Nursing Transitional Programs Need New and Improved Structure

Each summer a rite of passage takes place at our nation’s healthcare facilities: tens of thousands of newly minted nurses and medical school graduates make the transition into the real world.

As you can imagine, this is a busy time–for the nurses landing their first full-time jobs, for new medical school graduates transitioning into residencies, for residents transitioning into fellowship or independent group practices, and for healthcare facilities.

It is a process that can be challenging and has the potential to make or break careers. The first couple of years can be particularly tough for new nurses. Reports of burnout, low morale, and resignations are not uncommon. Some even leave the profession altogether, making the work of health facility administrators more difficult. But if executed properly, if novice health professionals are provided the right support, it is a process that can benefit all, including healthcare workers and the general public.

In this complex and fast changing healthcare environment, many employers, professional associations, and higher education institutions have recognized the need for longer and better structured transitions for new nurses.

Ditto for medical schools and physicians’ groups. In 2014, the Association for American Medical Colleges rolled out a new set of guidelines designed to help medical school graduates transition to their residency programs. The association cited data that showed a gap between the expectations of program directors and the performance of residents. Included in the guidelines are activities that new residents should be able to perform on their first day, including performing physical exams on patients.

An orderly, well-thought out transition can spur health professionals to do their best work, lead to heightened morale, and create a stable healthcare workforce. It can teach invaluable skills to new nurses while also improving outcomes for patients. Most of these transitions are the work of a variety of professionals in the healthcare space, including nurse managers, educators, pharmacists, physicians, and sometimes chaplains.

Throughout the United States, healthcare facilities are investing heavily in lengthy residency programs for new nurse graduates. These programs include classroom-style curriculum and strategies to sharpen critical thinking skills. Leading practitioners in a variety of healthcare disciplines recognize that summer is a time of transition in the industry. They are also relentless in their advocacy of health systems devoting extra effort to patient care and safety.

Residency programs are beneficial career building tools for rookie nurses, particularly those who take advantage of these opportunities at hospitals that have earned a magnet designation from the American Nurses Credential Center. A magnet designation is the most prestigious distinction bestowed on a healthcare organization for nursing excellence and high-quality patient care. Only 8 percent of the nation’s hospitals have earned this recognition, with six residing in Dallas-Fort Worth.

Magnet hospitals have higher percentages of satisfied nurses, lower nurse turnover and vacancy, and improved patient satisfaction.

Many hospital systems, including many in the DFW area, have developed robust residency programs that strive for this gold standard. There are many outstanding examples that offer a variety of options to enhance the development of novice nurses.

For instance, Texas Health Resources has a comprehensive program designed to aid new graduate nurses in their transition from students to professionals and help them gain the skills and confidence that will help them succeed. Texas Children’s Hospital helps new graduate nurses address the realities of clinical practice, overcome fears of making errors and successfully manage multiple patients. JPS Health offers a 12-month nurse residency program that includes monthly case study discussions with clinical pharmacists, opportunities for certifications in EKG and ACLS, as well as networking and social support. Baylor Scott & White Health has an array of internships that last between three and four months, depending on the area of interest. Some programs are highly specialized. Another noteworthy example is Children’s Health, which offers a program aimed at new graduates interested in careers in pediatric nursing.

Programs such as these not only enhance healthcare careers–they stabilize the nursing profession, which continues to confront a shortage. Above all, they ensure improved healthcare outcomes for all Americans.

It is in our best interest to support these programs and to encourage more hospitals and health systems to invest in them.

Anne Bavier is dean of the University of Texas at Arlington’s College of Nursing and Health Innovation and president of the National League for Nursing.

Posted in Expert Opinions.