KINGSTON, R.I. – March 27, 2014 – Sitting in a classroom at the University of Rhode Island’s Providence Campus, the nurses begin sharing their experiences as part of the state’s first nurse residency program. They talk of profound lessons, outstanding mentors and triumphs. Some of their stories draw appreciative nods and smiles. Tears bring helpful suggestions and reassuring pats on the shoulder.
Each Friday in Providence, the residents, all fully licensed registered nurses, learn about the value of support as they recount their clinical experiences and then learn from an expert about evidence-based practices that can lead to full-time jobs. On this day, the residents learn from URI Nursing Professor Marlene Dufault about the critical importance of communication among nurses as shifts change in hospitals and other clinical settings.
As this first round of the residency program nears its conclusion in June, it is doing exactly what it was designed to do—give residents experience in what is called the continuum of care through clinical experiences, both in the acute care setting as well as the community setting, so they are ready to enter the full-time job market.
Eleven of the original 17 members of the group already have jobs, and the remaining members say their various rotations, with the help of their preceptors, have boosted their confidence, given them new skills and helped them become comfortable with new techniques and technology.
The residency program was launched in October of 2013 as a workforce and skills development initiative.
The residency program gives licensed registered nurses additional skills and guidance from preceptors, practicing registered nurses at each clinical site. Participants also receive stipends. Graduates of Rhode Island’s five nursing programs, University of Rhode Island, Rhode Island College, Community College of Rhode Island, Salve Regina University and St. Joseph’s Hospital are eligible for the program. The program focuses on unemployed and underemployed newly licensed nurses.
Rhode Island joined Connecticut in 2012 as one of only two New England states and 20 nationally to receive funding from the Robert Wood Johnson Foundation’s “The Future of Nursing: Campaign for Action,” a $3 million joint initiative with the AARP.
“This program is the result of countless hours of development by nurse experts from academia and practice settings throughout Rhode Island, and one very special consultant from Massachusetts,” said Sandra S. Phillips, director of education at Kent Hospital and project director of the Passport to Practice Nurse Residency program.
“Everyone involved is extremely pleased with the success of our first cohort of residents,” adds Phillips. “Health care employers in the state have benefitted from the additional experience and nursing knowledge the program offered the participants and the residents have gained confidence and experiences that will support them throughout their careers. Being the project director has been one of the most rewarding experiences of my entire career.”
The success stories are only beginning in Rhode Island.
Linda Hancock landed a full-time psychiatric nursing job at Rhode Island Hospital just six weeks into the nurse residency program.
“It enabled many in the program to get back into nursing after having been out of work or out of school for a while,” said the Cumberland resident, who earned her nursing degree at RIC in 2013 after having run a business for 20 years.
Her first and only clinical rotation in the nurse residency programs was with The Miriam Hospital.
“It was in a pre-mildly acute unit where I primarily treated elderly patients who need care. “I was able to practice my skills, including providing intravenous medications, antibiotics and the full range of care.”
Carolee V.C. Larimar, of Providence, began a full-time job in February in the neuro-intensive care unit of Rhode Island Hospital. A former holistic health practitioner with numerous certifications, she earned her bachelor’s degree in nursing at RIC in 2013.
“This program allows you to more skillfully ease into practice, and obtain skills that you need your license to carry out,” Larimar said. “This residency shortened my career path by allowing me to gain experience as a new grad in critical care. Normally, it takes several years to obtain the position that I just started. It’s amazing that I am able to start my career in my first choice specialty at Rhode Island Hospital. Like so many other career driven nurses, striving to make a difference and obtain a rewarding position, I was anticipating having to leave Rhode Island. I was packing boxes for New York City when I received news of acceptance into the Rhode Island nurse residency. This program allowed me to stay in Rhode Island and obtain a highly rewarding position, “Larimar said.
The program has also been helpful to younger nursing graduates.
“The biggest thing as a novice nurse is building your confidence so that you can deliver quality care,” said Leeann Moran, a North Kingstown resident and 2011 graduate of the University of Rhode Island’s College of Nursing who delayed entering the field because of family commitments.
During her rotation at the Thundermist Health Center in West Warwick, she provided immunizations and treated a wide range of patients. She worked with preceptor Todd Kirschhofer.
“I am a fully-licensed, fully qualified registered nurse, but with Todd as my preceptor, I could ask questions on the spot,” Moran said.
“She was great,” said Kirschhofer. “She handled phone triage and follow-up work with patients. We moved her around a lot, including having her work at Thundermist’s school-based program at Deering Middle School. Leeann is eager and she has the initiative.”
Nurse residents who have been enrolled in the program since September have to complete four rotations at hospitals, long-term care facilities, community-based clinics, developmental disability centers, home care agencies and free clinics.
Registered nurses Mike Stern and Anny Lopez, both of whom earned their associate’s degrees in nursing at the Community College of Rhode Island, both of Providence, had rotations at Care New England’s Visiting Nurse Association operation in Warwick.
Stern visited and provided hospice patients with home care, while Lopez visited patients as part of her community health/therapeutic rotation. Both were struck by the poverty of some of their patients, but were determined to provide compassionate, quality care.
Stern’s preceptor, Chris Kelly, said the partnership between Care New England’s Visiting Nurse program and the residency program is effective for both.
“One-on-one is the best way to learn,” Kelly said. “Critical thinking, and figuring out what to do when you are the only one at the bedside is so important to visiting nurses and the residents who are learning in this environment. Our patients adore (Mike) Stern. He is objective, and not afraid to ask questions.”
Stern said every experience makes him a better nurse.
“In hospice nursing, you are caring for someone who is at the end of life, and so that encompasses all of the spiritual and emotional aspects of care. My job is to help them get the most of their time. It’s very humbling because they have opened their lives to me.”
Lopez worked with preceptor Sandra Mann during her community health rotation.
“You assess the entire patient,” Lopez said, “and that includes hygiene needs, smoking, blood pressure and many other areas. And it’s not just about the patient. It’s about their environment and their families. Are they eating right? And it’s all about documentation.”
Other members of the residency program and their hometowns are:
Amanda St. George, Barrington; Jennifer Jennings, Warwick; Laura Boucher, Providence; Emily Burton, North Kingstown; Tami Tarbox, Warwick; Gladys Ansah, Providence; Janell Danzer, Coventry; Lynda Plante-Dalpe, Cranston; Simone Tessier, Cranston; Livia Graves, Cranston; Samantha Ohsberg, Rumford, and Madelyn Maher of Middletown.
Additional background on the nurse residency program:
Rhode Island’s program is unusual in the United States, as most are affiliated with specific hospitals or agencies.
The $600,000 initiative was funded by the following agencies and groups listed here in alphabetical order: Blue Cross Blue Shield of Rhode Island, Care New England, Community College of Rhode Island, Governor’s Workforce Board Rhode Island Innovative Paternships Grant, Lifespan, Rhode Island Center for Nursing Excellence, Rhode Island College, Rhode Island Foundation, Rhode Island State Nurses Association, Robert Wood Johnson Foundation State Implementation Program Grant, Routhier Foundation, Salve Regina University and University of Rhode Island.
Lynne Dunphy, professor and interim associate nursing dean at URI and co-leader of the state’s action coalition, and the URI Foundation successfully raised additional funds from other participating agencies and groups. Randi Belhumeur, who earned her master’s degree at URI in food science and nutrition, is the nursing residency’s program coordinator.
Leeann Moran, a North Kingstown resident and 2011 graduate of the University of Rhode Island’s College of Nursing, works with her preceptor, nurse Todd Kirschhhofer, as part of her residency rotation at Thundermist Health Center in West Warwick.
Carolee V.C. Larimar, of Providence, who began a full-time job in February in the neuro-intensive care unit of Rhode Island Hospital, talks with fellow nurses residents about her experiences with the nurse residency program. A former holistic health practitioner with numerous certifications, she earned her bachelor’s degree in nursing at RIC in 2013.
Registered nurses Mike Stern and Anny Lopez, center, both of whom earned their associate’s degrees in nursing at the Community College of Rhode Island, both of Providence, completed rotations at Care New England’s Visiting Nurse Association operation in Warwick. The preceptors for their residency rotations at Care New England were registered nurse Chris Kelly, left, and registered nurse Sandra Mann, right.
Randi Belhumeur, left, who earned her master’s degree at URI in food science and nutrition, the coordinator of the Passport to Practice, a statewide nurse residency program, and she talks with members of the first cohort that is wrapping up its first year. Residents from left are: Gladys Ansah, of Providence; Mike Stern of Providence, Tami Tarbox of Warwick, Emily Burton of North Kingstown and Laura Boucher of Providence.
URI photos by Michael Salerno photography.