Transition to Practice

The Center for Clinical & Professional Development at North Shore Medical Center in Salem, Mass., recognized the need to better support our newly licensed nurses (NLNs) transition into practice.

Prior to 2014, our NLN orientation mirrored the experienced nurse’s orientation, with the exception of 4 additional weeks of orientation on the patient care unit. Each clinical nurse educator developed additional NLN evidence-based experiences unique to his or her unit. While beneficial to the NLN, this process was inefficient, nonstandardized, and vulnerable to competing priorities. The team assembled with an aim to create a pilot transition-into-practice program to shepherd NLNs into the role of a professional nurse. We titled it “Tales From The Bedside” (TFTB).

Creating a New Training Program
The TFTB framework was modeled after Nurse of the Future Core Competencies (NOFCC), which defined the knowledge, skills and attitudes necessary for success in the practice environment. The TFTB cohort model consisted of 12 weekly sessions comprised of didactic learning, case study, debriefing, clinical narrative writing, featured guest speakers, and simulation exercises. The clinical nurse educators were paired to foster relationships and develop the curriculum for NOFCC topics.

The clinical nurse educators used ingenuity and creativity to develop a curriculum to position our NLNs for success. The NLNs found the weekly debriefing event most beneficial as they shared stories of an experience they had, recognized they were not alone, and developed strategies to use in the future. The summative evaluations were outstanding, and the NLNs recommended that all NLNs participate in TFTB.

Archive ImageA

Chrissy Perez, MSN, RN, OCN, a professional development specialist at North Shore Medical Center in Salem, Mass., works with two nursing students inside a mock patient room. photo courtesy of North Shore Medical Center

Soon, a new need arose: the ability to on-board NLNs with every orientation session and support their transition into practice. The team rose to the challenge to design a new TFTB program that would accommodate a rolling admission into the program. In its pilot phase, the responses to the program were overwhelmingly positive. Some NLNs chose employment with us because of the TFTB program.

SEE ALSO: New Trends in Resume Writing

Art and Medicine The team also searched for an outside-the-box strategy to pilot with the NLNs. After returning from conference, a proposal was brought forward to implement an Art in Nursing Program. The team found evidence in the literature of a medical model in which interns obtained learning experiences in an art museum. The clinical nurse educators created the “From Paint to Patient” program and developed it collaboratively in consultation with a museum in our community. The experience consists of a visit to the museum and pairing the NLNs into groups to review four identified pieces of art and think about their applicability to nursing. The groups reconvene afterward, and under the guidance of the docent, share their observations. The docent then shares information about the art object and draws observations from the NLNs. The clinical nurse educators generate discussion about the artwork and relate it to nursing practice to improve critical thinking skills, teamwork and communication.

This creative experience was born from one seed provided from one educator and blossomed into a formal program that continues today.

Essential Teamwork
The support of the administrative staff at North Shore Medical Center helped assure success of the program. From scheduling rooms to updating schedules to preparing handouts to paying invoices, our administrative team effectively supports the team’s work. We would not be able to realize such successes without their unending support, encouragement and expertise.

Debra Pelletier is the executive director of nursing practice at North Shore Medical Center in Salem, Mass.

About The Author