Nurse Residency Programs: Future for Post-Acute Care

The New Jersey Action Coalition, in response to the Institute of Medicine’s recommendation to implement nurse residency programs across all practice settings, initiated a statewide program for new graduate RNs working in post-acute care (PAC) beginning in 2014. To date, more than 100 nurses and their experienced preceptors from more than 50 facilities in the state have completed this education program. The new book, Developing a Residency in Post-Acute Care, that I co-authored shares the experiences, program content and lessons learned from that innovative project.

How can this book help nurse leaders in post-acute settings to meet the challenges they presently face to provide safe, person-centered, evidence-based nursing care? It provides current, ready-to-use education for PAC nurses as well as other caregivers. Nurses in PAC strive to care for increasingly complex patients; adapt to new regulations and financial restrictions; and incorporate patient care technologies previously unknown outside of acute care. The rapid rate of change is unprecedented, requiring continual, stressful and swift improvements in knowledge and skill. Preventing rehospitalization alone requires a nursing staff with proficiency in assessment, early identification of deterioration, and appropriate intervention. Adding to this environment is high nurse turnover with vacancies expected to increase as experienced nurses retire. These events will create a practice gap that nurse leaders will have to fill, much of it with education to insure the competence and confidence of nursing staff.

Clinical safety and competence are always critically important; however, nurses must be knowledgeable and skilled in many areas in order to be effective. For example, teamwork and collaboration are essential to thriving in an interprofessional environment. Expertise in communication is required for all interactions with patients, families and colleagues; and as consumers develop greater expectations for care, communication becomes an indispensable skill. Regulatory expectations for nurses to participate in evaluating and implementing best practices as well as leading performance improvement projects requires education in these areas as well. These are among the topics detailed in Developing a Residency in Post-Acute Care.

The need to intensify nursing professional development in PAC is compounded by often limited resources. Nurse educators with a dedicated role are less common than in acute care, and responsibility for education often falls on someone with multiple jobs. Management, infection control and/or employee health are commonly combined functions, and these may take precedence over education. PAC care settings may not be able to afford subscriptions to print or online journals, and usually do not have access to medical libraries. Even with those resources, the time to research best practices or innovative solutions to problems probably does not exist in the extremely busy life of a PAC nurse leader. The Internet is a vast store of educational resources, but locating and evaluating options can be very time consuming. This book can dramatically reduce the amount of effort spent researching and preparing educational sessions by suggesting content, methods and literature/media sources.

With education come increased nurse confidence, greater accomplishment and the possibility of role expansion. With that, staff engagement and satisfaction increase, yielding the added benefits of improved retention, workplace stabilization, renewed professional energy and a more successful PAC setting.

This story was originally posted on MedPage Today.