Tuesday, December 8, 2020
A graphic of a person holding their head with their hands

Now that we have discussed strategies for gaining buy-in from residents, let’s address the ‘busy battle’.  New graduates are coming into practice with a loaded plate.  They have mandatory training requirements, meetings, call shifts, shift pick-ups, many are going back to school, and all have a life outside of work.  The idea of adding one more thing to their already full plate is no doubt, completely overwhelming.   

I think that all of you nurse leaders out there can totally relate to what this feels like.  You have likely even used these same excuses when your boss has approached you about doing one more thing.  We are all guilty of making assumptions about a request before we even know the whole story.  New graduate nurses are no different. Not only is it important to know why we are being asked to do something, but it is important that we know exactly what will be expected of us and our time commitment.  

The IONRP models a learner-centered approach using a variety of techniques that allows for flexibility in learning. This innovative approach to nurse residency allows the residents to complete the program in small amounts of time, cutting down on the non-productive time away from the unit and improving the nurse's ability to complete the necessary work at their convenience.  Participants enrolled in the program receive didactic content through online modules when it is convenient for them. Next, they think about how this information is showing up in their practice using their Transition Journal. Followed up by discussion of their experiences with their peers during cohort discussions.  During the cohort discussion they set goals for improvement, work their scheduled shifts taking action on those goals, and receive ongoing feedback from mentors while they work.  

By dividing this program into small manageable bits of time, retention of knowledge and skills is attained, and the battle of being too busy is avoided.  Consider these 5 ways in which flexible and convenient learning can work for your residents:  

1. Home or work?  

Do residents have to do these program components from work? Or can they do it from home?  Strategize with the new graduate to creatively block out time at work or home depending on organizational policy and the resident’s life situation. Giving the resident choices will help them feel in control and allow a balance between work and personal life.   When they get to decide they may be more likely to commit to the time needed to put their nursing career on the right track, a win for them and your organization.   

2. Before, During, After, NOT Extra? 

If your organizational policy requires completion of the program components from work, think about how you can give them choices there too.  Can residents incorporate the program activities into their daily routine?  Can they arrive a little early, stay a little late, or even take advantage of downtime or low census? Consider all the ways in which the new graduate can complete the work required without making it feel like it is just one more EXTRA thing to do.     

3. Best of Both Worlds 

With the mix of activities completed in the program the resident might benefit from the best of both worlds.  There might be some things that work well for them to do at work, but other components that are better suited when they have quiet time at home or after their shift.  The modules can be bookmarked so the resident can come and go throughout their shift.  Whereas journaling might be a great activity for them to do when it is quiet, and they really have time to think about their learning.  This might be something they prefer to do at home or after a shift.  

4. One Size Doesn’t Fit All 

Check in with your residents and learn more about what they have going on in their life.  Do they have kids? Are they going back to school? Working a second job? Caring for aging parents? On a unit with extremely high census? The program is only as flexible as the employer. What works for one resident might not work for another.  Check-in frequently with your new graduates to make sure they are managing their time and accomplishing the activities each month.  Depending on what is happening in their world things may need changing along the way.   

5. Sacred Time 

While this program thrives on flexibility there is one component that’s sacred, the cohort discussions.  One of the biggest roles for nurse leaders in this program is to ensure that the designated time for the cohort discussion is a scared time. Residents should not be pulled to patient care or scheduled to work during the scheduled cohort discussions.  Not only does this place undue stress and pressure on residents to complete activities but it also sends mixed messages leaving the new graduate wondering…Is it really that important?  

In the ‘battle of the busy’ breaking learning into easily digestible segments and providing flexibility and choice to the learner when it comes to when and where learning occurs, might be just want you need to get better engagement and overall results from your nurse residency program.

Nicole Weathers, Program Manager, IONRP nicole-weathers@uiowa.edu

& Lori Forneris, Apprenticeship Program Coordinator, IONRP lori-forneris@uiowa.edu