New Grad RN Residency Programs - Articles Archive. From The Floor. New Grad RN Residency Programs. Excellent programs at LAC+USC and City of Hope. I’ve written before about how difficult it is for newly graduated nurses to get the acute care experience many hospitals demand. I’ve also written about the nursing shortage, which is predicted to become more acute in the near future. This time, I want to talk about a way to solve both problems: the new- grad RN residency program. The First Two Years. Why are hospitals so insistent that nurses have at least two years of previous acute care experience? A 2. 01. 2 survey conducted by the American Nurses Association journal American Nurse Today found that “only 1. NGNs) were fully prepared to practice safely and effectively.” On top of that, NGNs’ turnover and attrition rates are too high for most hospitals’ comfort. Learn more about the programs Kaiser Permanente Northern California has to offer. Content in this Website is the property of Kaiser Permanente Northern California Residency Programs.The same 2. 01. 2 survey found that attrition can be “as much as 5. Considering those factors, it’s no wonder many facilities prefer to hire only nurses who have already made it “over the hump” of those first two critical years. Beyond Nursing School. An alternative that many hospitals are now choosing is to offer residency programs designed to give NGNs the experience and guidance they need to become full- time staff nurses. These programs are generally about 7. There is skill testing throughout the process, which may last anywhere from eight to 2. From an outside perspective, residency programs look like an extension of nursing school. The difference is that nursing school focuses on generalized skills and the knowledge needed to pass the NCLEX- RN. The residency program’s goal is to help new RNs develop autonomy and decision- making skills in real- world clinical scenarios. The New Grad Nursing Program at UCLA Health is one of the best nursing programs for new grads seeking to build a rewarding career in nursing with. New Grad Nurse Residency Program; Critical Care; Med/Surg; Perinatal Services. New BSN Nurse Residency Program Guide. Stanford/Palo Alto: New RN Residency Programs ** UC Davis Health System: Nurse Residency Program. The New Graduate Nurse Residency Program at Johns Hopkins Bayview Medical Center is designed to ease the transition from nursing student to skilled RN. The SRCHC Nurse Practitioner (NP) Residency Program is an opportunity for recently graduated Family Nurse Practitioners (FNPs) to experience a supported transition to becoming a primary care provider. This program is offered. They also learn to assimilate into the organizational culture of the hospital and unit in which they will be working. To learn more about these programs, I interviewed participants, preceptors and recruiters from the residency programs at two local hospitals: LAC+USC Medical Center and City of Hope National Medical Center. LAC+USC Med/Surg. LAC+USC Medical Center offers new- graduate- RN residency programs in several departments, including med/surg, emergency, OR and their many ICUs. The programs’ length varies by department, but is typically around nine weeks, the first six weeks of which are each divided into three days of class lectures and two days of clinical work. However, new RN residents are not considered to have “graduated” from the program until after they successfully complete their first year at the hospital. Ready for Patient Care. NGN residents in the med/surg unit spend their first week learning the layout, working the desk and shadowing a preceptor like James Nimnualrat, RN. Actual patient care begins on the second week, starting with one patient. All of the NGN’s direct patient care during this period is observed by the preceptor to ensure that the new grad is providing safe, appropriate care. If all goes well, residents will be assigned an additional patient each week until they have five patients. If the preceptors feel an NGN needs more time, they can ask the nurse manager for approval to extend the precepted period for a few additional weeks. The Preceptor’s Imprint. Each preceptor has his or her own style. For example, Nimnualrat says he focuses on modeling how to chart, providing examples of his charting methods, explaining why he charts the way he does and helping his preceptees develop a style that works best for them. Nimnualrat’s fellow med/surg preceptor Ramona Paolim, RN, BSN, encourages NGNs to self- assess. She says that learning to identify your own weakness as a nurse helps you become better grounded. Another of Paolim’s strategies is to assign the NGN resident one very sick patient and one with a much lower acuity, which helps to keep the new grad from becoming overwhelmed. Paolim and fellow preceptor Christine Mercado, RN, add that they strive to teach NGNs the need to, as Paolim puts it, “always know why they are doing what they are doing.” For instance, if the new grads are administering Tylenol, the preceptor asks if they know what the patient’s liver function is. Paolim says she enjoys being able to explain to the new RN “why we do what we do and how the various systems connect.” Mercado just loves being part of the process that helps mold a good team player, which she says is a beautiful thing to see. LAC+USC Emergency Department. The new- RN- residency program in LAC+USC’s very busy emergency department is similar to the med/surg program: six weeks of combined classroom and clinical work followed by three weeks of exclusively clinical work in the high- acuity North unit. Each NGN resident typically works with a preceptor for about a month, during which the new RN is gradually assigned additional patient booths, up to a maximum of four. After the preceptors turn in their final evaluations at the end of the month, the new grads are expected to be able to handle their four booths, but will still have access to a resource nurse for additional help if needed. Fast Pace and High Acuity. The ED program differs from the med/surg program in the high acuity of the patients and the constant pressure to turn over the booth to the next patient. The 1. 36- bed ER at LAC+USC is one of the largest and busiest in the country, so NGNs who want to make a career in emergency nursing will often bide their time waiting for a slot in this program. Hannah Deloria, RN, is an alumna of the program in which she is now a preceptor. Her preceptor during the residency program was Paul Triamarit, RN, BSN, MICN, who she says would keep her on her toes with pop quizzes. She now tries to follow the example Triamarit and her other preceptors set for her, helping “to not only ensure that these new grads will be able to take care of patients safely but to also help them become comfortable and confident in their role as an ER nurse.” Novice Nurses Become Great. Deloria urges NGNs to learn something new every day, whether it is a piece of equipment they have never used before, a disease process with which they are unfamiliar or a different nursing function in the department. She assures new grads that their initial anxiety will pass as their experience and knowledge grow. Triamarit is still a preceptor in the program, a role he has now had for 1. Recruiters Le. Vell Romeyn, Teresa Mc. Cormac and Leilani Patacsil, BSN, MBA, told me that one of their priorities is to find nurses who understand and have a passion for the specific personal and emotional challenges of oncology nursing. Recruiters will ask about candidates’ personal experience with cancer, whether they have previous experience working or volunteering with cancer patients and if the candidate is active in any of the many oncology nursing organizations, such as the Oncology Nursing Society, National Coalition of Oncology Nurse Navigators and the Association of Pediatric Hematology/Oncology Nurses. Candidates who are accepted for the program spend their first week becoming familiar with their unit’s policies and procedures, meeting other team members and learning basics like the locations of the equipment. By the second week, the NGN resident can expect to begin working hands- on with at least one patient. As the program progresses, the new grad will gradually take on additional patients. More Than Dressing- Changers. These NGN residents will learn to perfect their craft with the help of City of Hope preceptors like Zhen Afable- Torres, RN, BSN, and Jessica Belko, RN, BSN. Afable- Torres, a preceptor for about 1. NGN needs to have a strong grasp of “Nursing 1. However, Belko, herself an alumna of the residency program, says that the preceptor can make or break a nurse’s foundation. The NGN resident will typically shadow his or her preceptor for a time while also taking classes. The preceptor will observe and provide feedback on each procedure the new grad performs. Belko says she divides the coaching into three distinct steps: show, observe and return the demonstration. As a preceptor, Belko tries to ensure that her preceptee gets a well- rounded experience with a variety of patient- care scenarios. If a specific patient- care experience isn’t available in her unit, she will seek out a suitable opportunity in another unit. She says she looks for preceptees to show her that they are able to think for themselves and be more than just dressing- changers. Fierce Competition. Every one of the NGN participants I interviewed at both hospitals spoke with great enthusiasm about the residency program. They agreed that it provided them with much- needed skills and grounding in their specialty areas. All of the participants recommended these programs very highly. The bad news is that competition to get into these programs is fierce, to say the least. Also, since most of the participants will eventually become full- time staff nurses, the hospitals are very choosy about whom they accept. For its most recent cohort, City of Hope had about 1,0. How to Increase Your Chances of Getting Accepted. I asked the participants to share some words of wisdom for RNs who wish to follow in their footsteps. They also recommend volunteering for every healthcare- related role you can find to build up your real- world nursing experience. Joining a professional organization in your desired specialty area is also a good idea. Pay attention to detail. The recruiters at the two programs stressed the importance of following the application instructions to the letter and making sure your application and resume are free of typos and spelling errors. These things may seem trivial, but nurses must pay constant attention to the smallest details, so any glitches here will definitely send the wrong message. Send a thank- you note. Since there are so many applicants for each program, LAC+USC nurse recruiter Susanna Mortimer, RN, MSN, says follow- up calls and thank- you notes are a good idea. Mortimer adds that it’s also important to be flexible. Graduate Nurse Residency Program in Colorado Springs. ACUTE CARE SERVICESNeuroscience 5. CNeuroscience is a 2. The department specializes in acute stroke, TIA, seizure, epilepsy, and all Neurological related issues. The staff work 1. Renal Medicine 5. Patient Care Unit. This is a 3. 8- bed unit specialized to care for patients with medical disorders, hypertension, acute renal disease or ESRD as well as diabetes and heart disease. Other medical overflow may be placed on this unit if bed placement is available. There is also a 5 bed inpatient dialysis unit on this floor staffed by contract employees. The typical nurse- to- patient ratio is 1: 4 (days) and 1: 5- 6 (nights). Nursing Assistants are staffed each shift as part of the unit. All nurses are certified in continuous abdominal peritoneal dialysis (CAPD) after hire. The staff work 1. The unit participates in many activities including the yearly National Kidney Walk, the Patient Family Advisory Council and has an active Unit Practice Council. Surgical Trauma 6. Ortho- Neuro is a 2. All beds have monitoring capabilities for post- operative sleep apnea. This is a busy turnover unit as the average patient length of stay is 2. Typical RN to patient ratio is 1: 4- 5 (days) and 1: 5- 6 (nights). Ortho- Neuro 6. 6 Patient Care Unit. Ortho- Neuro is a 2. All beds have monitoring capabilities for post- operative sleep apnea. This is a busy turnover unit as the average patient length of stay is 2. Typical RN to patient ratio is 1: 4- 5 (days) and 1: 5- 6 (nights). Medical 7. 5 Patient Care Unit. Medical 7. 5 is a 3. Services provided include (but not limited to): gastrointestinal disease, diabetes, pulmonary disease, infectious disease, psychological disease, DVT prevention and treatment, care of post procedural and conscious sedation patients, care of post- surgical patients, comprehensive pain management, telemetry monitoring, point of care testing, comprehensive skin care, as well as restraints and alternatives program. The majority of patients experience a multiplicity of issues requiring multiple levels of care ranging from general to intermediate level. Typical RN to patient ratio is 1: 5- 6. Patient Care Techs are assigned to the nurses and are delegated to according to the nurse practice act. Medical Surgical North. MSN is a 4. 8- bed unit split into four- pods with all private rooms located on the Memorial North campus. There is a diverse population of medical/surgical patients, which includes orthopedic patients, gynecological surgery patients, cardiac patients, trauma patients, and general medical patients. Typical RN to patient ratio is typically 1: 5 on days and 1: 6 on nights. Patient Care Techs are assigned to the nurses and are delegated to according to the nurse practice act. The staff work 1. Staffing Services. This is the float/flex pool for Memorial - UCH. This department provides nursing care services for multiple departments both inpatient and outpatient. The nurses are hired by division specialty and techs are trained to float between all specialty units. The patient population on the unit includes: patients receiving active chemotherapy treatment, radiation oncology patients that need I- 1. Nursing staff are chemotherapy and biotherapy certified providing the highest nursing care to the oncology patient. The typical nurse to patient ratio is 1: 4 on days and 1: 5 on nights. REHAB SERVICE LINERehab Patient Care Unit. The Rehab Patient Care Unit, 'RPCU', is an acute care rehab unit at Memorial Hospital. This 3. 4- bed unit specializes in the rehabilitation of patients. The nurses and therapists work together to strive for the patient's independence. The population includes post- stroke, head injury, motor vehicle accidents, joint replacement and/or orthopedic patients. The typical nurse to patient ratio is 1: 6 on days and 1: 8 on nights. Patient Care Techs are assigned equally and work with the team; the assignment is according to the nurse practice act. EMERGENCY SERVICE LINEThe ED at Memorial is made up of 8. Staff generally works at one location or the other. Nurses are hired into a variety of assigned positions which may include days, mid- shifts or nights in 8, 1. Staff is offered self- scheduling. Memorial Central is the busiest ED in the state of CO. It is a Level II Trauma Center that has 6. TNCC, ENPC and/or PALS are required after hire and floor orientation. CRITICAL CARE SERVICESICUWe have 4. Memorial Central and Memorial North). The staff rotates between the two locations. The Central campus is a 3. Other patients include those who have undergone interventional radiology, vascular and cardio- thoracic surgeries, or who have sustained traumatic injuries. This campus is a Level II trauma center, and both primary stroke and chest pain accredited. The North campus ICU is a 1. It is a Level III trauma center. Nurses on both campuses provide care for patients requiring close monitoring with intensive therapeutic modalities- mechanical ventilation, continuous renal replacement, intra- aortic balloon pumps, vasoactive medications, and advanced hemodynamic monitoring. Nursing assignments are made on a shift to shift basis taking into consideration patient acuity and staff. Cardio. Vascular & Thoracic Unit. This 1. 8- bed unit specializes in the intermediate care of the adult cardiac, vascular and thoracic patient population. The patient requires monitoring and care of moderate or potentially severe physiologic instability or is stable, with a high potential for becoming unstable, and requires increased intensity of care and vigilance. This includes, but is not limited to, the following patient populations: Diabetes, Pulmonary/Respiratory Failure, Congestive Heart Failure, Cardiomyopathy, post angiography (angioplasty, stent), Invasive Radiology, arrhythmias, R/O myocardial infarction (MI), stable acute MI, Unstable Angina, cardioversion, Ablation, s/p pacemaker insertion, 2. CABG), vascular intervention, carotids, thoracotomies, transvenous cardiac pacing and post cardiac arrest. Special procedures include but are not limited to Telemetry monitoring, DVT prevention, comprehensive skin care, initiation and maintenance of comprehensive IV therapy, tracheostomies, chest tube insertion, gastric feeding tube, central line insertion, transvenous, epicardial, and external pacing, hemodialysis, epidural medication administration, drug loading for arrhythmias, specialty drug administration (Tikosyn), thrombolytic drug therapy, and participation in research projects. Unit nurses also help people to develop healthier life style choices through a comprehensive plan of care that includes risk identification and education around lifestyle modifications. The unit's role is to promote independence in our patients and help them achieve their greatest potential. The typical nurse- to- patient ratio is 1: 4 during the day and 1: 5 on the night shift, depending on acuity. The unit utilizes a team concept to patient care which consist of RNs and Patient Care Technicians. WOMENS SERVICESBirth Center. The Birth Center is a 2. OB triage, 1. 5 labor and delivery rooms, 2 OR's, and 4 recovery rooms. We are a referring hospital for Southern Colorado, doing 2,5. Pregnancy is our specialty. We care for a variety of low and high risk patients who come to deliver their baby or to have specialized monitoring for high risk issues such as pregnancy with multiple babies, cardiac problems (maternal or fetal), diabetes, or other chronic health issues. We are supported by a 5. B NICU as well as a normal newborn nursery with couplet care. Our medical providers include private practice OB- GYNs, a community health center practice which combines Certified Nurse Midwives and OB- GYNs, and maternal fetal medicine perinatology. The nursing team is expert at all areas of OB care from 2. Our specialty high risk OB transport team brings patients from Southern Colorado, New Mexico, and rural Kansas when a higher level of care is needed for mom or fetus. Mother/Baby Unit. The mother/baby unit is a 3. Nurses provide couplet care to mothers and babies post- delivery while providing education on post- partum care, breastfeeding, and infant and maternal health. The typical nurse to patient ration is 1 nurse to 3 couplets (mother and baby). Women's Pavilion. This is an 1. 8 bed unit comprised of all private rooms. The patient population is stable high risk antenatal care, patients with gynecological issues, and post- op GYN patients. Also included is care for intrauterine fetal demises under 2. We provide individualized care for our pregnant patients who live on our unit for up to 3 months, waiting for delivery. Our GYN and post- op GYN patients receive the highest level of professional care as we help them to recover after treatment or survey. Staff are experts in women's health and wellness, caring for a wide variety of issues, including diabetes, hypertension, cardiac issues, and other chronic health concerns. Our long term patients are pleased with the professional care and personal touches from the staff, often commenting they are better educated and prepared to care for themselves and their babies than when they were admitted. Our medical providers include a large perinatology practice for high risk pregnancies, private practice OB- GYNs, and community health OB- Gyns who engage in collaborative, evidence based practice for best patient outcomes.
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