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Nurse Residency: 7 Sins of Nurse Leaders

I have said it before, but I will say it again … “buy-in and support from all levels of nursing leadership is essential to the success of a nurse residency program.” Specifically, the nurse manager directly over the resident(s) participating in the program. It doesn’t matter if you are paying $1,000 per year to run a program or $100,000 per year, if the nurse manager doesn’t show their support for participation in the program, the program will not be successful. Nurse managers play a substantial role in whether or not the resident engages and whether or not learning occurs. If a nurse manager chooses not to let their resident participate in residency class whether in person or online, then nothing can be gained and transferred back to the unit in which they are employed. The nurse manager’s role is to ensure the resident is made available to attend the residency discussion, support the process, and help to minimize anything that might hinder their ability to participate and want to engage. I recently read the book titled Webinars with Wow Factor by Becky Pike Pluth. They identified several “sins” that managers can commit that can destroy the learning process when it comes to online learning. As I was reading this, I couldn’t help but think how much this applies to nurse residency programs in general as well. Here are seven sins to consider:

1. Expecting the program to solve all of life’s problems
Nurse residency programs have been proven to help with retention, comfort, confidence, and job satisfaction while increasing competence, but it won’t solve all your unit problems. Healthy work environments are also an essential component to achieving those desired outcomes. If the unit environment doesn’t welcome, support, and challenge the resident, you will continue to have problems in those areas regardless of how great your residency program is. Work to ensure your unit is one that is safe, empowering, and satisfying.

2. Not holding residents accountable
Many times residency facilitators feel helpless because while they are responsible for facilitating the program, their hands are often tied when it comes to leverage for accountability. Facilitators can report to the managers, but then if there is no follow through from the manager, behavior will not improve. If managers do not hold the resident accountable for attendance, engagement, and participation from the very beginning, the residency facilitators will be fighting an up-hill battle for the duration of the program taking away from the learning that could be occurring. Expectations must be set and enforced by the manager from day one of the program. 

3. Putting the program down
Sharing negative opinions about the program, content, or facilitator and making the resident feel as though attendance isn’t all that important will destroy any chance at positive outcomes. It is hard enough to make residents available to attend and sharing negative opinions adds additional barriers for the residency coordinator to overcome. Always speak positively about the program and get the residents excited to attend. Your support will set the tone for everyone involved.

4. Not following up
After the residency discussions, nurse managers infrequently follow up to discuss ideas on how to implement the learning and strategies in their daily practice at the bedside. This is a mistake because it doesn’t encourage the resident to transfer their learning back to the bedside. Check in with your resident at a minimum of once per month and hold them accountable for transferring knowledge into action.

5. Failing to celebrate a resident’s achievements
It is not just a preference of the millennial generation, let’s face it, all employees regardless of the generation like to be recognized for a job well-done. Essentially, we are asking/requiring new graduate nurses to give us one more year of their life to dedicate to the growth and development of themselves as nurses. While professional development is a lifelong process, there is most definitely an extra degree of time commitment they must meet during participation in a nurse residency program. Recognition of their participation, achievement, and movement towards the next level will increase excitement surrounding the program and help to promote engagement.

Specifically, when it comes to residents completing the discussions in the online environment, here are some additional sins identified in the book ‘Webinars with Wow Factor’ to consider:

6. Not providing an uninterrupted area for the webinar discussion
Hovering over the resident during webinar discussions does not help residents better participate in the discussion. Walking by the area where the residents is completing the discussion too many times or having the resident complete the discussion in a public location where others are in and out will make the resident conscious that he/she is being watched. Interruptions are also a no-no. If your resident is in the building during the webinar, it does not mean it’s okay to interrupt. All these actions increase stress and tension leading to retention going out the window and a reduction in overall participation. Keep your distance and give the resident a quiet, uninterrupted location to complete this portion of the program so he or she can breathe and enjoy the process of learning online. 

7. Having multiple residents share
I know it might be tempting to just let the residents sit at the same computer and interact as one person, but it can take away from the online learning experience. Having one resident man the computer all while the others sit back isn’t engaging and doesn’t enhance learning. Let each resident fully participate; type in the chat box, use the microphone, and talk in separate breakout rooms. The ability to apply the content is associated to their participation in the discussion activities.

While these are directed towards managers, the same holds true for other levels of leadership in the organization. Each leader plays a role in promoting and supporting the program. If residents are hearing the same message of what it is they will gain if they fully participate their perception of the time spent will be positive.  

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

Posted On: 
Oct 17th, 2018