As experienced nursing professional development (NPD) practitioners with backgrounds in academia, we noted a gap in the knowledge and skills of newly licensed nurses transitioning into practice at Sarasota Memorial Health Care System (SMHCS). After surveying multiple nursing students and newly licensed nurses, a common theme of decreased practice readiness caused concern. We also assessed that nursing students craved more education and skills practice time.

Numerous publications examine the challenges of a student nurse transitioning to practice. Boswell and Sanchez (2020) examined key stressors for newly licensed nurses and found lack of knowledge and experience was a main stressor. Jadalla et al. (2024) perceived clinical competence scores were low for students who had altered clinical experience during the COVID-19 pandemic. They did not feel prepared to transition to practice. These challenges have led many organizations to develop successful transition-to-practice programs. As NPD practitioners, we committed to addressing these gaps before the nursing students transitioned to practice. We developed an innovative teaching and learning program structured to assist Sarasota Memorial Health Care System (SMHCS) employees who are also nursing students. The program is called the Sarasota Memorial Health Care System (SMHCS) Learning Enrichment & Apprenticeship for RN Students (LEARN) and enhances their transition into the role of a newly licensed nurse.

The LEARN Program

The LEARN program is a structured program that provides professional development for SMHCS employees who are also enrolled in any nursing school. SMHCS employees may be working in various roles such as Patient Care technicians (PCT’s), lab technicians, pharmacy technicians etc. The goal of the program is to bridge the gaps in nursing school and assist in the transition to becoming a newly licensed RN. The program is facilitated by two LEARN program coordinators who are NPD practitioners in the centralized education department.

The two areas of the LEARN program include educational LEARNing seminars and the opportunity to bridge from a PCT into a nurse tech role where additional skills can be performed once competency validated.,.

LEARNing Educational Seminars

All SMHCS employees who are in nursing school are invited to attend quarterly LEARNing educational seminars. The content of each seminar varies. Topics are chosen based on gaps identified from nursing student surveys as well as nurse residency program coordinator feedback. Examples of topics include: a newly licensed nurse panel, charting basics, developing critical thinking skills, crucial conversations, transition to practice, and more. Twice a year, a hands-on skills fair is offered to those students nearing graduation. This includes how to assess patients promptly, as well as the opportunity to practice skills with the guidance of the LEARN program coordinators.

Nurse Tech Role

Another area of the LEARN program is the opportunity to advance from a PCT role to the role of a Nurse Tech. For those employees in a PCT role, the unit manager has the opportunity to promote a (PCT) who is enrolled in an accredited nursing school to the nurse tech role. The nurse tech may then perform additional skills once they are validated by the program coordinator, followed by competency validation on their unit. These additional skills allow the nurse tech to develop additional skills they will then utilize as a future RN. The skills included in the nurse tech role  are removal of NG tubes, G-tube site care, peripheral IV site dressing changes, suture/staple removal, application of adhesive strips, and skin tear dressing change. These skills were selected by the work group that designed the program and the Florida Board of Nursing (FBON) input on this role.

The LEARN program coordinators collaborate with unit NPD practitioners and our specialty teams program coordinators to provide additional opportunities for those in the nurse tech role. Shadowing opportunities are offered to the nurse tech to learn more about potential areas of interest as a future nurse. The nurse tech can also attend peripheral IV, wound/ostomy, and basic arrhythmia classes to further advance their knowledge in these areas. The nurse tech may follow a nurse who is specialized in areas such as wound care or the vascular access team to learn the team’s role and how they are a resource to them as a future nurse. Our NPD team trains the nurse techs on completing chart audits utilizing resource tools. We discuss the rationale of auditing and the learning that can occur with topics like restraints, CAUTI/CLABSI, etc. The purpose of the chart audit is to allow the student nurse to build critical thinking skills and see the nursing aspects of charting. We also offer fun learning experiences for them, like patient experience Bingo. With this activity, they learn the importance of HCAHPS and patient experience. Once they complete certain activities like answering a call light in less than two minutes, asking a patient how they can make their experience better, and preventing a safety issue for their patient, they mark their cards. The first five nurse techs to complete their Bingo card each week over four weeks win a prize.          

Program Outcomes

Outcomes are limited at this time since the program started in September of 2023. Surveys were conducted after each learning event to ask detailed questions around perceptions of learning needs, confidence, and preparation for transition. There is high satisfaction from learners with 4.9/5 noting increased confidence in their role. 94% strongly agree and 6% agree that the events have provided information to transition to their role as a nurse.

For the first year of the program, there were 2 graduating cohorts between 09/23-12/24. The retention rate was nearly 50%. Several new graduate nurses moved to other states, left the organization for unknown reasons, or received scholarships from other area hospitals. The anticipated retention for our next graduation cohort is 80%.

Areas for Growth

The LEARN program has shown to be valuable in closing the gap in the knowledge and skills of newly licensed nurses transitioning into practice, based on anecdotal information and survey data. After nearly two years of program implementation and multiple methods of gathering feedback from relevant parties, common concerns emerged. From 09/23-12/24 the LEARN program comprised education and skills validation offered to only nursing students hired into the nurse tech role. It was recommended to expand the LEARN program to offer educational seminars for all student nurses employed at SMHCS, providing this opportunity to more employees.

One point of feedback we received from the nurse techs was their difficulty finding time to add the additional skills to their workload. Surprisingly, the educational seminars became more valuable to the student nurses than independently performing the skills they were validated on. The favored education topics in the program were team communication and difficult conversations, transition to practice, charting, and developing critical thinking skills. They also appreciated having time to practice skills to improve their confidence before they transitioned to practice.

Our next steps have included opening the seminars to all SMHCS student nurses. The first LEARNing education seminar of 2025 had favorable feedback. 100% agreed that the event provided them with information to transition to their nursing role. 4.7/5 agreed they even increased their confidence as they transition to their role as a nurse. We plan to continue evaluating the program outcomes and providing additional learning opportunities to all nursing students employed at SMCHS. We have increased learning opportunities in 2025 to five LEARNing education seminars and four skills validation days for the nurse techs.

References

Boswell, C., & Sanchez, L. (2020). Assessing Stressors for Interns: Using the Casey-Fink Graduate Nurse Experience Survey. Journal of Continuing Education in Nursing, 51(11), 516–521. https://doi.org/10.3928/00220124-20201014-08.

Jadalla A, Hardan-Khalil K, Dyo M, Kardously J, Skaff K, Williams M. The perceived preparedness of prelicensure nursing students to transition to practice. Teaching and Learning in Nursing. 2024;19(3):260-264. doi:10.1016/j.teln.2024.04.001