The pandemic upended healthcare in innumerable ways, and one of the less visible ones is how it affected the transition to practice for clinicians who were in school studying to become the next front-line clinicians.
The transition to practice from medical and clinical education was named the No.1 patient safety concern of 2024 by ECRI safety experts.
Hospital leaders told Becker's that while COVID-19 shutting down schools and forcing more virtual and distance learning limited their time to train with peers in person and at the bedside, the transition to practice has always been challenging.
Here is what C-suite executives have experienced in their hospitals and health systems related to this challenge:
Vicki Good. DNP, RN. Chief Clinical Officer of the American Association of Critical-Care Nurses: I would say we were seeing it prior to COVID-19. I think that COVID has exacerbated it to a certain extent. Our educational partners had to make some major shifts during COVID, decrease in clinical time that they could get in the hospitals, and they had to do more simulated training, etc. So hospitals said before COVID that new graduate nurses in particular weren't ready for practice, is the term that people would use. But I think that just got exacerbated even post-COVID because they had such, you know, limited time in the clinical setting.
When you consider these complications and the fact that our training programs haven't increased, hospitals just can't cover everything that needs to be covered, and you also can't have somebody walk out of their educational setting and walk right into the hospital ready to practice immediately.
There are programs out there that are very successful. We need to figure out, how do we replicate this, and how do we spread it? So there are programs called"earn as you learn" where the hospital offers to pay students to come do clinical time in the hospital while they're a student, to get them increased exposure to patients. It also helps them learn the culture of the hospital, learn the interactions with patients, and overall prepares them better to come out of school. And that's a program that hospitals are investing in to try and get them ready even before they exit nursing school.
Sunil Madan, MD. Chief Medical Officer at Luminis Health (Parole, Md.): To address challenges with the transition to practice, we are going back to the basics with them once they get here. It is a process improvement model that we use to structure outcomes. If you put the right structures in place and our processes and standards that already work in place, you will get the outcomes you desire. We're refortifying, redefining, and restrengthening those structures and processes and using technology to help us streamline it to deliver the outcomes we want. We are retraining people, and then we're also using a multitude of other strategies to help the new or younger workforce as well. So whether it's a digital mentorship program for a young worker or longer, in-more-detail mentorships or another innovative practice like virtual nursing. We've launched a virtual nursing program, which is additive to our normal nurses that are already working in staff. The senior nurse that sits virtually helps with tasks or answers questions to support the young workforce.
Kathy Tregear, MSN, RN. Chief Nurse Executive at Beebe Health (Lewes, Del.): I agree that nationally, it is a concern, and here's why. There are still a fair number of new to practice and relatively new to practice folks who may have gone to school during COVID-19, and when folks were doing going to school during COVID-19, they spent probably more time in the SIM lab than they did in the hospital in terms of patient care. And because so much of what we did electively was shut down, people didn't get as robust of an experience.