such as writing clinical narratives, case study analysis and dialoguing with clinical experts. This process is learner-directed, addressing new graduates’ issues and needs as developing practitioners. Through methods that focus on application of learning to the clinical situations new graduates encounter in practice, the goal is to enhance their ability to deliver quality care.
To address the unique needs of each new graduate, an individualized plan is created to build clinical skills and develop competency. Tailored to the new graduate’s distinctive learning style and learning needs, the plan outlines specific activities and strategies to achieve the new nurse’s professional career goals.
Upon entering the residency program, new graduates are typically partnered with an experienced nurse designated as a clinical coach. Focused on guiding the new graduate’s learning and professional development, a coach is someone to help the new graduate succeed. A coach is committed to helping the new graduate achieve professional goals and provides ongoing support, encouragement and valuable feedback throughout the first year of practice.