Via SmartBrief, comes an article in the MohaveDailyNews reporting on the increasing popularity of internships, residencies, and mentoring programs to maintain nurse retention.
...Many novice nurses like O'Bryan are thrown into hospitals with little direct supervision, quickly forced to juggle multiple patients and make critical decisions for the first time in their careers. About 1 in 5 newly licensed nurses quits within a year, according to one national study.It's funny, I was just thinking the other day about the fact that it's been about three years since I started down this path, and that in three years, if I had simply been given a stack of textbooks and had 2-3 days per week on the job training without clinical write-ups, I would probably have learned a hell of a lot more. Imagine that: 3 days per week for 3 years, plus almost unlimited time to read about physiology, pharmacology, psychology, and other relevance! That would kick ass!
That turnover rate is a major contributor to the nation's growing shortage of nurses. But there are expanding efforts to give new nursing grads better support. Many hospitals are trying to create safety nets with residency training programs.
‘‘It really was, 'Throw them out there and let them learn,''' said University of Portland nursing professor Diane Vines. The university now helps run a yearlong program for new nurses.
...Medical school grads get on-the-job training during formal residencies ranging from three to seven years. Many newly licensed nurses do not have a similar protected period as they build their skills and get used to a demanding environment.
Some hospitals have set up their own programs to help new nurses make the transition. Often, they assign novices to more experienced nurses, whom they shadow for a few weeks or months while they learn the ropes. That's what O'Bryan's hospital did, but for her, it wasn't enough.
So more hospitals are investing in longer, more thorough residencies. These can cost roughly $5,000 per resident. But the cost of recruiting and training a replacement for a nurse who washed out is about $50,000, personnel experts estimate.
...The American Association of Colleges of Nursing and the University HealthSystem Consortium teamed up in 2002 to create a residency primarily for hospitals affiliated with universities. Fifty-two sites now participate in that yearlong program and the average turnover rate for new nurses was about 6 percent in 2007.
...The federal government has jumped on the bandwagon. Since 2003, it has awarded $17 million in grants for 75 hospitals to start first-year training programs.
The National Council of State Boards of Nursing is considering a standardized transition program. It cited a study showing a link between residencies and fewer medical errors, but also pointed to the inconsistency among current efforts.
These government/nursing association programs seem to suggest either that (1) nursing schools are an inherently poor forum for training in a profession like nursing, or (2) nursing schools are simply doing a crappy job. My guess is that the stress should be more on #2. There is not enough recognition of reality in nursing school: viz., daily care planning is simply not done in hospitals anymore, and work loads are maybe 5x as much as clinical loads. Care plans need to either be jettisoned altogether or be a more abstract and managerial tool used/created by the CNS. Oh, and then there's all that reflective learning BS that needs to go, too. Honestly, if you were a patient talking to a nursing instructor, would you tell her you wanted the patients to be more reflective or know med administration more thoroughly?
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