Published on July 31, 2017

RN Residency Transition Program makes historyRN Residency Transition Program makes history

The Cape Cod Healthcare RN Residency Transition Program made history recently, when it became the first of its kind in Massachusetts to receive accreditation from the American Nurses Credentialing Center (ANCC).

“The ANCC accreditation is the gold standard in professional nursing practice,” said Kathleen Tardy, MSN, RN, director of Clinical Education for Cape Cod Healthcare. “We received the accreditation with distinction, which is the highest level. It is a huge accomplishment and we are very proud of that.”

To achieve accreditation is no easy task and it takes a very large team of nurses and hospital support from administration on down, at all levels, to make it a success. The focus is always to provide what is best for the patient.

“We can demonstrate that we provide excellent patient care because we are looking at the most current nursing research on how that is defined,” said Tardy. “It’s all about the patient experience and every time we meet with our nurse residents throughout the program, we talk about this.”

The 28-week competency-based, rigorous program is for newly hired, novice nurses at Cape Cod Hospital and Falmouth Hospital who do not have acute care experience. They are either new graduates, had a job in a non-acute setting or have been practicing less than one year.

300Cape Cod Healthcare hires approximately 40 novice RNs per year and they are divided into three cohorts with approximately 12-15 new nurses in each group, according to Tardy. Their commitment to the RN Residency in Transition Program includes 315 hours of clinical time on the medical-surgical unit they will be working on and 72 hours of coursework.

“While new nurses come to the hospital with the basic knowledge from their education, their experience with bedside nursing and direct patient care is narrow,” said Tardy. The residency program is set up to provide all of the components a novice nurse needs to learn, gain experience and succeed in their new role.

Hands-On Experience

The program framework is based on the Benner’s model from “Novice to Expert.” The model was developed by Patricia Benner, RN, PhD, FAAN, FRCN, and defines the five levels of nursing, which are:

  • Novice
  • Advanced beginner
  • Competent
  • Proficient
  • Expert

As the novices progress through the program, they incorporate what they learn in the classroom courses with hands-on experiences in the hospital.  A preceptor and educator on their units work together to help them learn and develop the knowledge to assess changing medical situations with their patients, and adjust as they need to.

“Our preceptors are seasoned staff who are constantly at the bedside, meaning an experienced RN is overseeing, evaluating, and reinforcing what they have learned so the novice does well,” said Cheryl Brennan, MSN, RN, senior clinical educator and site clinical coordinator for Cape Cod Healthcare.

ANCC-A

“The patients get the best benefit because the novice is gaining the knowledge and experience of the preceptor that they, in turn, will be able to use over time.”

nurse preceptor
From left to right: Carmen Piroski RN, preceptor for Criscello Luz Roque, BSN, RN

“One of the things we work hard to do in this program is intertwine the American Nurse Association (ANA) standards and the ANA code of ethics,” said Brennan. The Scopes and Standards of practice are the who, what, where, when, why and how of nursing practice according to the ANA.

The ANA describes the code of ethics for nurses as “a guide for carrying out nursing responsibilities in a manner consistent with quality in nursing and the ethical obligations of the profession.”

After the first 12 to 14 weeks, and the nurse novices have demonstrated the required skills on their medical-surgical unit, they work independently under the guidance of their nurse manager and clinical educator. Cape Cod Hospital’s Clinical Education Team includes an off-shift nurse educator who is available as a resource for the novices.

Brennan and the other clinical educators mentor the novices during this phase and continue to be a resource for them as they move forward with their careers.

Falmouth Hospital Origins

One of the requirements of the program is a group evidence-based practice project that is decided upon by the cohort of nurse novices. It addresses an area they have observed needs improvement. The January 2017 group decided to do a project that would provide education about precautions and infection control.

Lauren Seitz, BSN, RN, a novice nurse in the January cohort, and employed at Falmouth Hospital, recently gave a presentation about the project. The goal was to educate visitors, patients and staff about the proper use of the gowns, mask, eye protection and gloves when visiting a patient who is on precautions. She demonstrated putting on the protective equipment and the order of removing them followed by proper disposal.

“When the novice program does a project, they look to see what can contribute to nursing practice, which is everything nurses do for the care of their patients,” said Tardy.

The RN Residency program has grown over the past couple of years but had its origin at Falmouth Hospital about 10 years ago.

“Cheryl Brennan really created the novice program and we give her credit for starting and building the program,” said Tardy.

Another key player was Sarah Provencher, BSN, RN, clinical educator at Falmouth Hospital, who was hired 10 years ago as a coordinator to oversee the new nurses starting at the hospital.

“The program has continued to evolve every year since then,” said Tardy.

Something unique to the novice nurses entering the RN Residency Transition program are their backgrounds. Seitz was a paralegal when she decided to go into nursing. She took the certified nurse aid course and the phlebotomy course at Cape Cod Community College and has worked in various areas of Cape Cod Healthcare including Cape Cod Healthcare Laboratory Services and JML Care Center.

Criscello Luz Roque BSN, RN, is a dentist. He graduated from dental school in the Philippines, his home country. Licensing in the United States would require him to start over and complete dental school before he could practice here.

While Luz Roque had seven years of subacute care experience as a nurse, it didn’t compare to what he is learning now, he said.

“In the RN Residency Transition Program I am really motivated because there is no more expected of me than the RNS who are truly novice. I am making the most of this opportunity to learn,” he said.

“The whole community of Cape Cod Healthcare wants to give us the best support everywhere in the hospitals,” said Seitz. “Everyone wants us to be a success from IV support, to the technicians in diagnostics, to the emergency department and the nursing supervisors.”

“The hospital really invests in our nurse novices, it is all about good patient care,” said Tardy. “If we train our own, they are going to live in the community and take care of each other. It is the ideal.”

[Featured Image: From left to right — Kathy Tardy, MSN, RN, Cheryl Brennan, MSN, RN, Sarah Provencher BSN, RN, “Precaution Penny,”Lauren Seitz, BSN, RN, Melissa Cavanaugh-Meau, RN]