Simmy King DNP, MS, MBA, RN-BC, NE-BC, CHSE, is the Chief Nursing Informatics and Education Officer at Children’s National in Washington, DC, one of the top-rated children’s hospitals in the country. I recently had the opportunity to sit down with Simmy to talk about COVID and how it’s impacted Children’s National’s Transition to Practice program for nurses – a year-long program that enables nurses to transition from an academic learning environment to a clinical setting.
Floros: What is the environment like now at Children’s National, given COVID, and how has it impacted your Transition to Practice program?
King: Children’s National has had their Transition to Practice program in place for many years. Since 2001. We were recently accredited by the American Nurses Credentialing Center for our Transition to Practice program. This is a robust, year-long program that enables the nurse to seamlessly transition from their academic learning environment into their clinical, practice-based setting. Since the onset of COVID-19, we’ve seen a disruption in academic nursing school programs. Schools shut down and clinical placements were stopped. Hospitals were forced to rethink how they could reintroduce students into a clinical environment to meet the clinical learning requirements.
We quickly realized that that disruption and lack of clinical learning was going to significantly impact the Transition to Practice for nurses graduating during the summer and fall. We needed to think about what to do for our Transition to Practice program to meet the learning need that would be lost by not having the end-of-the-year practicum experience, or the clinical learning experience that would have augmented their learning as they prepared for their new job.
So, we regrouped, and we started to think about how we could provide the missing pieces.
One of the first things we did was to adopt a program called vSim. This is an interactive, computer-based learning simulation program. vSim was designed to enable us to identify gaps in learning for our newly licensed registered nurses. We could quickly assess clinical reasoning or critical thinking gaps and then, create a process in which they would feel more comfortable discussing what was missing in their clinical practices.
So, during that first week of orientation nurses in the Transition to Practice program would complete two modules within the vSim program. At the end of the week, we held guided debriefs. What we heard from the nurses was that what they had learned in school was being reinforced. They didn’t feel there was a significant gap. It helped with their confidence and comfort level in their very first week. It also helped us understand what was missing as we started to also think about how we were going to augment the year-long curriculum as well.
Floros: We’ve talked about attracting and retaining nursing talent previously. And you’ve mentioned that the Children’s National Transition to Practice program is a really important component in the recruiting process. You engage with nursing students early and have them come to the hospital. And you continue your engagement to the point that when they graduate, they have positions. If I remember correctly you said that the nurses with whom you engage earlier in the process have higher retention rates and really thrive in your health system.
King: Yes, that is true and it’s a great point to bring up. I like to use the phrase we’re “preserving the pipeline,” and it’s been especially critical during the COVID pandemic. Simulation is a great way to bridge the gap we’ve had during COVID – whether it’s interactive e-learning or high-fidelity simulation. But the experience in the practice-based setting is so vital.
We knew that it was very important for students, still in their academic settings, to continue their clinical learning experience in a practice-based setting. Especially as they near graduation. What we learned is that those individuals who do participate in a summer immersion program or have student nursing roles within an organization such as a patient care tech or a safety attendant, have much higher average length of employment rates. We have data, more than three years of data, that highlights this. There is less turnover with individuals who had had previous experiences in the hospital environment, specifically our hospital environment. So, we believe strongly that this type of program is essential. We were one of the few hospitals in the country, to continue our LAUNCH program.
Another creative approach we launched last fall is our Pediatric Virtual Learning Series. Using the simulation team we took a few topics that our students highlighted over the summer – the principles of documentation, managing early escalation, and code response. We created and offered a four-part series for our nursing students and faculty. There were more than 70 students participate and six faculty in these one-hour simulations with debriefs and pre-learning.
The response was so positive that we’re preparing our next series for the spring. Our plan is to make these available to the schools for future semesters and students. We really do think that this disruption in learning and the educational framework within nursing is opening new innovative and creative ways for academic practice partnerships.
If you would like to hear more from Simmy King and CJ Floros, here’s an excerpt from their discussion on retention. Next week we’ll continue our Q&A session with Simmy King in Part 2 of this blog series.