It’s well known that both nationally and internationally, we are facing a looming nursing workforce shortage. There is a multitude of data that points to a current nursing shortage and forecasts this will continue and, indeed, worsen in the future.
At Stony Brook, we have successfully created strategies to mitigate the impact of the national nursing shortage. In this episode of Healthcast, experts from Stony Brook Medicine will discuss some of the ways we’ve been able to achieve this, including a deep dive into our Nurse Residency Program.
The Experts
- Carolyn Santora, MS, RN
- Katherine Lewin, MS, RN, NPD-BC, CCRN
- Meghan Doelger, DNP, RN, CCRN
- Brenda Janotha, EdD, DNP-DCC, ANP-BC, FNP-C, FAANP
What You’ll Hear in This Episode
- 00:00 Opening and Introductions
- 3:25 Impact of evidence-based practice and nursing professional development on the current nursing workforce and the future of nursing
- 5:25 Stony Brook’s Nurse Residency Program
- 10:45 How evidence-based practice is integrated into Stony Brooks’ Nurse Residency Program
- 14:35 Structure for nursing research at Stony Brook Medicine
- 16:30 Being a staff nurse at Stony Brook
- 19:20 How does the Stony Brook School of Nursing prepare students for the transition from academic to practice?
- 20:00 What the Stony Brook School of Nursing has to offer students + the partnership between the School of Nursing and Nurse Residency Program
- 21:30 What it’s like to be a resident at Stony Brook Medicine
- 25:30 Closing Remarks
Full Transcript
00:00 Opening and Introductions
Announcer
Welcome to Healthcast, where leaders and experts from Stony Brook Medicine come together to discuss a range of topics from leadership and strategic planning to patient care and the inner workings of a successful health care system.
Carolyn Santora, MS, RN
Well, hello and welcome. My name is Carolyn Santora. I serve as Chief Nursing Officer for Stony Brook University Hospital. It’s well known that both nationally and internationally, we are facing a looming nursing shortage. There’s a multiple of data pointing to a current nursing shortage, and it forecasts that this will continue and indeed worsen in the future.
There are various reasons for this. An aging workforce whose retirement is outpacing entrance into the field, a lack of faculty that restricts the numbers of undergraduate nursing students, and an increasing demand for health care from an aging population and chronic diseases.
At Stony Brook, we successfully created strategies to mitigate the impact of the national nursing shortage, resulting in a record low in nursing turnover and a vacancy rate that’s currently less than 5 percent, which puts us in an elite 5 percent of hospitals nationwide with that low of a vacancy rate.
How have we done that? Well, by striving to have a safe, empowering and healthy work environment, and by supporting staff to practice at the full extent of their license and their education. We’re also extremely lucky to be a hospital associated with a school of health professionals who are educating the workforce of the future.
I have with me today three nurse leaders who will speak to some of our programs. I would first like to introduce you to Katherine Lewin and Dr. Meghan Doelger. And later, we’ll be joined by Dr. Brenda Janotha. She’s the Associate Dean of Academic Affairs for Stony Brook School of Nursing.
Meghan, could you introduce yourselves to our viewers?
Meghan Doelger, DNP, RN, CCRN
I’m Dr. Megan Bolger. I’m the nurse scientist at Stony Brook Medicine. I lead nurse research and evidence based practice for the hospital, and I collaborate with the Nurse Residency program to help the nurse residents to complete an evidence based practice project during that first year. I’m the co-chair of the Nursing Science Council, which I founded, which leads research and EBP in the hospital. And that’s kind of my role in a nutshell.
Carolyn Santora, MS, RN
Thank you. And Katherine, tell us about yourself and your role.
Katherine Lewin, MS, RN, NPD-BC, CCRN
Hi, I’m Katherine Lewin, and I’m the coordinator for the Nurse Residency program here at Stony Brook University Hospital. I work under the Department of Nursing Professional Development and Education, and my title is a Nursing Professional Development Specialist. My background and specialty is in nursing professional development.
And clinically, prior to becoming a Nursing Professional Development Specialist, I focused on critical care. I’ve worked very closely with departments throughout the organization. Our inpatient units, as well as our School of Nursing and Meghan, as well as our nurse scientists.
3:25 Impact of Evidence-Based Practice and Nursing Professional Development
Carolyn Santora, MS, RN
So, Katherine, that’s great. Can you tell us how your department actually impacts the current nursing workforce and the future of nursing?
Katherine Lewin, MS, RN, NPD-BC, CCRN
Yes. So nursing professional development plays a huge role within the nursing profession. Here at Stony Brook, from day one, our department works with our new graduate nurses and new nurses that are hired into the institution. As a specialty, nursing professional development focuses on many key things to retain and recruit nurses. One of those things is orientation. Another thing also is transitions to practice and partnering with our schools of nursing, as well as content experts within organizations to help recruit and retain the best nurses, and also to provide them with the education that they need to be successful within the profession.
Carolyn Santora, MS, RN
Meghan, same question for you. How do you and your role impact our current nurses and the future of nursing?
Meghan Doelger, DNP, RN, CCRN
Thanks, Caroline. So I really want to help nurses to use evidence in everything that they do in practice. So we want to make sure that it’s kind of the intersection of what the best research shows as well as clinician and patient preferences.
I want them to have all that information accessible when they’re taking care of a patient at the bedside. So I work very closely with the nurse residents during their first year because one of the expectations during that program is that they learn how to use evidence based practice. So we actually develop a project during the course of that year to improve some sort of problem that they see with their practice.
So it kind of makes them feel empowered, not just to show up to work every day, but also to take something, and even though they’re new to practice, to be able to improve the care that they provide to their patients.
5:25 Stony Brook’s Nurse Residency Program
Carolyn Santora, MS, RN
So these nurses actually can impact on the future of nursing and help create the nursing workforce of the future. That’s really great.
Katherine, can you give us an overview of a Nurse Residency program as a program that attracts many new graduates? So tell us about that, about the program.
Katherine Lewin, MS, RN, NPD-BC, CCRN
Sure. So our Nurse Residency program here at Stony Brook University Hospital is over 20 years old. The program is a 12 month program. We enroll every newly licensed nurse that meets specific enrollment criteria. So it needs to be the nurse’s first RN role, so they cannot have any other RN experience. And also they have to have graduated their pre licensure program within the past 12 months prior to hire. So anyone that meets that criteria that’s hired here is enrolled in the program.
So as I said, it’s a 12 month program. We provide a curriculum supported by our partner, an RCN, which is an evidence based curriculum. Which allows us to really add on to what those nurses have learned in their undergraduate programs. So we really pick up where nursing school has left off, and the program not only delivers curriculum content that’s evidence based, we also use a model of peer support for nurse residents in their cohorts to support each other through the challenges that they may face during this first year of practice.
So one of the components of our residency program, as Meghan mentioned, is an evidence based practice or quality project. So that is an initiative that we work on after the third class, through class 12. So we work on that as well as providing the residents with a lot of support, discussing what they’re experiencing related to the curriculum and the content that we’re talking about.
But also we provide them support with different types of learning modalities. So for example, we have a seminar that’s focused on cardiac arrest and code blue. Within the program, we actually provide an interprofessional simulation experience in partnership with the School of Nursing and our Rapid Response team to support our nurse residents to learn what to do in those situations.
In addition, we’re really fortunate as well. We have classes in-person, all 12 classes. It is an eight hour seminar or class day, but we also have support on the units for our nurse residents as well. So the program itself runs a curriculum of 12 classes over a full year with those practice requirements. But we also follow our nurse residents in the clinical field.
Carolyn Santora, MS, RN
There are nurse residencies all over the country. What makes our program unique?
Katherine Lewin, MS, RN, NPD-BC, CCRN
Thank you, Carolyn. That’s a great question. After just attending the National Nurse Residency Conference, I think we can highlight a few things that really make our program unique. Number one is how long standing our program is. The program, as I mentioned before, is over 20 years old, and we were one of the first five programs in the nation over 20 years ago when nurse residencies were just being conceptualized.
So that alone makes our program stand out. In addition, we are an accredited program, and we’ve been accredited since 2012. So that keeps us up to date with all the best evidence, with what the requirements are to maintain a program that really supports our nurse residents.
In addition, the fact that we have an eight hour class or seminar once a month – for that to have that in-person provided on work time really stands out. Many organizations are doing much shorter seminars or classes for their nurse residents, which really doesn’t allow you to fully explore all the concepts of the curriculum as well as provide the peer support that’s needed, and also the time to work on those project initiatives.
The other thing that really makes our program stand out is the partnership between our department and nursing professional development and our content experts throughout the organization.
So our program runs on a content expert model, meaning that whatever is being presented or facilitated in class is facilitated or presented by that content expert. So Stony Brook being such a large organization with so many different departments and disciplines, really allows our nurse residents to network with individuals throughout the organization. And that includes Meghan as our nurse scientist, and also the support they receive on the units.
So I work very collaboratively with our unit facilitators or nurse specialists to help support the nurse residents, and their expertise is also utilized within the program.
And then additionally, one other thing that makes our program stand out is the fact that we do have an academic partnership with the School of Nursing here, which is really unique to our program. It’s a best practice and it’s also a piece of our accreditation, and something we’re really fortunate to have here at Stony Brook. That allows us also to have content experts within the School of Nursing to help facilitate residency, to help support our evidence-based practice and quality initiatives. But also it allows for us to utilize those resources within the School of Nursing.
So the latest technology, classroom space, anything that you could think of, we have at our fingertips.
10:45 How Evidence-Based Practice is Integrated into Stony Brooks’ Nurse Residency Program
Carolyn Santora, MS, RN
Wow, that’s so impressive. Meghan, you heard all of this and a lot of what she said also focused on evidence-based practice and how we bring that into the curriculum. Can you describe how you interface with the residency, for the evidence-based practice projects that you might bring there and how you work with those residents?
Meghan Doelger, DNP, RN, CCRN
Sure. But I first have to add, Katherine, that you do an amazing job of listening to the residents and seeing what they want, and adding new pieces to the curriculum every year or two.
So for example, I think a couple of years ago I had a doctoral student who was working on a simulation for de-escalation, and the nurse residents really wanted to learn how to do that. So Katherine worked with her to integrate that into the curriculum also. So I’m really impressed by that.
Just to go back to the evidence-based practice project, the School of Nursing also works with the residents to give them an intro to EBP. And then I meet with the residents most of the time after that.
So we kind of do project development and we do experiential learning. So they select a topic, they do a literature search, they synthesize the evidence, and then they make some recommendations for a practice change. They get to sort of the point of a project proposal once they’re finished with their residency, and then we take it from there.
So they graduate and then there is one project per cohort that’s selected to go to the Nursing Science Council, which I run, and then we help with the implementation piece of it. So some of the experts from the Nursing Science Council who are more experienced with evidence-based practice, they help the nurse residents to make that a reality, to carry it out and to implement their projects.
Carolyn Santora, MS, RN
Can you actually describe one of them? Just one of the evidence-based practice projects that have come to fruition? And it may have actually changed practice here.
Meghan Doelger, DNP, RN, CCRN
Sure. Okay. So it’s hard to pick one, but I have a project that I really like that’s in the works right now. So this is a difficult IV access project. So it’s better identifying patients who come in who are at risk for or who have difficult IV access.
There’s a growing body of evidence that patients who come in, we shouldn’t just stick a peripheral line in them. We should actually try to assess how difficult it’s going to be to get the line in and actually, the evidence really recommends using ultrasound guided IV placement as a first line for those patients.
So we found that in the literature and we felt kind of compelled to do something about that because we really don’t want our patients to be subjected to additional venipuncture if they don’t need it. So we worked on identifying an assessment tool that we found in the literature and then an escalation pathway. So if a patient is at risk for difficult IV access, then what are we going to do?
So we’re going to jump to the ultrasound guided IV placement potentially as the first line. So we’re in the process right now of trialing that on one of the units with plans to go house wide, hopefully. I really like that project because it kind of incorporates all the things that we really want to incorporate, like the patients – making sure that we provide the best care to them.
It’s also for the nurses too. It helps improve their workflow because then they don’t have to try unsuccessfully to stick the patient and get more behind or delay the patient to go to tests, things like that. And there may be some cost savings involved with that as well. So it kind of covers all the pieces of something we look for in a project.
14:35 Structure for Nursing Research at Stony Brook Medicine
Carolyn Santora, MS, RN
Yeah. So you’re actually helping new nurses change practice at the bedside and impact on Stony Brook nursing. That’s great. The other part of what you do goes beyond evidence-based practice, you do research also, pure research. Can you tell us about your structure for research here?
Meghan Doelger, DNP, RN, CCRN
Sure. So through the Nursing Science Council, we have a lot of interested individuals who have some expertise with research.
We also partner with our physician colleagues and the School of Nursing on certain research projects as well. So I actually have a project right now. My research interests are critical care because that’s kind of my background, as well as improving the nursing workflow because I feel like we often add so many things to the nurses day and I really want to be thinking about how we can streamline that or work more efficiently.
So we have a research project right now – I’m the principal investigator. We have a physician lead who’s also the co-principal investigator. So this is a nurse-led research study; we’re looking at the bispectral index monitor. It’s a little sensor that sits on the patient’s forehead and it measures how sedated the patient is. So this has been typically used in the O.R., but not so much in the ICU setting so far.
So we’re testing it out in the ICU setting. And what we want to know is how when you compare that to traditional methods of clinically assessing the patient, how sedated they are, we want to know which has a bigger impact on the nursing workflow. So is one easier to use than the other? And we also want to know if two nurses are looking at the bispectral index monitor and they’re getting a value, are they interpreting it the same way? So we’re comparing those two things.
And that study, actually we were awarded a grant from AACN as well as Sigma Theta Tau, so we’re using some of the money to do some data analysis for that. So that’s one of the projects that we’re working on right now.
16:30 Being a Staff Nurse at Stony Brook
Carolyn Santora, MS, RN
So one last question for you, Meghan. You do such fabulous work. You have your doctorate, you’re doing research, you’re leading evidence-based practice. But you started here as a staff nurse. Tell us what it’s like to be a staff nurse at Stony Brook.
Meghan Doelger, DNP, RN, CCRN
So I started in 2016 as a staff nurse, but I was an experienced ICU nurse when I came here, so I knew a little bit about the ICU and what to expect.
And so I started in the ICU flow pool and every time I showed up, people were happy to see me because I was coming to help them. But I just found when I came to Stony Brook that it was so welcoming and I found a lot of recognition for what I was doing. So I remember the first time my manager sent a letter home, like a note home, thanking me for something, I was just so touched by that.
And I also won Nurse of the Year for the flow pool. Like, I found a lot of recognition here, which was really professionally satisfying. And I also got to know nurses throughout the hospital, which kind of helped me in this role now where I lead research and EBP throughout the hospital. So I have contacts everywhere, a little bit of an interest everywhere throughout the hospital. I had experience in a nurse residency program at another hospital, which I loved, but I kind of felt like I was coming home when I came to Stony Brook, I knew I found the place I wanted to be.
Carolyn Santora, MS, RN
Thank you so much. And actually, thank you both Katherine Lewin and Dr. Meghan Doelgar for your valuable insights. And thank you to our wonderful listeners and viewers for tuning in for the first part of this program.
When we come back, we will be joined by Dr. Brenda Janotha, who is the Associate Dean of Academic Affairs with Stony Brook School of Nursing, so don’t go anywhere.
Welcome back. We now have Dr. Brenda Janotha joining the conversation. Brenda, would you mind introducing yourself to our listeners and viewers and tell us about your role and how you interface with the hospital.
Brenda Janotha, EdD, DNP-DCC, ANP-BC, FNP-C, FAANP
So I am the Associate Dean for Academic Affairs in the School of Nursing. I serve as the liaison for the academic practice partnership between the Division of Nursing and the School of Nursing.
I’m fortunate because we’re in a large academic medical center under the great leadership of a great Division of Nursing, with you and at helm, Carolyn. So this is a wonderful opportunity for me.
This is a long standing, formal academic practice partnership, just like the nurse residency is. It really bridges the gap between the academic learning and the clinical practice of our students. And it really benefits both nursing education and nursing clinical practice.
19:20 How Does the Stony Brook School of Nursing Prepare Students for the Transition from Academic to Practice?
Carolyn Santora, MS, RN
Yeah, that transition from academics for the students into actual practice is difficult. So how does the School of Nursing prepare them for that?
Brenda Janotha, EdD, DNP-DCC, ANP-BC, FNP-C, FAANP
So through our academic practice partnership, we have this formal relationship where I think we both inform each other. The Division of Nursing informs the School of Nursing, and the School of Nursing informs the Division of Nursing on how we’re preparing our students.
This formal practice partnership that we have is a nice form of structured communication and collaboration. So I think that really helps us to understand the needs of the students as well as understand the resources that we need to provide the students with to be successful.
20:00 What the Stony Brook School of Nursing Has to Offer Students + the Partnership Between the School of Nursing and Nurse Residency Program
Carolyn Santora, MS, RN
Great. You know, we hire nurses from all backgrounds in all types of programs. What does our School of Nursing have here at Stony Brook to offer those students and those new nurses?
Brenda Janotha, EdD, DNP-DCC, ANP-BC, FNP-C, FAANP
Educational opportunities. One of the great things that Katherine and her team and my team in the School of Nursing have been able to accomplish with the nurse residency is to allow students who have an Associate degree who are currently enrolled in the School of Nursing and in the Nurse Residency program upon completion to earn academic credit for the work that they’ve done in the program.
So this is one opportunity of allowing that seamless transition to education. We also have a Masters in Education program, a Masters in Leadership program. We offer online, our faculty interfaces with the nurses and staff in the hospital, so I think that also helps to lead to that collaborative effort to further education here. We also have the APRN programs, we have eight APRN programs that we offer and two doctoral programs; we have the DNP program and the PHC program.
21:30 What it’s Like to be a Resident at Stony Brook Medicine
Carolyn Santora, MS, RN
You know, that’s so great. All of our nurses need to know this. They have so many things that they can do right through our own School of Nursing at so many levels. It’s a great partnership.
Katherine, back to you for our final question. For our nursing students who might be becoming part of our residency, can you describe what it’s really like to be a resident here at Stony Brook?
Katherine Lewin, MS, RN, NPD-BC, CCRN
Sure. Our Nurse Residency Program really relies on support and connection. When we ask our nurse residents what they think the most beneficial part of the program is, many times they respond that peer support – that connection, that authenticity – the education that we provide to our newly licensed nurses, as well as our experienced nurses, is really groundbreaking. We’re able to provide them with an opportunity not only to grow in the classroom, but also on the unit in their clinical practice. They grow professionally as well.
So to be a Nurse Resident here is really all encompassing. You’re coming into an organization that partners with an academic medical center to support your growth and transition. And really beyond that first year as well. So if you’re looking for a Nurse Residency Program, the opportunities here really are unparalleled by many of the organizations that are surrounding.
And also, if you want to be a part of a program that’s nationally recognized, we’ve been fortunate to be nationally recognized for the work that we’re doing here.
Brenda Janotha, EdD, DNP-DCC, ANP-BC, FNP-C, FAANP
Can I just add something? Because I think something very cutting edge with the Nurse Residency Program and you mentioned it earlier, was that we’re having a shortage for faculty workforce. And now part of the nurse residency is a preceptorship academy, which allows these students who are new graduates to really understand the importance of being preceptors and being role models to the future of the nursing workforce. So it really builds in that workforce pipeline.
Carolyn Santora, MS, RN
You know, Brenda, there’s a lot of collaborative projects that we work on together with the School of Nursing. One of them, I believe, is nursing research. Can you tell us a little bit about that and how both the School of Nursing and the hospital participate in that?
Brenda Janotha, EdD, DNP-DCC, ANP-BC, FNP-C, FAANP
Yes, absolutely. So we definitely share resources for Nursing Research Day. Your nurse residents have poster presentations at our Nursing Research Day. We have presentations from both hospital faculty and clinical faculty at the hospital, and through the Division of Nursing as well as through the School of Nursing.
There’s a lot of opportunities that are founded in that opportunity at the event because we have the opportunity for all the faculty from the School of Nursing and the Division of Nursing Staff and Administration to work together.
We also have a retreat where we offer a faculty retreat where the School of Nursing and the Division of Nursing come together to look at different projects that, you know, we feel would really benefit both the hospital staff nursing, as well as the students in the School of Nursing.
Carolyn Santora, MS, RN
And, you know, we have clinical nurse specialists and nurse specialists here, many who were educated through our School of Nursing, which, by the way, is number eight in the nation – one of the best schools of nursing in the country. They also teach at the School of Nursing.
Brenda Janotha, EdD, DNP-DCC, ANP-BC, FNP-C, FAANP
So we have a very unique opportunity for shared resources with joint appointments and clinical faculty, both teaching in the school and working as clinicians at Stony Brook University Hospital, which informs practice and makes our students even stronger candidates.
Carolyn Santora, MS, RN
Yeah, it’s just such a wonderful collaborative relationship between our school. We’re so lucky to have right on campus with us, I mean, it’s not down the block, it’s across a bridge, a School of Nursing to enhance the academic piece of the work that we do, the science that we bring to nursing. And that makes us very, very special.
Brenda Janotha, EdD, DNP-DCC, ANP-BC, FNP-C, FAANP
And we’re very lucky because you allow us to offer these clinical opportunities and really prepare our nursing graduates ready for practice when they leave.
Carolyn Santora, MS, RN
I can’t tell you how appreciative I am that you came to speak with us today. How lucky our students are here back in the School of Nursing and then our residents, our new nurses and all the opportunities that all of our nursing staff have through the residency, through the School of Nursing.
25:30 Closing Remarks
So thank you to all of our experts for your time. And thank you to our listeners and viewers for tuning in. I hope you enjoyed today’s conversation as much as I did. For more information about our residency and nursing education programs, you can visit the Stony Brook School of Nursing webpage and the Stony Brook Medicine Nursing Portal. Thank you all.
Announcer
Stony Brook Medicine is Long Island’s premier academic medical center. We transform lives through scientific discovery, education and care, and we bring together innovative research, advanced education and extraordinary health care expertise to set the standard for how healthy communities thrive. For more information, visit Stony Brook Medicine or follow us on social media.
*DISCLAIMER: The information provided in this podcast is for educational and informational purposes only and is not intended as a substitute for professional medical advice, diagnosis or treatment. If you think you may have a medical emergency, call your doctor or emergency services immediately.
