Faced with an acute nursing shortage, hospitals develop mentoring, internship programs
As the nursing shortage has grown more acute due to the pandemic, hospitals in South Florida are establishing creative ways to mentor and train nurses.
The pandemic exacerbated the nursing shortage when many nurses opted for lucrative traveling nurse jobs, or they retired. At the same time, nursing school enrollment has not kept up with demand, which has grown due to an aging U.S. population.
(The number of U.S. residents age 65 and over is projected to shoot up to 82 million by 2030, up from 54 million in 2021.)
The result: Registered nursing (RN) is among the top occupations in job growth through 2029, according to the U.S. Bureau of Labor Statistics’ Employment Projections 2019-2029. The Bureau projects 175,900 openings for RNs each year through 2029.
NURSING FELLOWSHIP AT MEMORIAL
Memorial Healthcare System began a nursing fellowship in August 2021 to develop nurses to work in its 13 specialty areas, which include surgery, intensive care and oncology.
“Nationwide, the specialty areas of the hospital are the most complex places, where the sickest patients need care and where we had the most vacancies,” said Maggie Hansen, senior vice president and chief nurse executive at Memorial Healthcare in Broward, which operates six hospitals, urgent care centers and a nursing home and has 14,000 full-time employees. “With so many baby boomers retiring and taking all of that knowledge and skill out of the workforce, it was creating an experience complexity gap that we needed to address.”
Due to a competitive market for hiring nurses, Memorial created the nursing fellowship program to recruit nurses as well as develop its employees.
“If we don’t prepare them to continue their growth and move into these new practice areas, then we might not end up with the right level of competence to be able to provide the care that our patients need,” Hansen said.
HANDS-ON COACHING, SIMULATION TRAINING
The program includes class instruction, hands-on coaching with a specialty clinical educator, seminars, evidence-based project participation and simulation training. Nurses can then take the national certification exam in their specialty.
Memorial has 99 nurses studying in the yearlong program, which began with staggered cohorts at all six Memorial hospitals. The first cohort will graduate in August 2022 with six nurses.
The fellowship program will be expanded to include training for clinical educators and infectioncontrol practitioners.
“Clinical educators, who teach the nurses, are retiring so we have to teach nurses to be educators,” Hansen said. “Also, because of the pandemic, we noted a need for infection-control practitioners, which are usually nurses. They are very difficult to find. There are not enough of them. During the pandemic, that became very evident because our life depended on them.
“It is a horrible thing that we are going through with a nursing shortage, but it definitely gives us an opportunity to solve problems and we like that,” Hansen added.
Memorial also created the emeritus nursing program, which began in January. Nurses who have retired from Memorial within the last three years can return on a part-time basis to train new specialty nurses.
“These are retired nurses that are actually missing their work family that want to come back, but not full time,” Hansen said.
“They want to share their knowledge and skill with the new nurses. With all the baby boomers retiring, the nursing workforce is going to be mainly made up of new nurses. The emeritus nurse can be their mentor and guide them to the next step in their career.”
BROWARD HEALTH’S ICU INTERNSHIP PROGRAM
Broward Health Medical Center in Fort Lauderdale also created initiatives to combat the nurse shortage.
“We had a really hard time with COVID,” said Nicole Puleo, clinical specialist in the critical care department at Broward Health. “We had a huge shortage of critical care nurses, especially with many staff leaving for lucrative travel nurse contracts.
“Due to that and nurses retiring due to COVID, we started to think outside of the box of what we could do to help get new staff and quickly.”
n July 2021, Broward Health launched its intensive care unit (ICU) internship program to train new nurses for the ICU.
The 30-week program provides instruction, simulation lab learning, clinical practice, presentations and hands-on training.
The program also incorporated a critical care course from the American Association of Critical-Care Nurses.
Nine nurses graduated from the program in February, Puleo said. The second group of seven nurses will graduate in July, when a third group will begin the program.
“We were getting new grads fresh out of school and had to figure out how to educate and prepare them for this type of
ICU,” Puleo said. “It gets new nurses competent to care for an ICU patient.
“Going into critical care is a specialty, so they have to elevate their care and critical thinking in order to care for those patients,” Puleo added.
“Typically, patients in ICU require ventilatory assistance, such as a respirator or ventilator, if they are not breathing on their own. They just need a higher level of care, monitoring and a lot more work.”
The ICU program offers a support group, with Puleo and fellow Broward Health clinical specialist Paul Bratton meeting with the new nurses every week for the first six months, and following up regularly during the first year.
“We want to make sure any nurse that comes into nursing feels supported and knows they have someone to go to when they have questions,” Puleo said. “That they don’t feel alone and have an avenue to have a mentor as well.”