Nursing Residency Program Improves Staff Performance, Retention

Nursing Residency Program Improves Staff Performance, Retention

Geri-Res Program brings new, higher level of learning, mentorship to caregivers.

Paul Bergeron   8/15/2023

Recruitment

​The nursing shortage is real and is being felt in just about every health care provider environment. The shortage is acute in skilled nursing facilities and assisted living communities, which have struggled to gain and retain nurses. Facilities compete for the same workers by raising hourly pay so those companies don’t risk losing out.

Organizations in Wisconsin and Minnesota, however, are on to something. They have begun offering a nursing residency program that not only attracts nurses but improves nurses’ performance levels and incentivizes them to stay.

The Geri-Res program, developed through the renowned Center for Aging Research and Education at the University of Wisconsin-Madison School of Nursing, was launched this year. Offered at organizations in acute care settings and assisted living, the program is gaining momentum.

Residencies are standard in hospitals. Barbara J. Bowers, PhD, RN, FAAN, University of Wisconsin School of Nursing, said some nursing school graduates and nurses in general will only work where residency programs exist. 

“One of the benefits of adopting Geri-Res is that a nurse who is new to long-term care may select a facility with a nurse residency program instead of going down the street to a competitor who doesn't have one, but that pays $1 or $2 more an hour,” Chris Fangboner, vice president of partner ecosystem and digital education, Pathway Health, Lake Elmo, Minn., said. “All facilities are fighting for the same pool of talent so this small investment into the success of their new nurses will deliver them an advantage in recruitment,” he added.

Geri-Res is turnkey, providing organizations with what it needs to implement a world-class geriatric care nurse residency program. The two program components, Clinical Coach and Nurse Resident, leverage a mentor/mentee model to create the best learning environment for new nurse success. The coaches are appointed—often they are the two most experienced nurses within the organization.

The Clinical Coach prepares for a mentor role by going through six learning modules. The Nurse Resident goes through 12 online, evidence-based, self-paced learning modules. Each module is paired with exercises, quizzes, and time with the Nurse Coach. The online format means curriculum modules can be accessed anywhere, anytime. 

Each module is normally completed in a week, and this is the recommendation, Fangboner said, but it is not a requirement. Because Geri-Res may be added to a facility's existing onboarding program, it is flexible enough to be adapted to what the facility already has in place.

The first year, and even sometimes the first month, at the job is terrifying for nurses, Bowers said. “They sometimes don’t know what’s coming and often they have to take on more than they thought,” she said. Coaches can also serve as mentors in the Geri-Res program, Bowers said.

“Providing a residency program creates confidence and comfort for newly hired nurses, especially in that first month,” she said. Geri-Res addresses the transition-to-practice gap often experienced by both new graduates and experienced nurses entering a long-term care practice setting.

Research shows that nurse residency programs Strengthen nurse retention, lower costs, and Strengthen nurse preparedness for safe and competent practice. Traditionally available only in acute care settings, Geri-Res offers the same benefits to long-term care organizations with a residency tailored specifically to nursing in the long-term care practice environment.

The required modules are Introduction to Long-Term Care; Pharmacological Considerations; Resident Quality of Life; Maintaining Mobility; Cognitive Impairment; Communicating with the Team; Communicating with Families; Pain; Cultural Diversity; Skin; Sensory Changes; Infection Prevention; Evaluation and Final Steps; and Nutrition.

Six additional modules are available to nurse residents at no cost and can be taken at their convenience and their choosing: End of Life Care; Urinary Incontinence; Depression; Change in Condition and Care Planning; and Quality Assurance and Performance Improvement.

The program was established through a generous grant from the Margaret Cargill Foundation. “This allowed us to hire experts in so many fields to help create the curriculum,” Bowers said.

The cost is typically charged to the organization: $199 for nurses; $249 for coaches. Participants earn 12 continuing education credits for completing the course. The Geri-Res curriculum is appropriate for new nursing school graduates as well as experienced nurses new to long-term care.

The University of Wisconsin launched eight Geri-Res pilot programs. Fangboner and his team at Pathway have been responsible for bringing the Geri-Res program to the public and to the attention of national and state health care associations.

A mission-driven organization, Fangboner said of Geri-Res, “We want to get this program out there as much as possible. Now that word is getting out, we’re speaking with organizations that have 10 to 60 senior communities in their portfolios.”

Fangboner has signed 27 coaches since March. “This program will grow exponentially as more associations receive grants to help them get started,” he said.

Bowers said that many nursing home directors aren’t fully aware of the high cost of turnover in their communities. “The program has proven so beneficial and in demand that organizations are now using it to recruit nurses,” Bowers said.

Fangboner said, “Nurses need to feel supported while doing their jobs. By joining this program, the organization is showing their nurses that they are investing in them, helping them learn more, and is not just throwing them out there to get their jobs done.”

Bowers, again, said it goes back to the first month—or even the first day—on the job. Coaches teach it, model it, discuss it, and follow up with resident nurses to ensure they are comfortable with what they’ve learned.

Bowers said the training opens new treatment methods and other work skills, helping to fill in the gaps for those nurses who work each day with only what they know and what they’ve learned.

“You’d be amazed at how many new nurses are afraid to speak to physicians,” Bowers said. “The module helps to put them at ease and explains to them what information is needed and how to best present it.” Geri-Res also demonstrates how to share negative feedback with patients, co-workers, and families. “For some, this comes naturally, but for many, it’s a challenge,” Bowers said.

“It’s so important that once nurses start, they keep going, beginning to end. They see that once they take the first few modules they want more, and they want the program to continue,” Fangboner said.

Some organizations’ nurse workforce is made up of 25 percent from outside the U.S. and Fangboner has worked with clients using this as training for English as a Second Language residency program.

“Geri-Res would be very helpful to facility groups that have immigration recruitment programs and for English as a Second Language nurses already here in the United States,” he said. “They know how to care for others but might not be familiar with the unique nature of how it works in the U.S. and might not have communication soft skills.”

Paul Bergeron is a freelance writer based in Herndon, Va.

CPRMC named “Great Community Hospital”

Posted on Friday, August 18, 2023

An exterior view of Carolina Pines Regional Medical Center. CONTRIBUTED PHOTO

Carolina Pines Regional Medical Center (CPRMC) was one of 153 hospitals included in the 2023 Becker’s Hospital Review (Becker’s) listing of “great community hospitals” released on Friday, July 28. Carolina Pines was one of only six hospitals from the state of South Carolina to make the list.

Hospitals recognized in the listing, per Becker’s, are lauded for their “clinical excellence, compassionate care and economic impact on their communities.” Becker’s editorial team selected hospitals for inclusion based on several outside rankings and ratings organizations, including U.S. News & World Report, Healthgrades, CMS, The Leapfrog Group and The Chartis Center for Rural Health.

“It’s quite an honor to make this listing and a nice validation of their hospital’s efforts to advance the health and well-being of their patients and their community,” said Bill Little, CEO of CPRMC. “Our team at Carolina Pines embraces the opportunity to provide highly skilled, compassionate care to those from the surrounding areas who come to us in need. This recognition ‒ much like their quality ratings, their growing list of accreditations, and their many innovative approaches to Strengthen their services ‒ indicates that they are making the positive impact they want to make in their community.”

Becker’s described community hospitals as “vital pieces of the overall healthcare system, expanding care access to patients who might otherwise need to travel great distances or face other barriers to care.” 

CPRMC has a legacy of expanding quality care access to those it serves throughout Hartsville and surrounding areas. For example:

• the hospital continues to use innovative approaches to ensure it is properly staffed, recently announcing its participation in Project BOLD, a program that provides student loan forgiveness to new employees who commit to work at CPRMC upon completing their education;

• in that same vein, it also recently partnered with a local higher education institution, Coker University, to create a nursing school and internship program to function as a workforce development pipeline for the Pee Dee area and the state as a whole;

• in addition, CPRMC recently added on-site dialysis service expansion to better serve an area with higher-than-normal rates of hypertension and diabetes; 

• the hospital is also part of the MUSC Health Network, including its telehealth program that enables healthcare providers across the Network to work together to achieve quality care in a more effective manner than can be achieved independently.

Even prior to this Becker’s listing, the hospital’s pursuit of providing the highest-quality care earned recognition. For instance, CPRMC achieved a Leapfrog Group “A” grade for patient safety in two consecutive Leapfrog surveys through Fall 2022 and received an “A” grade in Leapfrog’s most exact survey in Spring 2023. In the past few weeks, the hospital’s employed Medical Practice also attained recognition as a Patient-Centered Medical Home from the National Center for Quality Assurance as well as Gold Seal Approval® Certifications from The Joint Commission for its Heart Failure Program and its Total Knee and Hip Replacement Program.

Previously, CPRMC earned The Joint Commission’s (TJC) Gold Seal of Approval® for the hospital and laboratory and achieved advanced certification as a Primary Stroke Center. It also recently received Chest Pain Center accreditation from the American College of Cardiology.

“We strive to be the best they can be and offer the right services at the right time to those who come through their doors,” said Little. “We know they are part of a great community and consider it a privilege to have the opportunity to make a positive impact on their community, one patient at a time.”

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