Texas leads the list of states with the most travel nurse jobs.
The most in-demand travel nurse specialties are in med-surge, emergency department, and step-down, says a new report that looks at current travel-nurse trends.
The Q1 2023 Jobs Report by Nomad Health, a digital marketplace for healthcare staffing, looks at the most in-demand travel nursing specialties based on the company’s own job data collected January 1, 2023-March 31, 2023, from more than 80,000 users, according to the report.
The report also reveals which states have the most travel nurse jobs, as well as which states travel nurses want to work in the most, based on their search behavior.
“This supply-and-demand data for travel nurse jobs is meant to help facilities, government bodies, and reporting bodies understand the latest employment trends in travel nursing and the impact it has on nurse staffing supply and demand,” according to the report.
These are the travel nurse specialties most in demand by healthcare facilities during Q1 2023, according to the report:
Med-surg: 17% of jobs
Emergency department: 8% of jobs
Step-down: 7% of jobs
Med-surg/telemetry: 6% of jobs
Medical ICU: 5% of jobs
Telemetry: 5% of jobs
Operating room: 5% of jobs
Labor and delivery: 2% of jobs
Rehabilitation: 2% of jobs
Psychiatry: 2% of jobs
Texas led the list for top states for travel nurse jobs, with 7% of jobs, most likely for two reasons, the report says. Texas is a large, rapidly growing state, but it also is a “compact state,” which allows travel nurses to obtain a multi-state license, speeding up the credentialing and employment process for travel nurses.
California and New York both came in second with 6% of jobs; Florida followed at third with 5% of jobs; Massachusetts, Pennsylvania, Illinois, and North Carolina tied for fourth with 4% of jobs; and Maryland rated fifth with 3% of jobs.
Nomad also looked at where travel nurses most wanted to work, based on states that they searched most.
“In this list, we noticed common factors that make these states appealing for travel nurses including an ample supply of jobs, low cost of living, and high quality of life,” the report says.
California and Florida were the most popular, both with 6% of queries, followed by Texas with 5%; New York, North Carolina, and Georgia each received 4%; and Arizona, Colorado, Virginia, and Massachusetts each received 3%.
Galen College of Nursing has multiplied its campuses nearly fourfold since HCA's acquisition 3 years ago.
When HCA Healthcare acquired a majority stake in Galen College of Nursing, one of the nation’s largest private nursing schools, in early 2020, the nursing school consisted of a handful of campuses.
Since the HCA acquisition, Galen has expanded to 19 campuses nationwide, plus an online program, with an enrollment of some 12,000 students. The newest campus, announced in April, will open in the latter part of 2023 in Salt Lake City, Utah.
Partnerships between hospitals or health systems and schools of nursing are becoming more common as healthcare leaders search for creative ways to bolster the number of nursing students, and thus, their nursing pipeline.
Sammie Mosier, DHA, MBA, BSN, NE-BC, CMSRN, HCA’s senior vice president and chief nurse executive, spoke with HealthLeaders about the health system’s supercharged approach to educating future nurses amid a national nursing shortage.
Sammie Mosier, SVP and CNE, HCA Healthcare / Photo courtesy of HCA Healthcare
This transcript has been lightly edited for clarity and brevity.
HealthLeaders: What have been benefits of HCA’s acquisition of Galen College of Nursing?
Sammie Mosier: Not all healthcare providers can offer degree programs like we can with our nursing school. One of the obvious opportunities is to ensure that we have a Galen College of Nursing in our markets, and that does a couple of things.
It introduces a supply of nurses and so it's an opportunity for us to recruit those nursing students early. Also, we have a nurse extern program that allows our nursing students to come into the hospitals and participate in that program. It gives them hands-on experience and exposure to healthcare, which has been something we've been challenged with over the last couple of years with some of our students. They have gotten out of school, and they passed their NCLEX but they didn't necessarily get a lot of hands-on training in their programs, so this is mitigating that barrier.
We have more than 5,500 nurse externs in our hospitals and that is allowing them to get hands-on opportunities with our patients, but then it also gives them exposure to different care areas so that they’re a little more familiar with the hospital environment and they also can determine which specialty they want to go in when they graduate. So, they're interviewing us just like we're interviewing them.
HL: How has Galen grown, and in what ways, since it became part of HCA?
Mosier: We’ve more than doubled in footprint. We're currently at 17 schools [Editors’ note: Two more campuses have opened since this conversation]. When we purchased Galen, it had four campuses and, I believe, was getting ready to open a fifth, so we’ve definitely helped expand that, and that's been based on market needs.
The school has about 12,000 students enrolled. We look at that and determine how many more schools of nursing we need. We do have some expansions planned over the next three years based on the enrollments that we're seeing, so Galen definitely has not been short on gaining students in every one of our markets. They actually have exceeded enrollment expectations, which emphasizes that it's not that people are not interested in nursing; it’s that there's a barrier for them getting into nursing school, so Galen is opening that up.
NCLEX testers since 2019 in the U.S. have numbered about 149,000 to 150,000 testers each year, and as we expand Galen, that's going to put more students with the ability to test, so we'll change the national statistics as we grow this program.
HL: You referenced barriers, and one barrier is that nursing schools don’t have enough instructors. How is how is Galen doing in filling those seats?
Mosier: This is where we have a really good partnership with Galen. They have a good culture with a positive and supportive environment, so they're able to attract talent. They have created a pathway that takes nurses who are passionate about education, and they teach them how to teach. They have unique training, where they take new faculty members and do extensive individual orientation with them that lasts about 12 months. Then they have additional programs and separate tracks so that those nurses who are becoming faculty continue to move from a novice to expert just like our nurses do.
We also have benefit where together we created a program for their master's program. They have a master's in education, and they have a master's in leadership. With the master's in education, they can build their instructor gaps with that, and the master's in leadership is where my pipeline comes into play as far as directors and ACNOs and CNOs for the future. So, there’s a good partnership there.
Galen also has invested heavily in resources to establish a common curriculum and assessment, so those 17 campuses don't look different. They're able to leverage the size and scale of Galen, to be able to help support their educators.
HL: How has the pipeline benefited HCA regarding filling staffing gaps? What percentage of Galen graduates go on to work in HCA facilities?
Mosier: We’re starting to get that data now because a lot of the programs that we opened are just starting to graduate students, so we'll have better statistics in the future to report on that. We're starting to see that, and that nurse extern pipeline is helping us think about the potential conversion rate there, too.
Obviously, our goal is to get them to convert to full-time nurses. I tell everyone that it's not a short-term strategy; it’s a long-term strategy when it comes to the Galen. Within the next year, we'll really start seeing the benefit of that in the markets that opened earlier and then that will continue to build.
6 out of 10 have seen or experienced racism from colleagues, data reveals.
Nearly eight out of 10 nurses have seen or experienced racism/discrimination from patients, and almost six out of 10 nurses said the same about racism/discrimination from colleagues, says a new report from the Robert Wood Johnson Foundation (RWJF).
RWJF examined nurses’ experiences and perceptions of racism and discrimination in both healthcare settings and nursing schools through a nationwide survey of nearly 1,000 nurses from March 2022 through April 2022 conducted by research organization NORC at the University of Chicago.
Although diversity, equity, and inclusion (DEI) efforts became primary focal points for the nation in the wake of the 2020 murder of George Floyd and the resulting racial justice movement, there has been little research on nurses' experience and witnessing of discrimination, according to RWJF.
The survey explored the extent and severity of racism and discrimination happening around nurses, how often it's reported, and the culture of the institutions where it occurs.
Among the key findings were:
Asian, Black, and Hispanic nurses are significantly more likely than white nurses to have seen or experienced microaggressions. Two-thirds of nurses have seen or experienced microaggressions due to race/ethnicity from patients, and nearly half (47%) of nurses said the same about microaggressions from colleagues.
Fewer than one in four nurses formally reported racism or discrimination they saw or experienced to workplace management. Although 40% of nurses discuss observing or experiencing discrimination because of race/ethnicity with their supervisors, only 23% formally report or document incidents.
Nurses say their organizations are prioritizing diversity, equity, and inclusion (DEI) initiatives, but more education and training is necessary. Nine in 10 nurses say equitable patient outcomes are a stated organizational priority at their current workplace.
Nurses say there was a culture of racism/discrimination in their nursing school and that more training/education is needed. More than half of nurses say that their nursing school taught about racially/ethnically sensitive bedside manner while with 60% of Black/African American respondents reporting racism/discrimination. Less than one-third said they were taught about racial bias/stereotypes or systemic racism in healthcare.
Reporting racism
While most survey respondents say their organizations are prioritizing DEI initiatives, very little formal reporting occurs when nurses or their patients experience racism, the report notes.
Fewer than one in four (16%) nurses report discrimination they saw or experienced to human resources; instead, most nurses (57%) speak with their fellow nurses, nursing directors/supervisors/managers (40%), or other staff (37%). Black nurses are most likely (64%) to have discussed with other nurses discrimination or racism they’ve observed.
Among nurses who reported such observances or experiences, more than 50% say their relationship with supervisors, senior leaders, and fellow nurses was negatively affected, the report says.
Finding solutions
Additional training and educational programs would be beneficial to addressing this problem, including at nursing schools where respondents reported a culture of racism exists, respondents suggest. More than half of nurses say their nursing school taught about racial sensitivity in caring for patients, but less than one-third were taught about structural racism in healthcare, a topic that could benefit patients and employees alike.
Most nurses (91%) say diversity and inclusion at the staff level is an organizational priority; 78% say that about having an ethnically and racially diverse leadership team.
Most of those surveyed (85%) say hiring ethnically and racially diverse nurses is an organizational priority, and most agree hiring practices would improve the ability to recruit and retain racially and ethnically diverse nurses.
Zero-tolerance workplace discrimination policies, clear consequences, and reporting anonymity would improve nurses’ workplaces’ ability to retain racially and ethnically diverse nurses, eight in 10 nurses say.
"If we are to truly provide just and equitable care to our patients, we as nurses must hold ourselves accountable for our own behavior and work to change the systems that perpetuate racism and other forms of discrimination," said Beth Toner, RN, director of program communications at RWJF.
Nurses who binge-drink also multiply their risk for COVID.
Nurses who work the night shift or binge drink may double their risk of COVID-19 infection, according to a study that set out to determine why many first responders develop severe COVID despite not having associated risk factors such as obesity, diabetes, and hypertension.
The report, published in Alcohol: Clinical and Experimental Research, indicates that both night shift work—causing circadian misalignment—and alcohol misuse have been shown to affect sleep and promote inflammation in the body, which has been linked to COVID severity.
“Understanding the mechanisms underlying these risk factors could help to mitigate the impact of COVID-19 on our at-risk healthcare workforce,” according to the report.
Both disruption of circadian rhythms and unhealthy alcohol use decrease resiliency to several inflammatory disorders including respiratory infection/pneumonia and acute respiratory distress syndrome—two features of severe COVID-19—the report says.
Data was gathered from American Nurses Association members who were surveyed about alcohol use, sleep patterns, experience with COVID infection and chronotype, or whether the nurse was a “night owl” or “morning person.”
Findings included:
Unhealthy alcohol use was associated with poor sleep quality.
Nurses with high-risk features for alcohol misuse and binge drinking were both more likely to work the night shift.
Night shift work and binge drinking were associated with an increased rate of COVID-19 infection.
Shift work, binge alcohol use, and high-risk features of alcohol misuse by LCA were associated with a later chronotype.
Of the 750 nurses included in the study, 25% met the criteria for alcohol misuse. The U.S. Centers for Disease Control and Prevention defines alcohol misuse as more than one drink per day on average or four or more drinks on one occasion in a month for women and men, more than two drinks per day, or drinking five or more drinks on one occasion.
Those nurses tended to be younger, were more likely to be white, and reported poorer sleep and greater stress, anger, or worry prior to sleeping, the study reveals.
To improve health outcomes in night shift workers, the report’s authors recommended further study into the mechanisms of alcohol and circadian misalignment.
The funding will help recruit and train the next generation of nurses for 'the most rewarding career imaginable.'
Atlantic Health System (AHS), based in Morristown, New Jersey, is poised to expand and diversify its pipeline of nurses by about 2,000 nursing jobs thanks to a $2.75 million Nursing Expansion Grant it is receiving from the U.S. Department of Labor.
The money will help establish Atlantic Health System’s Pathway to Ensuring Access and Clinical Excellence in Nursing (AHS PEACE), which will create professional pathways for RNs in acute care and critical care specialties, as well as clinical pathways for nursing assistants. Candidates from historically marginalized and underrepresented populations will be included in these positions, according to AHS.
AHS PEACE will support the creation of about 2,000 nursing jobs through the recruitment of graduating high school students, college-level undergraduates, and entry-level incumbent healthcare workers. The program will create partnerships with area colleges and universities, workforce development agencies, and non-profits.
The grant is one of 25 totaling more than $78 million that the labor department recently awarded to nursing programs in 17 states to address critical staffing challenges and to strengthen and diversify the workforce.
“Nurses make up the single, largest group of professional team members at Atlantic Health System and are essential members of the care continuum across all of healthcare,” said Trish O’Keefe PhD, RN, senior vice president, chief nurse executive, Atlantic Health System and president of Morristown Medical Center.
“Nurses have always served on the front lines of care, as a patient’s most direct connection to needed healthcare services,” O’Keefe said. “This program … will help Atlantic Health bolster those front lines while welcoming hundreds of new healthcare workers to the most rewarding career imaginable.”
AHS, a not-for-profit system, offers more than 400 sites of care in New Jersey, Pennsylvania, and the New York metropolitan area, including its seven hospitals.
Dickison, who has served as NCSBN’s chief operating officer (COO) since 2017, will assume his new duties from retiring CEO David Benton on Oct. 1, 2023. Prior to his appointment as COO, he served NCSBN chief officer, examinations, for seven years.
Philip Dickison, PhD, RN / Photo courtesy of NCSBN
The NGN, launched just weeks ago and more than a decade in the making, is an enhancement of the prevailing NCLEX, using real-world case studies to measure a nurse's ability to think more critically and make the right decisions.
At the core of this enhanced exam is the NCSBN Clinical Judgment Measurement Model (NCJMM), developed by Dickison and other NCSBN researchers as a framework for the measurement of clinical judgment and decision-making within the context of a standardized examination.
“Because clinical judgment underlies almost all of a nurse’s activities, it is of paramount importance to NCSBN,” Dickison said when NGN was launched. “We need to be able to measure it effectively to safeguard public protection. We need to help ensure that when a regulatory body licenses a nurse to practice, they are safe to care for you and your loved ones.”
Dickison’s profound knowledge and experience in testing have made him a renowned leader in the world of psychometrics and an in-demand speaker on the subject. He has been active in the certification and licensure community for more than 30 years.
“Although we conducted a global search, it was Philip’s wide-ranging expertise, experience, and passion for public protection that clearly rose to the top,” said Jay Douglas, MSM, RN, CSAC, FRE, president of the NCSBN board of directors. “We are confident he is the right person at the right time for our organization and excited to see how his vision and leadership will further our past successes and advance the innovative work we are currently undertaking.”
The grant also is focused on providing diverse nursing instructors.
A $2.7 million grant to Southwest Adventist University (SWAU) is part of the latest efforts to amplify not only the numbers of nurse educators over the next five years, but of a diverse nursing faculty.
SWAU, in Keene, Texas, will use the grant—Promoting Postbaccalaureate Opportunities for Hispanic Americans Program (PPOHA)—to develop a Master of Science in Nursing Education program to be offered in a completely online format, scholarships for the first cohorts of nursing educators, and a $250,000 Nursing Educator Endowment to support future generations of nursing educators.
The proposed program is specifically designed to prepare educators for post-secondary teaching positions in community colleges and universities that offer nursing programs, particularly in areas where there is a striking disparity between the demographics of the population and the demographics of current nursing faculty.
The PPOHA program, through the U.S. Department of Education, provides grants to expand postbaccalaureate educational opportunities for Hispanic students and expand postbaccalaureate academic offerings in colleges and universities that are helping large numbers of Hispanic and low-income students complete postsecondary degrees.
The need for more nursing faculty is considerable. Nursing schools had to turn away more than 78,000 qualified applications in 2022 alone due to lack of faculty and training sites, according to the American Association of Colleges of Nursing (AACN). Even more concerning, 10,000 applications were turned away from graduate programs, further limiting the pool of potential nurse educators, according to AACN.
SWAU’s grant is among several being awarded with the specific intent to expand nursing programs and faculty. The U.S. Department of Labor recently awarded 25 grants totaling more than $78 million to nursing programs in 17 states, most of which went to colleges and universities to strengthen and diversify the workforce.
“We are excited about this opportunity to expand what we offer and provide this education program through SWAU,” project director Terri Gibson, DNP, said. “We know that patients need compassionate nurses, and quality educators and programs are needed to make this key nurse role more available.”
NTI annually brings together thousands of nurses and other healthcare professionals who care for acutely and critically ill patients and their families. This year, the in-person convention is being held May 22-24 in Philadelphia, with the theme “Starting Now.”
“So, starting now, we’re taking bold steps toward implementing AACN’s HWE standards,” said Bettencourt, also an assistant professor in the Department of Family and Community Health at University of Pennsylvania School of Nursing. “One step will focus on implementing the standards in individual units. The other step focuses on them in hospitals.”
AACN’s HWE standards consist of six pillars:
Appropriate staffing
Authentic leadership
Skilled communication
True collaboration
Effective decision-making
Meaningful recognition
Nurses in AACN’s Clinical Scene Investigator (CSI) Academy have already been making changes that contribute to creating a healthy work environment, Bettencourt said.
Change projects from the CSI program have resulted in significantly improved outcomes such as reduced CLABSIs, CAUTIs, and falls, along with an estimated $84 million in hospital savings, she told attendees.
“This fall, AACN will start to roll out 60 nurse-driven CSI teams to develop change projects focused specifically on unit-based HWE standards implementation,” Bettencourt said. “Several months after that, we have envisioned a multi-site project that will connect 45 hospitals across the country to study how zeroing in on the health of the work environment impacts the patient journey across the continuum of care—including outcomes for patients, nurses, and the organization.”
Next year is NTI’s 50th anniversary, Bettencourt noted.
“What do we want our ancestors to say about us in another 50 years, when they reflect on how critical care nurses took on one of the most difficult times, one of the greatest challenges in the history of healthcare?” she said.
“I’ve been quoted by several media outlets when I said our healthcare system is being brought to its knees. Because it is,” she said. “We can either surrender to that narrative, or we can start to change it—starting now.”
Bettencourt’s comments kicked off three days of learning in such formats as more than 200 educational sessions, supersessions featuring motivational keynote speakers and AANC leaders, online pharmacology classroom sessions, posters, and exhibitors.
NTI also includes the Critical Care Exposition, the largest and most comprehensive trade show expressly for progressive and critical care nurses.
With new structure, OU Health aims to become Oklahoma’s 'employer of choice.'
OU Health in Oklahoma City is redesigning its human resources structure to build a culture of excellence with the goal to become Oklahoma’s “employer of choice.”
Key strategies in the multi-year HR roadmap to achieve that goal include ensuring employees have the tools required to fulfill career aspirations, along with a reward system “in return for delivering an exceptional experience for team members, patients, and the communities we serve,” according to an announcement from the health system.
The redesign follows the layoff of nearly 100 employees in January.
As with other health systems, workforce shortages remain a challenge for OU Health, Carolyn Kloek, MD, the new inaugural chief medical officer told HealthLeaders.
“Our providers, nursing staff, and other key pieces of the healthcare workforce are stretched thin,” she said. “We need to continue to do everything we can to support members of our healthcare workforce and get creative in the ways that we design and deliver care at OU Health.”
The new organizational structure will be led by Jimmy Duncan, SHRM-SCP, SPHR, the inaugural chief HR officer who joined the health system in January 2023.
Those newly named to Duncan’s team are:
David Conkerite II, vice president talent development & organizational effectiveness. Conkerite will develop systems to improve culture, talent, and organizational performance to achieve recognition of being a best place to work.
Berta Lundberg, vice president Total Rewards. Lundberg will manage the Total Rewards program’s five pillars: health, wealth, well-being, recognition, and career journey.
Taylor McCorkell, vice president human resources. McCorkell will serve as the workforce voice and provide strategic consultation to leadership on people and culture initiatives.
Rachel Bolton, administrative director talent acquisition. Bolton will implement systems to make OU Health the “first and best option” for healthcare candidates.
Levi King, associate vice president human resources strategy & performance. King will serve as the strategic thought leader for HR to ensure all initiatives are achieved.
The new leadership structure will ensure “people, culture, and performance excellence for OU Health,” Duncan said. “This is a crucial step in building a comprehensive HR system and transforming our organization to achieve success.”
CNO Rhonda Thompson's collaboration with local nursing schools is redefining curriculum to reduce first-year turnover.
When her first-year nurses were leaving Phoenix Children’s Hospital because they felt unprepared for the harsh realities of caring for their pediatric population, Rhonda Thompson reached out to local nursing schools.
Those collaborations redefined curriculum that is producing well-prepared pediatric nurses and appears to be reducing first-year turnover at Phoenix Children’s, says Thompson, DNP, MBA, RN, NEA-BC, chief nursing officer (CNO) and senior vice president of patient care services.
Thompson, who joined Phoenix Children’s in 2021, is now working on curriculum with about seven institutions of higher learning and expects that number to expand.
She spoke with HealthLeaders about how they are preparing new nurses to provide care to the littlest patients.
This transcript has been lightly edited for brevity and clarity.
Rhonda Thompson, chief nursing officer and senior vice president of patient care services / Photo courtesy of Phoenix Children's
HealthLeaders: What kind of first-year nurse turnover were you seeing before these collaborations began?
Rhonda Thompson: Prior to the pandemic, Phoenix Children’s was seeing the typical national average turnover of about 18% to 20%. Then the pandemic hit, and everybody's statistics were impacted by the fact that many nurses were leaving to go travel. During the pandemic, we were seeing upwards of 50% to 55% turnover of first-year nurses, especially in the very beginning of it, as people were reprioritizing their lives.
The Arizona State University (ASU) relationship and cohort started, and our focus was on, “How do we better prepare a very specific pediatric cohort of nurses that, once they're through their clinical rotation, they will be hired on at Phoenix Children's?” These are nurses who know they want to be a pediatric nurse, and we want to give them that opportunity, so they are part of what we call the Designated Education Unit, where we concentrated all of their clinical hours on the pediatric population and those kids that they would see at Phoenix Children's.
HL: How did you go about approaching schools to collaborate and how open were they to that?
Thompson: When I started at Phoenix Children's in 2021, I immediately did the academic tour, as I call it, by meeting with all the deans of the nursing schools and focusing in on not just the first-year turnover, but the reasons why we were seeing the turnover, because we were seeing a shift. It was no longer folks leaving to go travel; it was more about not being as prepared as they should be or could be, or as they thought they would be, so I focused on, “What are we doing to prepare them specifically for the softer skills?”
When I would talk with the nurses who were leaving, some of them were in tears, saying, “I just had no idea what I was going to see. I had no idea what I was going to have to do. I had no idea what I was going to hear.” Everyone can say, “My patient population is special,” but when it comes to taking care of pediatric patients, there are things that are pretty disturbing that we see and so we needed to help them prepare.
My approach was that we have to remember that we have a generation where swiping is an option for them. On their social media platforms, they swipe for those things that they don't want to see or hear. In nursing, “swipe” is not an option. When they walk into a patient room, they’re going to have to address whatever is happening within that room. They just can’t swipe it away.
HL: What were they not prepared for?
Thompson: I'll give you an example. You can read a chapter about child abuse, but when you see it, it leaves an imprint. I've been a nurse for almost 30 years, and I remember first walking into the room of a very, very severely abused child. There is really nothing to prepare you for that.
You learn about palliative care and hospice care, and you think you understand the fundamentals, and you may even understand the fundamentals, but are you emotionally and psychologically ready for when a child dies?
HL: How did you help to make sure that they were ready for all this?
Thompson: This is an evolution we continue to work on—the softer skills and things just as simple as how they cope with things in their everyday lives because we need to figure out how to build on those coping skills so that they have something to fall back on when they come to work and see the things that could create trauma for them.
The schools have been incredibly receptive. Their goal is not just to graduate nursing students and for them to pass the NCLEX, but for them to be gainfully employed and part of the community. The deans have been incredibly collaborative with me, specifically for nursing students for this patient population in creating an opportunity where they understand their own coping skills, that they have a support system around them, and that they're able to talk about the things they see and that bother them.
HL: How is the nursing schools’ curriculum being redefined?
Thompson: When the initial discussion started with ASU, we focused on pediatric modules in the students’ last year, and how we marry that into the Designated Education Unit and the simulation lab here at Phoenix Children's.
The schools have been adding curriculum around wellness and coping skills and opportunities to spend more time in simulation. But, it’s not the real thing, so some of what we've been talking about is how to create what we would consider a virtual reality environment that would immerse a student into such things as child abuse and the death of a child, so they can experience that emotion and the feelings that would be evoked by that … and curriculum could be built around that.
HL: Are you seeing that new nurses coming to your hospital are more prepared?
Thompson: It’s probably a little too soon to say. We have had an increase with our first-year retention rate, specifically with the ASU cohort, but it's too soon to say with the other schools because this has been an 18-month or so evolution of speaking with them and talking about what we're seeing.
For the ASU students, they get a very focused entire year of pediatric care and so they are better prepared coming into the organization. They already have built up their competencies as well as their confidence, which is key for newly licensed nurses, so they've already got that fundamentally built in on Day One of their work.
HL: What adjustments have you made to your orientation programs or nurse residency programs to preserve retention of new nurse graduates?
Thompson: We just reinvented our nurse residency program from a 12-month residency to an 18-month residency. That does not mean the orientation is longer; what that means is we created more opportunities for the cohorts to meet and discuss working on those softer skills, talking about the things that have been most impactful to them, and have some support system within the workplace.
We're also looking at preceptors—because they have a huge impact on these new newly licensed nurses—and how we can better prepare them to create a more positive work environment for the new hire, so we're revamping the preceptor education and training that will be a part of the residency. When I was a young nurse, you weren't a preceptor until you were a nurse for two or three years and now we're asking nurses at one year to precept newer folks and that creates a lot of anxiety, so we're looking at ways to better prepare them so that they have a positive experience and the new orientee has a positive experience.