Emory Healthcare Aids School to Nursing Transition With Residency

by Nicholas Pell

New nurses often find the transition between nursing school and practice difficult. To help support nurses during the end of the honeymoon and the beginning of reality as a nurse, Emory Healthcare of Atlanta, GA offers a year-long residency program. While hard data isn’t in yet, all anecdotal evidence suggests the program aids new nurses making the leap from college student to caregiver.

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Anecdotal evidence suggests the program aids new nurses making the leap from college student to caregiver.

Kelly Brewer MSN, RN, coordinator of Emory Healthcare’s residency program told us that residents seem “very pleased” with the program, acknowledging there’s still room for the health care system to grow and get used to it. “Our residents enjoy the camaraderie,” she says, adding that the program “allows residents to get to know people from different units and make more connections.” More than just connections, the program allows new nurses to obtain feedback from more experienced members of staff. “Residents get deeper contacts,” says Brewer, adding that “The literature shows that first-year support is very important for new nurses.”

The residents aren’t the only ones benefitting from the program. The hospital receives benefits from the program as well. While the residents gain from contacts and a support network, the hospital gets feedback from the residents, allowing for changes in the system. Nurses are encouraged to provide stories of successes and challenges. More than just “talking it out,” such communication fosters a supportive environment and positive, proactive changes that will benefit future nursing residents.

Nurse Residency Program Development

Emory Healthcare began the program in April of 2011. A discussion ensued between Emory and its nursing leadership over the best way to ease transition from college to career, as well as retain new graduates. The governing bodies of nursing are universally in favor of such programs, encouraging a year residency after graduating from a nursing program. The recommendation for a residency rests on strong, evidence-based studies. Residencies allow for hospitals to track important metrics like job stress and job satisfaction. For their own part, residents feel they have a sense of control over their practice, making residencies a win-win for everyone involved.

Emory adopted the UHC / AACN Nurse Residency Program as the model for its own. This program is based on the Dreyfus Model, first outlined by Patricia Benner in From Novice to Expert. This model emphasized five levels of skill acquisition, going from novice, to advanced beginner, to competency, to proficiency, and finally to expert.

Brewer is careful to say that a one-size-fits-all approach isn’t the intent of the UHC/AACN Residency, however. The program is fully based on a core curriculum, but can be tailored to each hospital’s core principles.“Residency programs should adapt to the needs and values of a system,” adding that “anything essential should be included.” Because different health care providers have different core values and different needs, residents must be trained in these procedures and values. While it’s important to look at what other health care providers and networks are doing, ultimately the program must be tailored to the individual needs of the provider in question. To aid in this goal, Brewer urges providers to “pull in experts where you need them.”

What’s Working

One effective practice at Emory is interactive education. “Our residents are just out of school and don’t want more school,” says Brewer. At Emory, resident training is kept interactive. Practice is related to relevant and current topics of the day. This allows residents to receive new training, but also to practice that training and learn by doing. “We prefer simulations or case studies over Power Point presentations in our residency sessions at Emory.” Resident participation is very important.

“We prefer simulations or case studies over Power Point presentations in our residency sessions at Emory.”

Originally Emory separated oncology and perioperative service nurses from the rest of the pack, due to their specialized training needs. Now, however, all residents are in it together. (Departments first wanted to give certain residents a little extra training. In practice, however, it was found that this made it difficult for residents to network.) To that end, Emory uses an overlay of the United Health System Consortium and American Association of Critical-Care Nurse Residency with specific, unit-based orientations. The latter acquaints a nurse with the specific needs and demands of his/her unit, while the former provides focused education in leadership, patient outcomes, and professional development in nursing .

Positive Outcomes

While hard data lies a few months away, Brewer anticipates a number of positive outcomes from the program. “Professional development and patient outcome are likely to improve,” she says, adding that, “patient outcome really is the name of the game.” Other expected improvements lie in the realm of leadership at bedside, conflict management, communication and effective patient handoffs between nurses.

Other anticipated changes include happier, less stressed and more plugged-in nurses who can perform their jobs more effectively. More practice means better outcomes.

Perhaps most importantly, the program trains nurses in how to take care of themselves while nursing, something Brewer considers very important during the transition. “Residents are at the point where they’re finding out that nursing might not be exactly what they thought it would be. We’re there to help them through the end of the honeymoon period.”

“patient outcome really is the name of the game.”

While times are currently tough all around, nursing and health care have been hit particularly hard. This makes continued support for nursing very important. “We’re very excited to see the results of our residency program,” says Brewer. The entire health care industry should take note as well.