PLATTSBURGH, NY - Two University of Vermont Health Network – Champlain Valley Physicians Hospital (CVPH) programs are laying the groundwork for long-term success by helping new to practice nurses and advance practice providers (APPs) transition confidently into their clinical roles. Designed to build a strong foundation for both professional growth and patient care excellence, the Nurse Residency Program helps new nurses as they move from an academic setting to real life clinical practice while the APP Transition of Practice (TOP) Program supports physician assistants and nurse practitioners who have joined the emergency department team.

The Nurse Residency is a year-long program that affords new to practice nurses dedicated time to build upon their already strong academic foundation while learning from real-world experiences. Each resident nurse is paired with a preceptor for their orientation who offers support and guidance. Case reviews and “hands on” experiences in the hospital’s simulation lab provide the nurse residents with opportunities to build confidence by connecting critical thinking with critical action. Peer support sessions and regular meetings with clinical education managers are also key elements of the program.

“Nothing can really prepare you for real life practice,” said CVPH Director of Nursing Excellence & Program Development Stephanie Drown, DNP, M.Ed., RN, CMSRN, NPD-BC, GERO-BC. “School provides the foundation of what you need as a registered nurse but that’s just the beginning.” Drown explained that the theoretical knowledge and controlled scenarios graduate nurses were accustomed to in school are quickly replaced as they enter the workforce, with unpredictable situations and the need for quick, critical thinking. “This program helps them adjust to the realities of clinical practice while they build confidence in their skills,” she said.

CVPH Director of Nursing Education & Professional Development Abby Bennett, MSN, MBA, RN, NPD-BC explains, “The turnover rate for new nurses is high across the country. Some research says that about 50% leave within their first two years practice. Our American Nurses Credentialing Center (ANCC) accredited Nurse Residency is designed to give our graduate nurses the additional support, guidance, and hands on experiences they need to become more confident and surround themselves with a supportive team. We want to set them up for success – now and in the future.”

In 2013, as the residency was launched, Drown said the 1-year retention rate for new nurses at CVPH was about 69%. Today, that percentage is more than 85% thanks in part to the program. “Our Residency program is providing valuable experiences and building strong partnerships for our new nurses. They are also laying a strong foundation for career development – offering nurses the opportunity to answer the question, ‘What does the rest of my career look like?’” Bennett said.

The CVPH program was first accredited in 2018 by American Nurses Credentialing Center (ANCC), a subsidiary of the American Nurses Association. It was the second nurse residency in New York State to earn this national recognition. “Today, graduate nurses are looking for accredited programs when considering where to practice,” Drown explained.

Success in the Emergency Department

In the Emergency Department, where turnover of APPs has been an ongoing challenge, the TOP program is helping to stabilize the team. It is also a year-long program that offers APPs like Derek Bush, PA a supportive environment, classroom and hands on training and education so they can adapt to the new setting and patient population.

“Before joining the ED team, I had been working in an inpatient setting – caring for patients who had already been admitted. Delivering care to ED patients is much different and the program has been helpful,” Bush said. Although TOP did not figure into his decision to come to CVPH, Bush says programs like it have increasingly become important to physician assistants and nurse practitioners across the country looking at prospective employers. “Health care can be tough – especially if you are new, it can be overwhelming. Having the team support is helpful.”

According to APP Manager Maurice Paquette, PA-C, CAQ-EM, who coordinates the TOP program, “We provide APPs new to emergency medicine the dedicated time to refine their clinical skills with additional training and hands on experiences. They are given the space to build their clinical confidence under the guidance of mentors and preceptors.” Paquette pointed out that the ED providers and staff play a key role in the program’s success. “It’s an investment of time for everyone but we believe it’s time well spent.”

Paquette said that within the profession, organizations that offer TOP programs are prioritized by those looking for new positions. “We receive inquiries from across the country because of this program. Applicants are willing to move here because of it.” The rate of turnover in the ED has decreased due in part to the program.

“Investing in our people and supporting their passion to deliver great care is an investment in our future,” explained CVPH Chief Nursing Officer Carly Haag, MSN, RN. “During this national sustained workforce shortage, attracting and keeping dedicated staff is so very important. Turnover puts additional stress on the entire team and can impact care.”

Under Paquette and Drown’s leadership, the CVPH TOP program is well on its way to seeking accreditation from ANCC’s Advanced Practice Provider Fellowships Accreditation Program. It is also being considered for other partners of the University of Vermont Health system. The Nurse Residency recently celebrated the graduation of 25 nurse residents with another class underway and will be seeking accreditation again this year.