With the ongoing global nursing shortage — and turnover among bedside nurses trending ever higher — training new nurses has become both more challenging and more important.
“Nursing is synonymous with caring,” says Jackie McCready, director of professional practice programs for education at The Johns Hopkins Hospital and Johns Hopkins Bayview Medical Center. “But that means we have to care not only for our patients, but for our nurses. Our new hires have to feel that we are looking out for them, that someone is paying attention.”
Last year, two ambitious pilot programs in nursing education were launched at Johns Hopkins. One is a newly centralized and updated program to identify, train and provide ongoing support for gifted preceptors, the nurses who traditionally provide one-on-one guidance during the first weeks a nurse spends acclimating to a new job.
The other is an initiative to train experienced nurses to act as coaches for new nurses who have completed that orientation and are working independently. “These new nurses were feeling alone out there,” says Eleni Flanagan, director of nursing for the departments of medicine and of radiology and radiological science, who helped spearhead the coaching program.
Flanagan and her team recruited and trained nearly 20 experienced nurses from The Johns Hopkins Hospital and Johns Hopkins Bayview using case studies to demonstrate how coaching can be done most effectively.
“We were very intentional about calling them coaches because, unlike mentors or preceptors, they are not showing the way — they are asking questions. ‘Where can you look up that policy or procedure? Let’s look it up together. Let’s look at your assignment and explain to me your priorities.’”
Flanagan says the coaches completed the training “feeling really excited. And something we did not expect was that training nurses to be coaches could help with retention, because they now feel empowered to help others and change the practice of nursing.”
Empowering nurses is also what drives McCready. She and her team of nurse educators were charged with creating a single preceptor training program relevant to all units, updating it to reflect the best evidence-based practices and overhauling new nurse orientation to help preceptors more systematically identify areas where their orientees might be struggling.
Last year, they launched monthly classes, alternating “novice” classes for new preceptors and “advanced” classes for more experienced preceptors who wanted to practice their precepting skills. The team also introduced hourlong, live webinars to answer preceptors’ most pressing questions. Produced quarterly and recorded, they are available to everyone in the health system.