RIH nursing internship recruiting, training tool

CHECKING IN: Chloe Grenga, left, assistant clinical manager, Surgical Intensive Care Unit, Rhode Island Hospital, converses with fellow nurse Bre St. Martin. / COURTESY  LIFESPAN
CHECKING IN: Chloe Grenga, left, assistant clinical manager, Surgical Intensive Care Unit, Rhode Island Hospital, converses with fellow nurse Bre St. Martin. / COURTESY LIFESPAN

When Rhode Island Hospital realized the mismatch between the number of its nurses who were highly qualified in critical care and the number of acutely ill patients it was caring for, the Lifespan facility created several nursing internship programs, including one in critical care.

It wasn’t a shortage of nurses, but difficulty getting seasoned, critical-care nurses to the hospital from other places that drove the decision, said Douglas P. MacNeil, administrative director, talent acquisition and sourcing, Lifespan Corp.

“[Nursing students] weren’t able to come out of school and immediately function in [critical-care departments]. … We came to that realization over time,” said MacNeil. Between Hartford and Boston, RIH’s intensive care unit is “pretty much it.” With six ICUs and four step-down units – representing about 150 beds out of a total of 719 beds – RIH is “a community hospital of critical care,” he said.

Established about a dozen years ago, the critical-care nursing internship has evolved over the years. As a model that works, said MacNeil, it has been the genesis for other, more recent internships, including in peri-operative services (surgery) and dialysis, which accept both new graduates and experienced nurses.

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The critical-care nursing internship is both a recruiting and training tool, said Donna Saul, RIH director of inpatient services for critical care. “We can take new graduates who would be hard-pressed to adapt to a critical-care environment without this support and who can produce at the other end of the [12-16 week] internship.

“They will still be novices, but [with] a strong support network and background to build on [will] become expert nurses,” she said.

Neither the internship nor its selection process is for the faint of heart. At times, RIH has had 150 applications for eight spots, including one applicant from as far away as Hawaii, said MacNeil.

As the tertiary-care hospital for the region with many critically ill patients, said MacNeil, RIH is a draw for graduates who desire critical-care nursing.

“We have some world-renowned faculty on medical staff [offering] opportunities to learn and advance in a career,” said Saul. “If you want to be in critical care in an academic setting, it’s really attractive.”

Chloe Grenga concurred. Thanks to the internship, Grenga, who earned her bachelor of science in nursing from Rhode Island College in 2012, achieved her goal – working as a surgical ICU nurse. “As a brand-new grad, you cannot just get hired onto the SICU. You have to do some kind of education,” she said.

Like other interns, Grenga was matched with a preceptor, a highly experienced staff nurse who mentors each intern.

The beginning of her internship, Grenga said, “was more role modeling and me observing. Then they give you the reins a little bit, but with the safety of someone … watching what you do.” In October 2016, she transitioned from her SICU nursing position to that of a SICU assistant clinical manager.

Interns are integrated into the intensive-care units from day one, MacNeil said. With one full day of didactic learning on the floor and four full days of classroom learning, interns earn entry-level, registered nurse salaries and benefits.

Neither MacNeil nor Saul believe that nursing schools are missing the mark by not graduating students who are prepared at the outset to work in critical care or other demanding specializations.

A nursing school’s mission is to provide a breadth of experience, creating thinkers and problem-solvers through their academic course work and clinical work, said Saul.

MacNeil agreed; with nurses working in outpatient, acute-care community hospital, school, industry and home settings, it would be difficult for college nursing programs to specialize to satisfy everyone’s career decisions, he said.

Graduates of the nursing internships are extremely qualified and highly marketable, said MacNeil, acknowledging that RIH assumes the risk of preparing these graduates for other hospitals, for the sake of patient care.

“It’s on us to keep them here … people have tried [to recruit them],” he said.

In the past five years, Lifespan has hired approximately 68 critical-care nurse interns and retained 58 of them, a retention rate of 85 percent, which MacNeil called comparable to Lifespan’s retention rate of other critical-care nurses. •

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