Document Type
Presentation
Publication Date
10-2025
Keywords
california; burbank; psjmc
Abstract
Purpose (What): This project aims to describe how transformational leadership by an ICU nurse leader led to the creation of the clinical coach program. This program supports and retains newly graduated nurses and experienced nurses transitioning into the ICU through collaboration with experienced preceptors.
Relevance/Significance (Why): In 2022, hospital leadership charged the ICU nurse manager with stabilizing the ICU workforce by reducing the reliance on costly temporary travel staff, a priority due to turnover during the COVID pandemic. The nurse manager, concerned about the impact of hiring many novice ICU nurses on patient safety, collaborated with experienced preceptors to develop a plan to ensure the successful integration of dozens of new ICU nurses into the unit over the next 24 months.
Strategy/Implementation/Methods (How): The ICU nurse manager and preceptors reviewed literature and found that having a designated support person was crucial for success in the ICU. Therefore, 4 experienced preceptors (2 AM and 2 PM) volunteered to become clinical coaches (CCs) who provided clinical, administrative, and emotional support to new nurses, their novice preceptors, and the education team. The CCs conducted structured visits with the new nurses, fostering the six standards of the Healthy Work Environment. CCs logged their visits into an electronic database to understand the needs of the new nurses and adapt the program for future cohorts. This process repeated for six cohorts from 2022 to 2024.
Evaluation/Outcomes/Results (So what): Since 2022, CCs have conducted over 600 individual coaching sessions with novice ICU RNs. 80% included coaching on eƯective clinical decision-making, highlighting the need for ongoing clinical support beyond precepted shifts. CCs also provided emotional support, helping novice RNs navigate moral distress, grief, and loss, which are common in ICU nursing. A 2024 program evaluation showed 89% of program participants agreed or strongly agreed that the CC program contributed to their intention to stay. Since implementation, first year turnover rates have remained below national benchmarks, all permanent positions have been filled, and the use of temporary staff has been dramatically reduced.
Conclusions/Implications (And now): Transformational leaders inspire and motivate their teams to create positive change. The CC program demonstrated how experienced preceptors partnered with their manager to lead from the bedside to develop an evidence-based program that improved retention and reduced the use of temporary staff.
For additional information check out our Poster Presentation from the 2025 Providence Nursing Research Conference.
Specialty/Research Institute
Nursing
Specialty/Research Institute
Critical Care Medicine
Specialty/Research Institute
Health Care Administration
Comments
References:
Barden, C. (Ed.). (2016). AACN Standards for establishing and sustaining healthy work environments: A journey to excellence (2nd edition). American Association of Critical Care Nurses.
Innes, T., & Calleja, P. (2018). Transition support for new graduate and novice nurses in critical care settings: An integrative review of the literature. Nurse Education in Practice, 30, 62–72. https://doi.org/10.1016/j.nepr.2018.03.001
Nursing Solutions Inc. (2024). 2024 NSI national health care retention and RN staffing report. NSI Nursing Solutions.