Location
2023 Providence Nursing Research Conference
Start Date
24-2-2023 3:00 PM
Keywords:
california, psjmc, burbank, covid-19
Description
Development of a RN Clinical Coach program to improve retention of ICU residents and fellows
Background:
The COVID-19 pandemic caused contributed to significant increases in ICU nurse turnover. To restore the ICU nursing workforce and rebuild a healthy work environment, evidence-based strategies are needed to provide social support and ongoing clinical skills development for large cohorts of ICU residents and fellows.
Purpose:
The purpose of the Clinical Coach program was to increase retention of ICU residents and fellows and foster a healthy work environment at a ministry in Southern California.
Methods:
In September 2021 the ICU manager at Providence Saint Joseph Medical Center (PSJMC) hired 18 RN residents (n=11) and fellows (n=7) as the January 2022 cohort. Acknowledging the challenges of such a large cohort, the manager brainstormed with her team to identify innovative strategies to ensure their success. A literature review was conducted to identify factors contributing to successful transition into ICU nursing practice. Evidence demonstrated the most important factor was having a designated support person. The Clinical Nurse Transition Program at Yale New Haven Health system was identified as an exemplar for a similar program at PSJMC. A team of PSJMC ICU nurses and leaders met with the Yale New Haven team to learn about their program and later convened to develop a program with the resources available locally. The team adopted the American Nurses’ Association Healthy Work Environment (HWE) Model as the theoretical framework for the program. The HWE model consists of six standards: skilled communication, true collaboration, effective-decision making, appropriate staffing, authentic leadership, and meaningful recognition. Six experienced preceptors were selected and trained to become clinical coaches to advance the HWE model and support the new nurses. In May 2022, the January cohort completed their formal preceptorship and began independent practice. At that time, the clinical coaches stepped in, providing up to four hours each weekly of dedicated time on the unit with the new nurses. During the encounters, the coaches provided at the elbow clinical support and debriefing on past challenging experiences. Visits were structured to reinforce clinical skills and address the HWE standards. The coaches submitted a brief report on the coaching sessions to a REDCap instrument that could be used to track encounters and identify common trends.
Results:
More than 250 coaching sessions from three cohorts have been recorded in 2022.
100% of RN residents and 85% of RN fellows from the January cohort have been retained.
Conclusion:
The Clinical Coach program has contributed to retention of RN residents and fellows. New ICU nurses are at risk for becoming overwhelmed and leaving the clinical setting, exacerbating existing staffing challenges.
Experienced preceptors may be key resources to support the ongoing clinical and social needs of new nurses after preceptorship.
Implications for practice
Inpatient units with limited preceptor resources who must onboard large cohorts of new nurses should consider partnering with experienced preceptors to identify unit-specific clinical and unit culture needs and develop a similar program for their specialties. The healthy work environment model provides a structured approach for coach/new nurse encounters.
Recommended Citation
Jones, Megan; Sumner, Sarah; and Mayberry, Kristen, "Development of a RN Clinical Coach program to improve retention of ICU residents and fellows" (2023). Providence Nursing Research Conference 2023 – Present. 2.
https://digitalcommons.providence.org/prov_rn_conf_annual/2023/posters/2
Specialty/Research Institute
Infectious Diseases
Specialty/Research Institute
Nursing
Development of a RN Clinical Coach program to improve retention of ICU residents and fellows
2023 Providence Nursing Research Conference
Development of a RN Clinical Coach program to improve retention of ICU residents and fellows
Background:
The COVID-19 pandemic caused contributed to significant increases in ICU nurse turnover. To restore the ICU nursing workforce and rebuild a healthy work environment, evidence-based strategies are needed to provide social support and ongoing clinical skills development for large cohorts of ICU residents and fellows.
Purpose:
The purpose of the Clinical Coach program was to increase retention of ICU residents and fellows and foster a healthy work environment at a ministry in Southern California.
Methods:
In September 2021 the ICU manager at Providence Saint Joseph Medical Center (PSJMC) hired 18 RN residents (n=11) and fellows (n=7) as the January 2022 cohort. Acknowledging the challenges of such a large cohort, the manager brainstormed with her team to identify innovative strategies to ensure their success. A literature review was conducted to identify factors contributing to successful transition into ICU nursing practice. Evidence demonstrated the most important factor was having a designated support person. The Clinical Nurse Transition Program at Yale New Haven Health system was identified as an exemplar for a similar program at PSJMC. A team of PSJMC ICU nurses and leaders met with the Yale New Haven team to learn about their program and later convened to develop a program with the resources available locally. The team adopted the American Nurses’ Association Healthy Work Environment (HWE) Model as the theoretical framework for the program. The HWE model consists of six standards: skilled communication, true collaboration, effective-decision making, appropriate staffing, authentic leadership, and meaningful recognition. Six experienced preceptors were selected and trained to become clinical coaches to advance the HWE model and support the new nurses. In May 2022, the January cohort completed their formal preceptorship and began independent practice. At that time, the clinical coaches stepped in, providing up to four hours each weekly of dedicated time on the unit with the new nurses. During the encounters, the coaches provided at the elbow clinical support and debriefing on past challenging experiences. Visits were structured to reinforce clinical skills and address the HWE standards. The coaches submitted a brief report on the coaching sessions to a REDCap instrument that could be used to track encounters and identify common trends.
Results:
More than 250 coaching sessions from three cohorts have been recorded in 2022.
100% of RN residents and 85% of RN fellows from the January cohort have been retained.
Conclusion:
The Clinical Coach program has contributed to retention of RN residents and fellows. New ICU nurses are at risk for becoming overwhelmed and leaving the clinical setting, exacerbating existing staffing challenges.
Experienced preceptors may be key resources to support the ongoing clinical and social needs of new nurses after preceptorship.
Implications for practice
Inpatient units with limited preceptor resources who must onboard large cohorts of new nurses should consider partnering with experienced preceptors to identify unit-specific clinical and unit culture needs and develop a similar program for their specialties. The healthy work environment model provides a structured approach for coach/new nurse encounters.
