DCH, UA Program Helps Bridge Gap from Classroom to Workplace

TUSCALOOSA, Ala. — No amount of studying and practice can truly prepare a nursing student for what it’s like in a hospital setting recent University of Alabama graduate Haley Patrick has discovered.

“It’s definitely different than school,” said Patrick, a nurse at DCH Regional Medical Center. “You’re on your own, having to learn policies, procedures and protocols of the hospital. You have to be more independent, make decisions on your own. The people I work with are great, and we’re a team, but I have to rely on myself more.”

The transition from nursing school to actual practice is a difficult one for many new nurses. In an effort to help smooth that transition, DCH Regional Medical Center partnered with UA’s Capstone College of Nursing to establish a nurse residency program at the hospital.

The idea for nurse residency programs started in the mid-1970s when the nursing shortage became more apparent. Nurse leaders discovered they were losing up to 60 percent of their nurses within that first year of practice.

“There is a big academics-to-practice gap,” said Rebecca Owings, a UA instructor of nursing and an academic liaison with the nurse residency program. “The programs began as a way to address that gap and improve nurse retention.”

The program at DCH, which began in August, is open to baccalaureate-prepared nurses who graduated within the last six months and work at least 56 hours per pay period. The one-year program, adopted from the University HealthSystem Consortium/American Association of Colleges of Nursing Residency Program, is a one-year interactive program that focuses on three key areas: leadership, patient safety outcomes and professional roles.

Residents meet monthly with a mentor/facilitator and hear from content experts in a variety of areas, like evidence-based practice, end of life care, cultural competence and more. The residents also participate in group activities and share in “tales from the bedside.”

“They talk about their successes and their challenges,” said Yvette Daidone, nurse residency coordinator at DCH. “They may have had their first death, or done their first code or had a challenging interaction with a physician. Those are all very stressful things to a new grad. This program provides a protected, safe environment where they can share, talk and cry about what happened that month.”

The residents also complete an evidence-based project, where they are asked to identify a hospital policy or procedure they feel could be improved. They will research that area and create a presentation based on their findings.

There are 30 residents in the program, and the hospital will soon accept applications for the next group. They are capping the program at 45 residents per year. While many of the residents are UA graduates, Daidone said they also have graduates from the University of Michigan and Mississippi University for Women.

The benefits for both DCH and UA are significant. Training a new RN who then leaves in the first year costs the hospital about $88,000, said Daidone.

“That’s a big chunk of change,” she said. “Data shows participation in a residency program greatly improves those turnover rates. If we can keep them through that first year, then they’ll stay longer and become our leaders and managers and directors in the hospital.”

It also helps the hospital with their recruitment efforts in hiring baccalaureate-prepared nurses and improves the overall atmosphere of the hospital with new ideas and ways of thinking.

For UA, the benefit comes in the research that is done while the program is ongoing.

Dr. Alice March, a UA associate professor of nursing and academic liaison, facilitator and advisory board member for the nurse residency program, is responsible for the research piece. By surveying the residents and observing their skills throughout the program, they are able to see how prepared the nurses are when first entering the world of practice and find ways to help better prepare in those challenging areas, March said.

“When our graduates are successful, it also reflects well on our nursing program,” said Linda Patterson, a UA instructor of nursing and an academic liaison with the nurse residency program. “We have the reputation of turning out people who have good potential, and this program helps them fulfill their potential.”

For Patrick, it’s all about support.

“I get to meet with nurses who are also new to the profession and experiencing the same things I’m experiencing, and we find solutions to problems as a group,” she said. “The first year of nursing is definitely the most stressful, and this really helps us get through it.”