Nurse residency program bridge to employment

ON-THE-JOB TRAINING: Amanda St. George, left, shadows nurse Todd Kirschhofer, pictured above, at Thundermist Health Center. Also pictured are Valerie Furr and her mother, Karen Izzo. / PBN PHOTO/MICHAEL SALERNO
ON-THE-JOB TRAINING: Amanda St. George, left, shadows nurse Todd Kirschhofer, pictured above, at Thundermist Health Center. Also pictured are Valerie Furr and her mother, Karen Izzo. / PBN PHOTO/MICHAEL SALERNO

Of the 17 unemployed and underemployed nurses participating in the “Passport to Practice” nurse residency program, 13 landed jobs – six full time, five part time and two per diem, months before the end of the program’s first year.
The jobs included seven in acute care and six in community care, said Alaina Johnson, grant manager for the program and executive director of Stepping Up, a Rhode Island workforce-development program.
Running from October 2013 through June, the residency program involves 11 different hospitals and clinics. Funded with $600,000 from a host of donors, the bulk of support came from the Robert Wood Johnson Foundation and the R.I. Governor’s Workforce Board, focusing respectively on nursing education and employment.
Though the first year hasn’t ended yet, program leaders are already gearing up for a second year that will begin in the fall. And they are focusing on how to continue beyond 2015, when remaining funding is expected to run out.
Amanda St. George of Barrington is one of the 17 who obtained per diem work at the West Warwick site of the Thundermist Health Center, which also has centers in Woonsocket and South Kingstown.
Armed with an associate degree from the Community College of Rhode Island, St. George had a clinical rotation in acute care at Kent Hospital during the early part of the program. But as the program wound down, with guidance from Project Coordinator Randi Belhumeur, she directed her attention to Thundermist, because of her natural interest in community care.
“Regardless of having gotten this position, my confidence is much higher than it was before I started the residency,” said St. George. “Besides the experience in the clinical portion of things, in our didactic sessions on Fridays we got a lot of good training and professional development.”
Deborah Drew, Thundermist’s West Warwick site director of nursing, said two other nurses besides St. George did clinical rotations at the various centers. At the West Warwick site, the involvement proved beneficial to the center as well as residents, she said. “We’re used to having student nurses and they’re able to shadow us,” Drew said. “But these nurse residents are actual RNs with licenses so they were able to do more, engage more and could actually help us out.”
Another resident, Linda Hancock of Cumberland, who said she has a nursing degree from Rhode Island College, had never had the opportunity during her studies to hang an intravenous bag. Now, after doing more hands-on work through her residency, Rhode Island Hospital has hired her full time.
“If every graduate nurse has to go through a program like this, it’s an experience you can’t replace because you don’t get to do a lot of [hands-on practice] in nursing school,” Hancock said.
Belhumeur, the program coordinator, said that patients coming to hospitals and clinics are sicker, and as the rules for insurance change, the sicker patients are treated in a hospital setting while those with less-acute symptoms are often transferred to community or even home-care settings. That trend is expected to continue, she said.
As such, the nurse residency program is an opportunity to provide training that educated RNs may not have gotten.
“We consider this a bridge from their clinical practice as students to transition them to clinical practice as registered nurses,” said Belhumeur. “The acuity level in the hospital care setting is: they are sick patients. Nursing school does not prepare you for that, but this as a bridge gives them the competence and confidence they need to practice as new RNs.”
Given the success and need, how can a program that serves only 17 nurses prove its value over the long term?
“Overall, our success rate of 70 percent placement of our residents is great,” said Sandra Phillips, program director and a director of education at Kent Hospital. “Plus, we can package all the didactic teaching and learning sessions. The tools to use for evaluations and educational content can be reused [in future residency programs].”
Michael Paruta, director of workforce development for the Care New England health system, says another measure will be whether the “Passport to Practice” can win a second grant to supplement the remainder of money, about $150,000, coming from the Robert Wood Foundation for the program’s second year. The reason the state invested in the program, Paruta believes, is because the training is transformative for these out-of-work nurses.
“From the state’s point of view, once these people move from unemployment or under-employment to employment, they’re moving to strong careers, not just jobs,” said Paruta.
“They’ll be taxpayers and residents and community members of Rhode Island. And when you take that investment and spread it over the resident’s lifetime, it’s a good investment. This to me seems a better long-term model [for] career and workforce development,” he said.
“It is a small number,” said Belhumeur, referring to the 17 nurses who participated. However, she believes organizers “have the ability to run a larger program.”
In the second year, soliciting corporate sponsors for the residents may be a viable additional funding strategy, she said.
The Institute of Medicine’s 2011 report on the future of nursing makes it clear that community care will grow as a major source of care, and that residency programs can help nurses “bridge the transition from education into practice,” Belhumeur said.
Getting more potential employers to participate in the residency program is also a goal, Paruta said.
This year, participating employers included Rhode Island Hospital, Kent Hospital, the Visiting Nurse Association of Rhode Island, Coventry Center Skilled Nursing and Rehabilitation, Thundermist, Bradley Hospital, Experience Access Point Rhode Island, Clinica Esperanza, Emerald Bay Manor, The Miriam Hospital and Women & Infant’s Hospital.
Moving more nursing residents into community care, not just hospitals, also could be a goal in the program’s second or subsequent years, said Lynne M. Dunphy, associate dean for external affairs and professor in the College of Nursing at the University of Rhode Island.
“We really want nurses to see how vital a career in nursing they can have, in other settings,” she said.

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