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Students Benefit from One-on-One Guidance from Hospitals' Seasoned Nurses
Dedicated Education Units' success fuels program growth
For four months, Beatrice Newberry Myers’ experiences as a nurse on Rhode Island Hospital’s Main 6 were nursing student Cooper Ferreira’s experiences. From taking vitals to assessing pain, Ferreira had a one-on-one opportunity to learn from the veteran nurse.
Ferreira and Newberry Myers, R.N., were paired for the 2018 spring semester’s 96 hours of clinical training on one of the hospital’s Dedicated Education Units – a model now used at both Rhode Island and The Miriam hospitals.
The current DEUs are hosted on medical and surgical units and provide students, under the guidance of seasoned nurses, with exposure to a range of patient cases. While the traditional small-group instruction model is most widely used, about 70 clinical training slots are in DEUs and the approach is expanding. The Miriam Hospital expects to launch a DEU collaboration with Rhode Island College in the emergency department in the fall, bringing the number of units to three at each hospital.
“The administration and nursing staff at Rhode Island Hospital saw the value of (DEUs) from the beginning.”
Jane Williams, Ph.D., R.N.
Dean of the School of Nursing at Rhode Island College
“This one-on-one experience was the best. No professor, no matter how good they are, is going to be able to give five or six students the same experience that you can get with one great nurse like (Newberry Myers),” says Ferreira, a Rhode Island College student. “It was eye-opening having a full load of five patients and taking on a lot of their care myself, but I had Beatrice there at every step.”
The 21-year-old Westerly resident, slated to graduate in December, benefited from Newberry Myers’ nearly 30 years of experience.
Nurse training has evolved in tandem with the clinical workplace, especially in recent decades, moving away from a watch-and-learn model and toward an integrated, hands-on true practice of their acquired academic knowledge.
Innovative Orientation Sets Nurses Up for Success
The challenge of a new job is absorbing and beginning to understand the organization’s culture processes and practices. Not every career, however, can have such a direct impact on the lives and well-being of others as nursing.
The Center for Professional Practice and Innovation at Newport Hospital strives to ensure that all its newly hired nurses get a comprehensive and supportive orientation to help foster their success and meet the hospital’s commitment to zero harm in patient care.
CPPI has existed in different forms through the years at Newport, and in its previous incarnation was known as the education office. The center was redesigned in early 2017 to better reflect the strategic goals of the hospital, handling orientation for new nurses and professional development for existing staff.
The orientation is designed to meet the needs of both recent grads and experienced nurses who are new to the hospital. New hires pair up with a preceptor, and can typically spend 8 to 12 weeks working under supervision. A three-day orientation session begins the experience, covering regulatory requirements, Lifespan and Newport Hospital policies and practices, environments of care, and more.
“Our goal is for our new nurses to be successful, and depending upon where they come from, their needs can vary, so the program is custom-fit to every nurse,” says Clinical Innovation Specialist Elizabeth Bryand, R.N..
The assigned preceptor and new nurse are scheduled together to facilitate a thorough, careful transition to independence. The preceptor can easily identify strengths over time and allow more autonomy in those areas, while working on areas that need shoring up.
During the orientation period, the new nurse attends meetings every two weeks with the preceptor, the unit manager, and Bryand, who acts as a facilitator.
Bryand says, “We try to make sure that they are getting what they need. That involves figuring out what they know, what they feel they need more of, and how we can help them get there.”
Students in the DEU model experience a rapid immersion into nursing practice, quickly moving into monitoring and charting patient progress, dispensing medication, working with patients and families on discharge plans, and coordinating services such as occupational and physical therapy.
Critical Care Internships
Rhode Island Hospital’s critical care internships have played a crucial role in bridging the gap between nursing school and specialized nursing for more than 10 years. Learn more
Jane Williams, Ph.D., R.N., dean of the School of Nursing at Rhode Island College and a Lifespan board member, is a champion of the DEU model. She said the approach was first used in Australia and later made its way to Portland, Oregon, before being more widely adopted throughout the United States.
“We won a small grant from the Governor’s Workforce Board to make connections with our colleagues and learn more about it,” Williams says. “The administration and nursing staff at Rhode Island Hospital saw the value of this from the beginning, and have been great partners.”
Newberry Myers, 59, has been at Rhode Island Hospital for 10 years, and was one of the first DEU preceptors when the first unit at Rhode Island Hospital opened on Bridge 7 nearly eight years ago. She thinks the model gives students a unique opportunity to gain more and deeper experience.
“When we’re one-on-one, they can get right to work,” she says. “When they’re coming on the floor for the first time, it might be a little more scary than when they’re learning in a group, but I tell them about what I do, I show them, and then I watch while they work and grow.”
On The Miriam Hospital’s 3 East, Erin McAlice, R.N., and Joanne Daniels, R.N., have been co-workers for four months, and their easy rapport is evident. When McAlice, 23, started on the unit, Daniels, 32, jumped at the chance to oversee her orientation period, mostly because she already had. In Fall 2016, her last semester at the University of Rhode Island, McAlice was a student in the 3 East DEU, and Daniels was her preceptor.
After graduation, McAlice worked briefly at another hospital, but then saw an opening to come back to The Miriam. She’s not the first DEU student to do so – they’ve had about a dozen in recent memory hired on 3 East and West. Daniels said the benefits of the DEU experience are significant, including expediting the orientation process and allowing the new staff nurse to integrate quickly.
McAlice had been eager to jump into her clinical role as a DEU student. She says, “You know what it’s like to work 12-hour shifts, to have three or four patients, to have coworkers. You don’t have total autonomy because you don’t have a license, but you can visualize yourself there.”
As a preceptor, Daniels says the direct relationship allows her to customize her student’s training, and lets the novice nurse more deeply develop their skills and critical thinking.
“If you’re with a different person every time, you don’t know what they know already,” she says. “With the same person, you’re able to see where they shine and where they need some support. You can work with that and get them past those bumps quickly and easily.”
Williams emphasizes that the preceptors are carefully chosen, screened through recommendations and their expertise on their given units. Further, they have to familiarize themselves with their students’ college curriculum to keep clinical learning consistent with the classroom.
“They grow together,” she says. “It’s a credit to them that in addition to doing their jobs well, they’re taking the time to learn and understand our curriculum, and incorporate it into their work and their teaching.”
And as health care continually changes and innovates, there’s never an end to the learning curve. While precepting Ferreira, and at the urging of her daughter who is also a nurse, Newberry Myers also took a class to broaden her own skill set, studying “Aging & End-of-Life Care” at Salve Regina University.
“I’d say, ‘Cooper, I have to write a paper! It’s been a long time!’” she says with a laugh.