Working to combat an ongoing nursing shortage and high national turnover rates among new nurse graduates, Bothwell Regional Health Center has launched an immersive nurse residency program.
A residency is a stage of training and education after earning a medical degree, most often associated with physician training. Nurse residencies are increasingly becoming the norm for hospitals after a standardized program was designed in 2000 by the American Association of Colleges of Nursing and the University HealthSystem Consortium.
New nurses can experience challenges, including unexpected roles, stress, time management and lack of confidence, and many of them consider leaving nursing soon after earning their degrees. According to several studies over the last 15 years, between 17% and 30% of new RNs leave nursing their first year and between 30% to 57% leave their second year.
Megan Elwood, RN, BSN, CEN, Bothwell’s Nurse Residency program coordinator, said the program is designed to combat those difficulties and help ease the transition from the classroom to bedside care.
“While new nurses get academic training and some clinical experience in nursing school, they can sometimes come to us without a lot of direct patient care,” she said. “That move from classroom to patients can be a big leap. We wanted to flip the script on how we train our new nurses and set them up for success.”
Moving from a previous six-week onboarding to a yearlong program means new nurses have more time for ongoing education and patient care under the supervision of veteran nurses. Residents are assessed individually and receive a training plan designed specifically for them and their clinical skills.
In the program, residents meet with their group twice a month for the first six months and then once a month during the last half of the year. This classroom time is built into each resident's full-time work schedule in departments throughout the hospital.
“In class, we’ll discuss their experiences and what challenges they may be having and learn from each other,” Elwood said. “There will be opportunities to learn from others and use our new virtual reality simulator to practice situations they may not have seen yet.”
The residents will also do daylong rotations in the hospital’s oncology, perioperative services, emergency, critical care and respiratory therapy units.
“These specialty clinicals will allow them to see what happens in other units and how departments work with or are dependent on each other,” Elwood said. “It creates a line of communication and mutual respect for what other nursing professionals do at the hospital.”
Six nurse residents are in the first program that started in January. Three graduated from State Fair Community College, two from the University of Central Missouri and one from Warrensburg Area Career Center.
Mattie Green and Faith Smith both graduated from SFCC in December and recently passed the state exam to become Registered Nurses. While they have taken different routes on their paths to becoming nurses, they both agree on the benefits of the residency program.
“I wanted to be a nurse my whole life, but life happened,” Smith, 45, said. “I didn’t get into health care until 2020 when I started at Bothwell as a CNA and then I got my nursing degrees. The residency program is like having training wheels. The support is great.”
Green, 22, agreed, and said Elwood is an important part of the program.
“Megan is so personable and accessible. If any of us needs something, anything, she’s there to help,” she said. “It’s like having a comfortable blanket.”
Lexi Molina received her bachelor’s degree in Nursing from UCM and did an internship at Bothwell after doing clinicals in Kansas City. She said she joined the residency for the promise of that supportive network.
"I got the most and best experience at Bothwell, and I’m just so grateful,” she said. “Nursing is scary. Lives are in your hands, and things can get messy. I want to be as prepared as possible and knowing we have the support of our group and other nurses means a lot to our confidence.”
The residents recently had a welcome luncheon with unit managers, other nurse leaders and the CEO to share their stories and receive advice. Elwood said this “soft landing” component is key to the program.
“We are not only providing them classroom and clinical education but emotional support,” she said. “Nursing is hard work. There will be good days, and there will be bad days, and we need to celebrate and support each other professionally and personally.”
Currently, 153 Registered Nurses are working in the hospital. Twenty-three are contract RNs working temporarily due to a lack of applicants for 33 RN openings. With a nursing shortage happening not only at Bothwell but nationally, Elwood said a residency program makes sense.
“We believe the program will help us address issues with burnout, increase the odds of retaining new nurses and give us a competitive edge when recruiting other nurses,” she said. “Best of all, it will create great nurses to care for our patients.”
