From nurse training to practice: 6 thoughts on easing the transition from Memorial Healthcare's 1st chief nursing executive

Physicians aren't the only healthcare providers receiving advanced training at Hollywood, Fla.-based Memorial Healthcare System.

The health system adopted a new nurse residency program in 2018 under the oversight of Maggie Hansen, RN, its senior vice president and chief nursing executive.

Ms. Hansen joined the Memorial team in 1996 and became the system's first chief nursing executive in 2016. One of her first major initiatives in her new role was transitioning the health system away from a homegrown nurse residency program toward a formal program that could provide comparative information and benchmarking data.

The nurse residency program accepted its first cohort of 72 trainees from Memorial's six hospitals in August 2018. As part of the training, nurses work side-by-side with physician residents in skills labs, rounds labs and other training sessions for all specialties, including surgery, pediatrics and critical care. The one-year program aims to provide nurses with real-world clinical experience that focuses on leadership, patient outcomes and professional development.

Ms. Hansen spoke with Becker's Hospital Review about the nursing residency program and shared advice for other health systems looking to implement a similar program.

Editor's note: Response have been lightly edited for length and clarity.

Question: What was the motivation behind establishing the nursing residency program?

Maggie Hansen: We've had a new graduate program for years. However, we know there will be future challenges when it comes to the pipeline for new nurses, since we currently have so many baby boomers who will be retiring. One-third of the current workforce is facing retirement, and one-third of nurses are also baby boomers. We're going to need a large volume of nurses to care for this aging population. But we'll also need younger nurses to gain the skills and knowledge retiring nurses have. So, we're strategically preparing ourselves with the nurse residency program.

In addition, only a small percentage of new graduates stay in their jobs after the one-year mark. A formalized residency program helps meet nurses' needs and improves engagement. Since implementing our program, we expect to have a 95 percent retention rate at the one-year mark.

Q: What type of skills does the program help nurses develop?

MH: The program teaches nurses to be better critical thinkers, communicate effectively, manage their stress and time, and take personal responsibility for learning. Healthcare changes at a more rapid pace than almost any other business or profession. Clinicians must continually learn. We employ a lot of nurses and physicians, and we want to make sure everyone is fully engaged in their work.

 Q: Do all new nurses graduates participate in the program or is it an application process?

MH: We expect to hire about 500 new graduate nurses in the coming year, and everyone will go through the residency program. We also dip into the student population and offer scholarships to individuals who meet specific criteria. It's similar to an internship where they learn from our own employees. This helps new nurses joining our team after they pass the National Council Licensure Examination exam, since they've already done critical rotations with the health system before.

Q: What do you think is missing or lacking from current nurse training?

MH: Our academic partners do a good job preparing nurses, but never to a level that prepares them for the different situations they'll see every day. The nurses will face unfamiliar technology systems, complex medical conditions, etc. You can't possibly prepare every nurse for what they will need in clinical practice. So we're closing that gap between what they learn and what they will experience on their unit with the residency program.

Q: What advice do you have for nursing executives looking to start a residency program at their own hospital?

MH: I would recommend nursing executives select a formal program that is customizable to their organization. We have a very strong organizational development department at our system. The program we selected allows us to customize based on what we teach. It doesn't have to be extravagant — it just needs to work for your organization. I would also recommend a health system have representation from all touch points on the care continuum involved in the selection process, including those who work in home health, clinics and skilled nursing facilities.

Q: You've worked at Memorial Healthcare System for 35 years. How have you seen the role of nurses change in that time?

MH: In the past, nurses were not as respected by other members of the healthcare team as they are now. There is a greater appreciation for the difference we make. We are the lifeblood for the patients. Nurses' opinions are very much respected in our health system, so much so that we have a nursing executive with a seat at the table. Our leadership team wants to know my thoughts about how C-level decisions will affect nurses and patient care.  

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